Anti-Hypertensive Medication Usage Modifies Associations Between PM2.5 and Blood Pressure in North Carolina Cohort of Heart Failure Patients
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Background/Purpose
Fine particulate matter (PM2.5) is associated with cardiovascular morbidity and is considered a causal factor in the development of cardiovascular disease. PM2.5 acts through many pathways including vascular dysfunction which can be seen in the strong associations between PM2.5 exposure and blood pressure (BP) as well as hypertension. Though many factors may modify sensitivity to PM2.5 exposure, one unexplored factor is usage of commonly prescribed medications. Medication usage may be particularly relevant for individuals with underlying cardiovascular disease who often have high rates of medication usage and increased underlying sensitivity to environmental exposures. To understand whether medication usage modifies the well-established associations between PM2.5 and BP we examined a cohort of heart failure (HF) patients. HF patients have both high sensitivity to PM2.5 and high rates of medication usage making them an ideal patient population for this question. We chose to examine anti-hypertensive (AH) medications given their direct actions on vascular function but as yet unpublished interactions with PM2.5 exposure. Thus, the goal of this study is to examine whether usage of AH medications modifies the associations between PM2.5 and BP in a cohort of HF patients