Lack of association between chronic exposure to biomass fuel smoke and markers of right ventricular pressure overload at high altitude

• Published in: The American heart journal Vol. 168; no. 5; pp. 731 - 738
• Main Authors: Caravedo, Maria A., Painschab, Matthew S., Davila-Roman, Victor G., De Ferrari, Aldo, Gilman, Robert H., Vasquez-Villar, Angel D., Pollard, Suzanne L., Miranda, J. Jaime, Checkley, William
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2014; Elsevier Limited
• Subjects: Adult; Age Factors; Aged; Alternative energy sources; Altitude; Arterial Pressure; Asthma; Biomass; Blood Pressure; Body mass index; C-Reactive Protein - metabolism; Cardiovascular; Cardiovascular disease; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cohort Studies; Diabetes; Echocardiography; Environmental Exposure - statistics & numerical data; Family medical history; Female; Health risk assessment; Hemoglobins - metabolism; Humans; Hypertension, Pulmonary - blood; Hypertension, Pulmonary - diagnostic imaging; Hypertension, Pulmonary - epidemiology; Insulin Resistance; Linear Models; Lung diseases; Male; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain - blood; Outdoor air quality; Peptide Fragments - blood; Peru - epidemiology; Population; Pulmonary arteries; Pulmonary Artery - diagnostic imaging; Pulmonary hypertension; Rural areas; Sex Factors; Smoke; Ventricular Dysfunction, Right - blood; Ventricular Dysfunction, Right - diagnostic imaging; Ventricular Dysfunction, Right - epidemiology; Ventricular Pressure; Womens health; Peru
• ISSN: 0002-8703; 1097-6744; 1097-6744
• DOI: 10.1016/j.ahj.2014.06.030

Chronic exposure to biomass fuel smoke has been implicated in the development of pulmonary hypertension and right ventricular pressure/volume overload through activation of inflammation, increase in vascular resistance, and endothelial dysfunction. We sought to compare N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and echocardiography-derived pulmonary artery systolic pressure (PASP) levels in a high-altitude population-based study in Peru with and without chronic exposure to biomass fuel smoke. NT-pro-BNP levels were measured in 519 adults (275 with and 244 without chronic exposure to biomass fuel smoke). Participants answered sociodemographics and clinical history questionnaires, underwent a clinical examination and blood testing for cardiopulmonary biomarkers. PASP was measured in a subgroup of 153 (31%) subjects. The study group consisted of 280 men (54%) and 239 women (46%). Average age was 56 years and average body mass index was 27 kg/m2. In multivariable analysis, there was no association between chronic exposure to biomass fuel smoke and NT-pro-BNP (P = .31) or PASP (P = .31). In the subgroup in which both NT-pro-BNP levels and PASP were measured, there was strong evidence of an association between these two variables (ρ = 0.24, 95% CI 0.09-0.39; P = .003). We found that age, high sensitivity C-reactive protein, being male, and systolic blood pressure were positively associated with NT-pro-BNP levels whereas body mass index, low-density/high-density lipoprotein ratio, and Homeostasis Model of Assessment-Insulin Resistance were negatively associated (all P ≤ .02). In this population-based study in a high-altitude setting, neither NT-pro-BNP levels nor echocardiography-derived PASP were associated with chronic exposure to biomass fuel smoke.