{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T05:45:58Z","timestamp":1793166358341,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Hypertension is a major global health burden. While air pollution is a known risk factor, the interactive effects of co\u2010occurring stressors like cold weather and geographic elevation are poorly understood. This study investigated the independent and joint effects of long\u2010term particulate matter (PM) exposure, cold waves, and elevation on hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a cross\u2010sectional study of 27\u2009602 adults across multiple regions in China. Long\u2010term exposures to PM and its chemical components were estimated using 3 independent, high\u2010resolution data sets, alongside cumulative cold\u2010wave days and residential elevation. Generalized linear models and principal component analysis were used to estimate associations with hypertension prevalence and blood pressure, assessing both multiplicative and additive interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Long\u2010term exposure to PM with a diameter of \u22642.5 \u03bcm was significantly associated with higher odds of hypertension (odds ratio per 10 \u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      increase, 1.100 [95% CI, 1.079\u20131.123];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Cold waves and elevation significantly modified this effect. The adverse association of PM with hypertension was synergistically amplified in regions with frequent cold waves (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction&lt;0.05). Conversely, while higher elevation was independently associated with lower hypertension odds (odds ratio per 100 m increase, 0.995;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), it significantly potentiated the adverse association between PM and hypertension.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The association between air pollution and hypertension is significantly modified by local climatic and geographic conditions. The synergistic effect of PM and cold waves suggests current assessments may underestimate the burden in susceptible regions, necessitating integrated, climate\u2010informed public health strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047614","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:22:24Z","timestamp":1771590144000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Cold Waves and Elevation Strengthen the Association of Particulate Matter Exposure With Hypertension Prevalence: A Large Multiregional Study in China"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2227-4363","authenticated-orcid":false,"given":"Ce","family":"Liu","sequence":"first","affiliation":[{"name":"Lanzhou University","place":["Lanzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"He","sequence":"additional","affiliation":[{"name":"Lanzhou University","place":["Lanzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Liu","sequence":"additional","affiliation":[{"name":"Chinese PLA General Hospital","place":["Beijing, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Wei","sequence":"additional","affiliation":[{"name":"Lanzhou University","place":["Lanzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Lanzhou University","place":["Lanzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoru","family":"Yang","sequence":"additional","affiliation":[{"name":"Lanzhou University","place":["Lanzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Chen","sequence":"additional","affiliation":[{"name":"Lanzhou University","place":["Lanzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5091-6621","authenticated-orcid":false,"given":"Chongjian","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhengzhou University","place":["Zhengzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9324-8942","authenticated-orcid":false,"given":"Bin","family":"Luo","sequence":"additional","affiliation":[{"name":"Lanzhou University","place":["Lanzhou, People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","volume-title":"Global report on hypertension: the race against a silent killer","author":"World Health Organization","year":"2023","unstructured":"World Health Organization . 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