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

Am Heart J. 2014 Nov;168(5):731-8. doi: 10.1016/j.ahj.2014.06.030. Epub 2014 Jul 24.

Abstract

Background: 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.

Methods: 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.

Results: 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/m(2). 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).

Conclusions: 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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Altitude*
  • Arterial Pressure
  • Biomass*
  • Blood Pressure
  • C-Reactive Protein / metabolism
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cohort Studies
  • Echocardiography
  • Environmental Exposure / statistics & numerical data*
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Hypertension, Pulmonary / blood
  • Hypertension, Pulmonary / diagnostic imaging
  • Hypertension, Pulmonary / epidemiology*
  • Insulin Resistance
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Peru / epidemiology
  • Pulmonary Artery / diagnostic imaging*
  • Sex Factors
  • Smoke*
  • Ventricular Dysfunction, Right / blood
  • Ventricular Dysfunction, Right / diagnostic imaging
  • Ventricular Dysfunction, Right / epidemiology*
  • Ventricular Pressure*

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hemoglobins
  • Peptide Fragments
  • Smoke
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • C-Reactive Protein