Prevalence of Cooking with Polluting Fuels and Association with Elevated Blood Pressure Among Adults in Port au Prince, Haiti: A Cross-Sectional Analysis.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI:10.5334/gh.1405

Rehana Rasul, Rodney Sufra, Marie Christine Jean Pierre, Reichling St Sauveur, Vanessa Rouzier, Joseph Inddy, Erline Hilaire, Fabiola Preval, Lily D Yan, Nour Mourra, Anju Ogyu, Daniella M Pierre, Jean William Pape, Denis Nash, Margaret L McNairy

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引用次数: 0

Abstract

Background: Cooking with polluting fuels is common in low- and middle-income countries and may impact blood pressure, yet data on this association in urban Haiti is limited. This study describes the prevalence of polluting fuel use and indoor cooking, evaluates their associations with blood pressure, and evaluates whether effects are heterogeneous by sex in urban Haiti.

Methods: Using cross-sectional data from the Haiti Cardiovascular Disease Cohort study, prevalence of polluting fuel use and indoor cooking was estimated. The associations between polluting fuel use and indoor cooking with systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension (HTN) (mean SBP ≥140 mmHg or mean DBP ≥90 mmHg) were estimated using generalized estimating equations. The interaction between polluting fuel use and sex was also evaluated.

Results: Among 2,931 participants, 58.2% were female and the mean age was 42.0 (SD = 15.9) years. The majority (88.2%) primarily cooked with polluting fuels. Polluting vs clean fuel users tended to have less than a high school education (38.0% vs 22.8%), earn ≤ 1 USD/day (70.5% vs 67.4%), and have high food insecurity (85.0% vs 64.3%). Polluting vs clean fuel users had similar HTN prevalence (adjusted prevalence ratio [aPR] = 0.94, 95% CI: 0.80, 1.10). Average SBP was similar for women (0.99 mmHg, 95% CI: -1.46, 3.44) and lower for men (-4.80 mmHg, 95% CI: -8.24, -1.37) who used polluting vs clean fuels. Cooking indoors vs outdoors was associated with higher HTN prevalence (aPR = 1.12, 95% CI: 1.00, 1.25) and higher average SBP (1.67 mmHg, 95% CI: 0.15, 3.20).

Conclusions: This study demonstrates that most Haitians in Port-au-Prince cook with polluting fuels and often indoors. Those with higher poverty are more exposed, with mixed results in their association with blood pressure. Longitudinal studies are needed to clarify causal relationships and inform interventions promoting clean fuel use. (ClinicalTrials.gov Identifier: NCT03892265).

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海地太子港成人使用污染性燃料做饭的普遍程度及其与血压升高的关系：一项横断面分析。

背景：在低收入和中等收入国家，使用污染性燃料做饭很常见，可能会影响血压，但有关海地城市地区这种关联的数据有限。本研究描述了污染燃料的使用和室内烹饪的流行程度，评估了它们与血压的关系，并评估了海地城市的影响是否因性别而异。方法：利用海地心血管疾病队列研究的横断面数据，估计污染燃料使用和室内烹饪的流行程度。使用广义估计方程估计污染燃料使用和室内烹饪与收缩压（SBP）、舒张压（DBP）和高血压（HTN）（平均收缩压≥140 mmHg或平均DBP≥90 mmHg）之间的关系。还评价了污染燃料的使用与性之间的相互作用。结果：2931名参与者中，58.2%为女性，平均年龄为42.0岁（SD = 15.9）岁。大多数（88.2%）主要使用污染燃料烹饪。污染燃料用户和清洁燃料用户的受教育程度往往低于高中（38.0%对22.8%），每天收入≤1美元（70.5%对67.4%），粮食不安全程度较高（85.0%对64.3%）。污染燃料使用者与清洁燃料使用者的HTN患病率相似（调整后的患病率[aPR] = 0.94, 95% CI: 0.80, 1.10）。使用污染燃料和清洁燃料的女性的平均收缩压相似（0.99 mmHg, 95% CI: -1.46, 3.44），而男性的平均收缩压更低（-4.80 mmHg, 95% CI: -8.24, -1.37）。室内烹饪与室外烹饪相比，HTN患病率较高（aPR = 1.12, 95% CI: 1.00, 1.25），平均收缩压较高（1.67 mmHg, 95% CI: 0.15, 3.20）。结论：这项研究表明，太子港的大多数海地人使用污染燃料做饭，而且经常在室内做饭。贫困程度越高的人受影响越大，其与血压的关系好坏参半。需要进行纵向研究，以澄清因果关系，并为促进清洁燃料使用的干预措施提供信息。（ClinicalTrials.gov识别码：NCT03892265）。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.