Coronary heart disease, hypertension and use of biomass fuel among women: comparative cross-sectional study
Open Access
- 8 August 2019
- Vol. 9 (8), e030881
- https://doi.org/10.1136/bmjopen-2019-030881
Abstract
Objectives To explore the associations of hypertension and coronary heart disease (CHD) with use of biomass fuel for cooking. Design Comparative cross-sectional study. Setting Rural villages in Sindh, Pakistan. Participants Women aged ≥40 years who had used biomass fuel for cooking for at least the last year (n=436), and a comparison group (n=414) who had cooked only with non-biomass fuel during the last year were recruited through door-to-door visits. None of those who were invited to take part declined. Primary and secondary outcome measures Hypertension was determined from blood pressure measurements and use of medication. CHD was assessed by three measures: history of angina (Rose angina questionnaire), previous history of ‘heart attack’, and definite or probable changes of CHD on ECG. Potentially confounding risk factors were ascertained by questionnaire and anthropometry. Associations of hypertension and CHD with use of biomass and other risk factors were assessed by logistic regression, and summarised by ORs with 95% CIs. Results After adjustment for potential confounders, there was no association of hypertension (OR: 1.0, 95% CI 0.8 to 1.4) angina (OR: 1.0, 95% CI 0.8 to 1.4), heart attack (OR: 1.2, 95% 0.7 to 2.2) or ECG changes of CHD (OR: 0.8, 95% CI 0.6 to 1.2) with current use of biomass for cooking. Nor were any associations apparent when analyses were restricted to long-term (≥10 years) users and non-users of biomass fuel. Conclusions A linked air monitoring study indicated substantially higher airborne concentrations of fine particulate matter in kitchens where biomass was used for cooking. It is possible that associations with CHD and hypertension were missed because most of the comparison group had used biomass for cooking at some time in the past, and risk remains elevated for many years after last exposure.Funding Information
- The Colt Foundation, UK
This publication has 52 references indexed in Scilit:
- Health and Household Air Pollution from Solid Fuel Use: The Need for Improved Exposure AssessmentEnvironmental Health Perspectives, 2013
- Solid Fuel Use for Household Cooking: Country and Regional Estimates for 1980–2010Environmental Health Perspectives, 2013
- In-home solid fuel use and cardiovascular disease: a cross-sectional analysis of the Shanghai Putuo studyEnvironmental Health, 2012
- Intervention to Lower Household Wood Smoke Exposure in Guatemala Reduces ST-Segment Depression on ElectrocardiogramsEnvironmental Health Perspectives, 2011
- Indoor Air Pollution and Blood Pressure in Adult Women Living in Rural ChinaEnvironmental Health Perspectives, 2011
- Hypertension with elevated levels of oxidized low-density lipoprotein and anticardiolipin antibody in the circulation of premenopausal Indian women chronically exposed to biomass smoke during cookingIndoor Air, 2010
- Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in menHeart, 2007
- Chimney Stove Intervention to Reduce Long-term Wood Smoke Exposure Lowers Blood Pressure among Guatemalan WomenEnvironmental Health Perspectives, 2007
- Heart disease epidemic in Pakistan: Women and men at equal riskAmerican Heart Journal, 2005
- Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study.Circulation, 1983