Meta-analysis/systematic review iScience The association between air pollution and hypertension: An umbrella review of systematic reviews and meta-analyses
Collectively, the available evidence supports a plausible role of PM 2.5 and PM 10 in elevating essential HTN risk; however, the association with GH remains inconclusive due to the limited studies.
Abstract
Summary Although a multitude of meta-analyses have indicated an association between air pollution and hypertension (HTN), substantial heterogeneity exists across these studies. This research aims to systematically assess the cumulative evidence on the link between air pollutants and both HTN and gestational hypertension (GH) through existing systematic reviews. A comprehensive literature search was performed in three databases (Embase, PubMed, and Web of Science) up to September 8, 2025. The AMSTAR 2 tool was adopted to evaluate the methodological quality of the included reviews. Totally, 11 eligible meta-analyses (8 on HTN and 3 on GH) were identified. Collectively, the available evidence supports a plausible role of PM2.5 and PM10 in elevating essential HTN risk; however, the association with GH remains inconclusive due to the limited studies. Further prospective cohort studies and investigations into biological mechanisms are needed to clarify the influences of air pollution on both HTN and GH.
Current evidence suggests that exposure to fine particulate matter may contribute to early-life elevation in blood pressure; however, given the paucity of longitudinal data and the complexity of multipollutant exposures, further research employing standardized exposure metrics, harmonized outcome definitions, and multipollutant models are needed to clarify independent pollutant effects.
H. C. Culpan, Yakup Gözderesi, Nur Canpolat et al.· Reviews on Environmental Hea...· 0 citations
The findings demonstrated a consistent association between NO₂ exposure and an increased risk of hypertension, particularly in poorly ventilated work environments, and underscore the importance of improving workplace air quality management, strengthening exposure monitoring, and implementing preventive occupational health strategies.
Ayudhia Rachmawati, Morrin Choirunnisa Thohira, M. Fitrah et al.· International Journal of Pub...· 0 citations
Objective The association between habitual tea consumption and hypertension remains controversial. This systematic review and meta-analysis aimed to synthesize observational evidence on tea consumption and hypertension and to explore whether this association differed according to tea type, sex, age, region, and hypertension diagnostic threshold. Methods PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP were systematically searched from database inception to December 2025 for observational studies in adults. Studies reporting a distinct hypertension outcome and an extractable effect estimate for tea consumption were eligible. Study quality was assessed using the Newcastle–Ottawa Scale or AHRQ criteria, as appropriate. The most fully adjusted ORs, RRs, or HRs were extracted. Because these measures are not mathematically identical, pooled estimates were interpreted conservatively as relative association estimates rather than directly interchangeable causal effect measures. Dose–response analyses were conducted for studies with at least three quantitative exposure categories. Results Twenty studies involving 319,565 participants were included. In 16 cross-sectional studies, tea consumption was weakly associated with lower hypertension prevalence (OR = 0.92, 95% CI: 0.87–0.97, I2 = 62.8%). This inverse association was stronger for black tea drinkers, Asians, women, participants aged < 60 years, and studies with a hypertension cutoff of ≥140/90 mmHg; these subgroup results are hypothesis-generating, not confirmatory. Pooled ORs of the four cohort studies indicated a 13% lower hypertension risk (OR = 0.87, 95% CI: 0.84–0.92, I2 = 31.9%). Dose–response analysis suggested a significant nonlinear association, with an initially steeper inverse pattern at lower intake levels followed by an apparent plateau at higher reported intake. Conclusion Habitual tea consumption was associated with a modestly lower likelihood of hypertension in observational studies. Owing to the observational design and marked inter-study heterogeneity, a definite clinical protective effect cannot be confirmed. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, CRD420261288902.
Ren-Yu Jiang, Jin-Yan Chen, Hong-Li Lin et al.· Frontiers in Nutrition· 0 citations
Previous studies have suggested that a high intake of nuts may reduce the risk of hypertension, however, the available data have been limited. Several additional studies have recently been published on the topic. We therefore conducted a systematic review and meta-analysis of cohort studies on nut consumption and hypertension to provide an updated assessment of the evidence. PubMed and Embase databases were searched up to 4th April 2026 for prospective cohort studies with adjusted relative risk estimates published in the English language on the association between nut consumption and hypertension risk. Random effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) for the association between nut consumption and hypertension. We used World Cancer Research Fund (WCRF) criteria to assess the strength of the evidence. Eight studies (20,665 cases, x) were included in the meta-analysis. The summary RR for the highest vs. lowest category of nut intake was 0.84 (95% CI: 0.77-0.91, I2=50%, pheterogeneity=0.05, n=8) and per 28 g/d was 0.80 (95% CI: 0.71-0.89, I2=75%, pheterogeneity<0.0001, n=8). There was no indication of publication bias with Begg's test (p=0.71) or Egger's test (p=0.10) or by visual inspection of the funnel plot. There was some indication of nonlinearity (pnonlinearity=0.07) and there was a 26% reduction in risk when comparing 30g/d vs. 0 g/d. Using WCRF criteria to assess the strength of evidence, we graded the likelihood of causality as probable. In this meta-analysis of prospective cohort studies, we found further evidence for a reduced risk of hypertension with higher intake of nuts. These findings support dietary guideline recommendations to include a serving of nuts per day.
M. Metoudi, Isabelle Sadler, S. Kassam et al.· British Journal of Nutrition· 0 citations
The findings suggest that lead exhibits threshold-free linear toxicity, while manganese may have a protective effect, supporting preventive strategies for environmentally induced hypertension.
Yunzhen Lei, J. Diao, Ming Xu et al.· Ecotoxicology and Environmen...· 0 citations
Despite growing research linking ultra-processed food (UPF) consumption to risk of cardiovascular disease (CVD) and hypertension, no study has systematically evaluated the methodological rigor underlying these associations. We systematically searched major databases to identify eligible studies. Data were extracted for dietary assessment methods, UPF classification, covariate selection, confounding control, statistical modeling and effect estimates. Random-effects meta-analysis was conducted to pool effect estimates. Meta-regression and sensitivity analyses were performed to explore sources of heterogeneity. Substantial heterogeneity was observed in the application of the NOVA classification for categorizing UPFs across the 46 eligible studies. Only two studies employed a directed acyclic graph to inform confounder selection; 42 used models with suboptimal adjustment, and 38 were overfitted due to adjustment for potential mediators. Pooled analyses indicated that higher consumption of UPFs was associated with a 9% higher risk of CVD and a 16% higher risk of hypertension, with stronger associations observed for coronary heart and cerebrovascular diseases. While higher UPF intake is consistently associated with increased risks of CVD and hypertension, methodological limitations may attenuate the observed associations. Strengthening methodological rigor through harmonized UPF classification and causal frameworks is essential to better elucidate the effect of UPF consumption on cardiometabolic health.
T. C. Mekonnen, Z. Abebe, A. Dessie et al.· Critical reviews in food sci...· 0 citations
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