IMPACT OF NIGHTTIME ROAD TRAFFIC NOISE AND AIR POLLUTION ON ARTERIAL BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS: A CROSS-SECTIONAL STUDY

Objective: Hypertension is a major cardiovascular risk factor highly prevalent across Europe. Air pollution and environmental noise are considered harmful to cardiovascular health. This study examines the association between exposure to road traffic noise, benzo-a-pyrene and blood pressure (BP) control in hypertensive patients. Design and method: We prospectively recruited patients from the Hypertensive Outpatient Clinic between October 2023 and November 2024, followed by a retrospective analysis of their medical records, including BP monitoring results (office, home, and 24-hour ambulatory blood pressure monitoring). Information on patients’ residences and noise annoyance was collected through questionnaires. Based on each participant’s residence, we estimated traffic noise exposure (Ln: nighttime average sound level) using the 2022 strategic noise maps of Krakow and its suburban areas, and benzo-a-pyrene exposure levels using air pollution maps. Patients were clarified according to pollutant thresholds: Ln >50 dB and benzo-a-pyrene >1 ng/m3as exposed and below these levels as unexposed groups. Separate and combined effects of these exposures on BP control were analyzed. Results: Overall, data of 158 patients (median age 65) were available for analysis. There were no significant differences in age, sex, blood pressure values between patients in noise exposed group (n=62) compared to unexposed (n=96), however exposed participants had a longer history of hypertension (median 10 vs. 6 years, p<0.01) and reported higher noise annoyance (median 1 vs. 0, p=0.02). There were no significant differences in age, sex, blood pressure values between patients in the benzo-a-pyrene exposed group (n=146) compared to unexposed (n=12), the unexposed group had a longer time of residence in the declared area (median 48 vs. 25 years, p<0,01). There were no significant differences in age, sex, office, home blood pressure values between patients in the benzo-a-pyrene and noise exposed (Ln >50 dB, benzo-a-pyrene >1 ng/m3) group (n=61) compared to unexposed (n=11). Co-exposure was associated with a significantly lower proportion of individuals with a physiological nighttime BP drop (20% vs 42%, p=0.03). Conclusions: This study demonstrates compounded impact on BP control of both air pollution and road traffic noise, emphasizing the need for comprehensive public health measures in urban settings.