Ambient air pollutants aggravate association of snoring with prevalent hypertension: results from the Henan Rural Cohort

Aim: We aimed to assess if snoring and ambient air pollutants were jointly associated with prevalent hypertension in a cross-sectional study. Methods: A total of 28440 participants aged 18–79 years were obtained from the Henan Rural Cohort. Snoring evaluated using Pittsburgh sleep quality index (PSQI) scale was classified into ‘Never’, ‘<3 times/week’ and ‘≥3 times/week’ groups. Concentrations of air pollutants (PM₁, PM_2.5, PM₁₀, and NO₂) were evaluated by a satellite-based spatiotemporal model. The independent and joint associations between snoring and air pollutants on prevalence of hypertension were analyzed by logistic regression models. Results: The mean age of all participants was 56.0 ± 12.2 years. The frequencies and prevalence of participants with hypertension were 3666 (32.39%) in men and 5576(32.57%) in women, respectively. The odds ratio (OR) and 95% confidence interval (CI) of participants with snoring frequency of <3 times/week, ≥3 times/week was 1.10(1.02–1.20), and 1.15(1.08–1.23) for hypertension, compared to those without snoring. Participants with a snoring (≥3 times/week) and higher exposure concentrations of PM₁, PM_2.5, PM₁₀, and NO₂ had 2.58-fold(95% CI: 2.30–2.90), 3.03-fold(95% CI: 2.69–3.41), 2.89-fold(95% CI: 2.57–3.25) and 2.75-fold(95% CI: 2.44–3.10) for hypertension, compared to those without snoring and low concentrations of air pollutants. Additionally, participants with high PM₁ and ≥3 times/week snoring (OR: 1.32, 95% CI: 1.18–1.48) was at a higher likelihood for prevalent hypertension, compared to those without snoring and with high PM₁. Conclusions: Snoring and high ambient air pollutants might be important predictors of hypertension, and higher concentration of PM₁ might aggravate the association between snoring and hypertension.