Association of a cleaner-burning stove with blood pressure in adults in rural Malawi
Author(s)
Type
Journal Article
Abstract
Background
Hypertension is a leading risk factor for cardiovascular disease, and its association with household air pollution (HAP) in sub-Saharan Africa is understudied.
Main objective
To investigate the association between blood pressure (BP) and HAP exposure in a population-based cohort in rural Malawi.
Materials and methods
In the Chikwawa district, the site of a previous randomized controlled trial of a cleaner-burning cookstove intervention (the Cooking and Pneumonia Study or CAPS), we recruited 1,481 randomly selected adults. A subset (∼21%) were from participating households in CAPS. This cross-sectional analysis investigates associations of BP with stove type and, in a sample of participants, with particulate matter ≤ 2.5 μm diameter (PM2.5) and carbon monoxide (CO), both measured using 48-hour personal monitoring. Two main types of analysis were conducted: a) assessment of differences in mean systolic BP (SPB) and diastolic BP (DBP) among three groups based on stove use/type and b) assessment of the associations between PM2.5 and CO with mean SBP and DBP; both analyses using multivariable linear regression.
Results
Of the 1481 participants, 910 provided BP data. There was no difference for either mean SBP or DBP between the CAPS intervention and control groups. However, when comparing all CAPS participants (i.e., those provided cleaner-burning cookstoves by study’s end) to the non-CAPS group, mean SBP was reduced (-3.53 mmHg, 95% CI:-6.54,-0.52), but not DBP (-0.73 mmHg, 95% CI:-2.36,0.90). Of these, 599 participants also had ≥24 hours personal exposure monitoring data. Neither the log mean PM2.5 concentration nor the log mean CO concentration was associated with either SBP or DBP.
Discussion
In this cross-sectional study in non-pregnant adults to measure both exposure to HAP and blood pressure in sub-Saharan Africa, we found evidence for an association between receiving a cleaner-burning cookstove and reduced SBP, but no evidence for an association between BP and personal exposure to PM2.5 or CO.
Hypertension is a leading risk factor for cardiovascular disease, and its association with household air pollution (HAP) in sub-Saharan Africa is understudied.
Main objective
To investigate the association between blood pressure (BP) and HAP exposure in a population-based cohort in rural Malawi.
Materials and methods
In the Chikwawa district, the site of a previous randomized controlled trial of a cleaner-burning cookstove intervention (the Cooking and Pneumonia Study or CAPS), we recruited 1,481 randomly selected adults. A subset (∼21%) were from participating households in CAPS. This cross-sectional analysis investigates associations of BP with stove type and, in a sample of participants, with particulate matter ≤ 2.5 μm diameter (PM2.5) and carbon monoxide (CO), both measured using 48-hour personal monitoring. Two main types of analysis were conducted: a) assessment of differences in mean systolic BP (SPB) and diastolic BP (DBP) among three groups based on stove use/type and b) assessment of the associations between PM2.5 and CO with mean SBP and DBP; both analyses using multivariable linear regression.
Results
Of the 1481 participants, 910 provided BP data. There was no difference for either mean SBP or DBP between the CAPS intervention and control groups. However, when comparing all CAPS participants (i.e., those provided cleaner-burning cookstoves by study’s end) to the non-CAPS group, mean SBP was reduced (-3.53 mmHg, 95% CI:-6.54,-0.52), but not DBP (-0.73 mmHg, 95% CI:-2.36,0.90). Of these, 599 participants also had ≥24 hours personal exposure monitoring data. Neither the log mean PM2.5 concentration nor the log mean CO concentration was associated with either SBP or DBP.
Discussion
In this cross-sectional study in non-pregnant adults to measure both exposure to HAP and blood pressure in sub-Saharan Africa, we found evidence for an association between receiving a cleaner-burning cookstove and reduced SBP, but no evidence for an association between BP and personal exposure to PM2.5 or CO.
Editor(s)
Dutta, Anindita
Date Issued
2025-03-01
Date Acceptance
2024-11-20
Citation
PLoS One, 2025, 20 (3)
ISSN
1932-6203
Publisher
Public Library of Science (PLoS)
Journal / Book Title
PLoS One
Volume
20
Issue
3
Copyright Statement
Copyright: © 2025 Bates et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40063536
PII: PONE-D-24-01984
Subjects
Humans
Malawi
Male
Female
Blood Pressure
Cooking
Adult
Rural Population
Cross-Sectional Studies
Middle Aged
Particulate Matter
Air Pollution, Indoor
Carbon Monoxide
Hypertension
Publication Status
Published
Coverage Spatial
United States
Article Number
e0315056
Date Publish Online
2025-03-10