The impact of air pollution on the course of arterial hypertension in residents of Kyiv

Abstract

Purpose. The main purpose of this work was to study the impact of acute atmospheric air pollution on the stability of the course of arterial hypertension (AH) in residents of the metropolis. The authors sought to analyze how the sharp deterioration of the environmental situation in Kyiv, caused by both technogenic factors (CHP, factories, generator operation) and the consequences of military aggression (missile and drone attacks and fires), correlates with the frequency of patients seeking cardiological care. Special emphasis was placed on identifying gender differences in the body’s response to negative environmental factors and assessing risks for patients with pre-existing cardiovascular pathologies in conditions of chronic military stress. Materials and methods. The study is based on a retrospective analysis of data from the РЕ Сlinic Medicom (Kyiv). The analysis included all cases of visits to cardiologists during two adjacent seven-day periods: before and after the date of the extreme peak of air pollution, which was recorded on September 20, 2024 using the SaveEcoBot system. The total sample consisted of 213 patients (106 people in the first group and 107 in the second). The criteria for destabilization of hypertension were complaints of increased blood pressure (BP) or BP recorded during the visit above 160/90 mm Hg. The analysis was conducted separately for “general” cardiology admissions and “specialized” (patients with a history of cardiovascular diseases). Statistical processing was carried out using the Pearson and Fisher criteria. Results. The analysis demonstrated that the studied groups were comparative in terms of age and the structure of comorbidities, such as diabetes mellitus, coronary heart disease, and atrial fibrillation. However, a tendency towards an increase in the proportion of women among those who consulted a doctor after the deterioration of air quality was found (from 46 % to 59 %, p = 0.065). The most significant results were obtained in the group of “specialized cardiological” visits: the proportion of patients with destabilized AH increased from 7.5 % in the period before pollution to 28.57 % in the period after it (p = 0.0163). The amount of such patients in a state of decompensation increased threefold in absolute numbers. At the same time, no significant changes were found in the proportion of complaints about blood pressure in general outpatient visits (28.3 % versus 29.91 %). This confirms the hypothesis that air pollution acts as a trigger for exacerbations specifically for vulnerable categories of patients with chronic disorders. Conclusions. The results of the scientific work allow us to conclude that acute air pollution in combination with chronic wartime stress does not cause an immediate increase in the total number of cardiology patients, but significantly worsens the course of the disease in people with previously established arterial hypertension. The identified gender differences indicate that women may be more sensitive to short-term environmental changes or show higher awareness when feeling unwell. The authors emphasize the need to strengthen preventive measures during periods of ecological disturbances: strict adherence to the antihypertensive therapy regimen, limiting outdoor exposure, and the use of personal protective equipment (respirators). The study emphasizes the critical role of air quality monitoring for the clinical practice of a cardiologist in the face of modern challenges.