Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Household fuel use and the regression from prehypertension to normotension among Chinese middle-aged and older adults: a cohort study

Hypertension Research volume 47, pages 3458–3466 (2024)Cite this article

Abstract

To examine the association of household fuel use with prehypertension regression among middle-aged and older people based on the China Health and Retirement Longitudinal Study (CHARLS), we included a total of 3501 participants with prehypertension at baseline, and they were followed up from 2011–2012 to 2015–2016 with information on blood pressure and household solid fuel use (heating and cooking fuels). Cox proportional hazards regression models were used to explore the hazard ratio (HR) and 95% confidence interval (CI) between fuel use and prehypertension regression. Additionally, we investigated the impact of switching fuels (2011–2013) on the regression to normotension during the 4-year follow-up. Linear regression was used to examine the effect of household fuel use on changes in blood pressure. Compared to solid fuel users, those who used clean fuel for heating at baseline had a positive effect on the regression of prehypertension (HR: 1.28, 95% CI: 1.08–1.53). Participants who used clean fuels for both heating and cooking had increased odds for the regression of prehypertension (HR: 1.32, 95% CI: 1.09–1.60). Compared to consistent solid fuel users, those who consistently used clean fuel for heating had a higher likelihood of transitioning from prehypertension to normotension (HR: 1.36, 95% CI: 1.06–1.73) and exhibited 2.45 mmHg lower systolic blood pressure. In conclusion, household clean fuel use for heating was positively associated with the regression of prehypertension to normotension. Furthermore, switching from solid fuel to clean fuel for heating could reduce the risk of prehypertension in Chinese middle-aged and older adults.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

References

  1. Egan BM, Stevens-Fabry S. Prehypertension–prevalence, health risks, and management strategies. Nat Rev Cardiol. 2015;12:289–300.

    Article  PubMed  Google Scholar 

  2. Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of Hypertension in China: Results From the China Hypertension Survey, 2012-2015. Circulation. 2018;137:2344–56.

    Article  PubMed  Google Scholar 

  3. Sun Z, Zheng L, Detrano R, Zhang X, Xu C, Li J, et al. Incidence and predictors of hypertension among rural Chinese adults: results from Liaoning province. Ann Fam Med. 2010;8:19–24.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Selassie A, Wagner CS, Laken ML, Ferguson ML, Ferdinand KC, Egan BM. Progression is accelerated from prehypertension to hypertension in blacks. Hypertension. 2011;58:579–87.

    Article  CAS  PubMed  Google Scholar 

  5. Huang Y, Wang S, Cai X, Mai W, Hu Y, Tang H, et al. Prehypertension and incidence of cardiovascular disease: a meta-analysis. BMC Med. 2013;11:177.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Han M, Li Q, Liu L, Zhang D, Ren Y, Zhao Y, et al. Prehypertension and risk of cardiovascular diseases: a meta-analysis of 47 cohort studies. J Hypertens. 2019;37:2325–32.

    Article  CAS  PubMed  Google Scholar 

  7. Materson BJ, Garcia-Estrada M, Degraff SB, Preston RA. Prehypertension is real and can be associated with target organ damage. J Am Soc Hypertens. 2017;11:704–8.

    Article  PubMed  Google Scholar 

  8. Guo X, Zou L, Zhang X, Li J, Zheng L, Sun Z, et al. Prehypertension: a meta-analysis of the epidemiology, risk factors, and predictors of progression. Tex Heart Inst J. 2011;38:643–52.

    PubMed  PubMed Central  Google Scholar 

  9. Ofori SN, Fobil JN, Odia OJ. Household biomass fuel use, blood pressure and carotid intima media thickness; a cross sectional study of rural dwelling women in Southern Nigeria. Environ Pollut. 2018;242:390–7.

    Article  CAS  PubMed  Google Scholar 

  10. In: WHO Indoor Air Quality Guidelines: Household Fuel Combustion. https://www.ncbi.nlm.nih.gov/pubmed/25577935.): Geneva, 2014.

  11. China: Accelerating Household Access To Clean Cooking And Heating. 2013.

  12. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G. Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol. 2014;43:61–8.

    Article  PubMed  Google Scholar 

  13. Burroughs Pena M, Romero KM, Velazquez EJ, Davila-Roman VG, Gilman RH, Wise RA, et al. Relationship between daily exposure to biomass fuel smoke and blood pressure in high-altitude Peru. Hypertension. 2015;65:1134–40.

    Article  CAS  PubMed  Google Scholar 

  14. Liu Z, Li M, Zhu Y, Hystad P, Ma Y, Rangarajan S, et al. Association of Household Utility of Cleaner Fuel With Lower Hypertension Prevalence and Blood Pressure in Chinese Adults. Int J Public Health. 2022;67:1605193.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lin L, Wang HH, Liu Y, Lu C, Chen W, Guo VY. Indoor solid fuel use for heating and cooking with blood pressure and hypertension: A cross-sectional study among middle-aged and older adults in China. Indoor Air. 2021;31:2158–66.

    Article  CAS  PubMed  Google Scholar 

  16. Liu Z, Hystad P, Zhang Y, Rangarajan S, Yin L, Wang Y, et al. Associations of household solid fuel for heating and cooking with hypertension in Chinese adults. J Hypertens. 2021;39:667–76.

    Article  CAS  PubMed  Google Scholar 

  17. Li X, Duan C, Chen Q, Xiao J, Jim Zhang J. Associations between cooking fuels and hypertension prevalence in Chinese adults: A prospective cohort analysis focusing on fuel transitioning. Environ Int. 2023;175:107953.

    Article  PubMed  Google Scholar 

  18. Deng Y, Gao Q, Yang D, Hua H, Wang N, Ou F, et al. Association between biomass fuel use and risk of hypertension among Chinese older people: A cohort study. Environ Int. 2020;138:105620.

    Article  PubMed  Google Scholar 

  19. Peng Y, Wang Y, Wu F, Chen Y. Association of cooking fuel with incident hypertension among adults in China: A population-based cohort study. J Clin Hypertens (Greenwich). 2022;24:1003–11.

    Article  CAS  PubMed  Google Scholar 

  20. Nicolaou L, Underhill L, Hossen S, Simkovich S, Thangavel G, Rosa G, et al. Cross-sectional analysis of the association between personal exposure to household air pollution and blood pressure in adult women: Evidence from the multi-country Household Air Pollution Intervention Network (HAPIN) trial. Environ Res. 2022;214:114121.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Misra A, Longnecker MP, Dionisio KL, Bornman RMS, Travlos GS, Brar S, et al. Household fuel use and biomarkers of inflammation and respiratory illness among rural South African Women. Environ Res. 2018;166:112–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Chan KH, Xia X, Ho KF, Guo Y, Kurmi OP, Du H, et al. Regional and seasonal variations in household and personal exposures to air pollution in one urban and two rural Chinese communities: A pilot study to collect time-resolved data using static and wearable devices. Environ Int. 2021;146:106217.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Zhu X, Yun X, Meng W, Xu H, Du W, Shen G, et al. Stacked Use and Transition Trends of Rural Household Energy in Mainland China. Environ Sci Technol. 2019;53:521–9.

    Article  CAS  PubMed  Google Scholar 

  24. Shen H, Luo Z, Xiong R, Liu X, Zhang L, Li Y, et al. A critical review of pollutant emission factors from fuel combustion in home stoves. Environ Int. 2021;157:106841.

    Article  CAS  PubMed  Google Scholar 

  25. Thangavel P, Park D, Lee YC Recent Insights into Particulate Matter (PM(2.5))-Mediated Toxicity in Humans: An Overview. Int J Environ Res Pub Health. 2022;19:7511.

  26. Stec DE, Drummond HA, Vera T. Role of carbon monoxide in blood pressure regulation. Hypertension. 2008;51:597–604.

    Article  CAS  PubMed  Google Scholar 

  27. Finks SW, Rumbak MJ, Self TH. Treating Hypertension in Chronic Obstructive Pulmonary Disease. N. Engl J Med. 2020;382:353–63.

    Article  CAS  PubMed  Google Scholar 

  28. Nathan SD, Barbera JA, Gaine SP, Harari S, Martinez FJ, Olschewski H, et al. Pulmonary hypertension in chronic lung disease and hypoxia. Eur Respir J. 2019;53:1801914.

  29. Kanagasabai T, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, et al. Cross-sectional study of household solid fuel use and renal function in older adults in China. Environ Res. 2023;219:115117.

    Article  CAS  PubMed  Google Scholar 

  30. Haddy FJ, Vanhoutte PM, Feletou M. Role of potassium in regulating blood flow and blood pressure. Am J Physiol Regul Integr Comp Physiol. 2006;290:R546–52.

    Article  CAS  PubMed  Google Scholar 

  31. Jessel S, Sawyer S, Hernandez D. Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature. Front Public Health. 2019;7:357.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Herman JP, McKlveen JM, Ghosal S, Kopp B, Wulsin A, Makinson R, et al. Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response. Compr Physiol. 2016;6:603–21.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Chu B, Marwaha K, Sanvictores T, Awosika AO, Ayers D Physiology, Stress Reaction. In: StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/31082164.): Treasure Island (FL) ineligible companies. Disclosure: Komal Marwaha declares no relevant financial relationships with ineligible companies. Disclosure: Terrence Sanvictores declares no relevant financial relationships with ineligible companies. Disclosure: Ayoola Awosika declares no relevant financial relationships with ineligible companies. Disclosure: Derek Ayers declares no relevant financial relationships with ineligible companies., 2024.

Download references

Acknowledgements

We would like to express our sincere gratitude to the China Health and Retirement Longitudinal Study (CHARLS) team for providing the data used in this study. We thank the researchers, fieldworkers and participants involved in this extensive data collection, which has provided invaluable insights into the health and well-being of older people in China.

Author information

Authors and Affiliations

  1. Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, P. R. China

    Jia-min Yan

  2. School of Public Health, Wuhan University, Wuhan, P. R. China

    Min-zhe Zhang & Qi-qiang He

  3. Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, P. R. China

    Qi-qiang He

Authors
  1. Jia-min Yan
    View author publications

    Search author on:PubMed Google Scholar

  2. Min-zhe Zhang
    View author publications

    Search author on:PubMed Google Scholar

  3. Qi-qiang He
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Jiamin Yan: Methodology, Software, Formal analysis, Writing – original draft, Writing – review & editing. Mingzhe Zhang: Methodology, Software. Qiqiang He: Conceptualization, Writing – review & editing, Supervision.

Corresponding authors

Correspondence to Jia-min Yan or Qi-qiang He.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yan, Jm., Zhang, Mz. & He, Qq. Household fuel use and the regression from prehypertension to normotension among Chinese middle-aged and older adults: a cohort study. Hypertens Res 47, 3458–3466 (2024). https://doi.org/10.1038/s41440-024-01928-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41440-024-01928-9

Keywords

Search

Advanced search

Quick links