Work

Air pollution and ambulatory blood pressure in American Indian communities: Methodology and preliminary findings from the strong heart air study

Year: 2026

Type: article

Abstract: ABSTRACT Background Exposure to low-level fine particulate matter (PM 2.5 ) may induce subtle changes in blood pressure (BP) levels detectable by ambulatory blood pressure monitoring (ABPM). To the best of our knowledge, no studies have examined this relationship jointly in indoor and outdoor environments, nor in American Indian communities. Objective We present the study protocol and description of the Strong Heart Air Study (SHS Air). Methods Over 18 months, 240 American Indian participants across each Strong Heart Study region will complete three in-home visits measuring 7 days of indoor and outdoor PM 2.5 concurrently using optical sensors with 24-hours of ABPM to assess the association between short-term PM 2.5 exposure and BP. Enrollment began 6/16/2025. At one central monitoring site per region, continuous weekly PM 2.5 samples are collected for chemical characterization. Results As of July 2026, 149 participants have been enrolled with mean age (standard deviation; SD) 47.3 (6.8) years; 66.2% female; and mean (SD) BMI 34.8 (9.4) kg/m². Mean (SD) 24-hour time-weighted ambulatory systolic/diastolic BP was 120.7 (14.6) / 74.8 (9.9) mmHg. The distribution of median (interquartile range; IQR) indoor PM 2.5 was 16.4 (5.9, 46.6) μg/m³, exceeding median outdoor levels, 2.7 (1.6, 9.2) μg/m³, measured using monitors pending calibration. Conclusions The SHS Air establishes a community-based approach for investigating the joint effect of outdoor and indoor PM 2.5 exposure on ambulatory BP levels in American Indian communities. This study can help clarify the acute cardiovascular health impacts of low-level PM 2.5 exposure and support future strategies to reduce environmental health inequities.

Source: American Journal of Preventive Cardiology

DOI: 10.1016/j.ajpc.2026.101795