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Principal Investigator: JONATHAN D NEWMAN
Organization: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
Fiscal Year: 2024
Award: $828,434
Funding agency: National Heart Lung and Blood Institute
PROJECT ABSTRACT
Air pollution is responsible for >213,000 excess deaths in the U.S. annually, and globally remains the 4th
leading cause of mortality. Further, most air pollution-related mortality is due to cardiovascular (CV) disease.
We and others have found that short term air pollution exposure increases systolic blood pressure (SBP) by 2-
10 mmHg, while longer term exposure promotes the onset of hypertension (HTN)—which represents a key
pathway from air pollution exposure to risk of CV disease. However, there is a gap in evidence in support of
personal strategies to reduce the adverse CV effects of air pollution, and consensus required to change public
policy on air pollution remains elusive. Until this evidence gap is addressed, air pollution exposure will remain a
potentially modifiable yet untreated risk factor for HTN and subsequent CV disease. In this context, the overall
objective of our proposal is to perform a pivotal clinical trial to test personal air cleaners (PACs) in indoor
settings to reduce fine particulate air pollution <2.5 µM (PM2.5)—the most vasculotoxic component of air
pollution—and lower SBP among a cohort of adults with treated and untreated HTN. Data from our group and
others show that PACs lower SBP by 3-5 mmHg over 3-10 days, have larger (≈8mmHg) reductions in SBP
among obese adults, and that these benefits may be driven by reductions in inflammatory cytokines. Under-
resourced communities—such as urban public housing residents—experience both indoor and outdoor air
pollution inequities, excess burdens of obesity and HTN, and are at high risk for the persistent adverse health
effects from PM2.5 exposure. We hypothesize that PACs reduce PM2.5 and lower SBP in a sustained fashion
among adults with treated and untreated HTN in New York City public housing. To test this hypothesis, we will
evaluate whether PACs reduce PM2.5 and SBP over longer, clinically relevant time horizons, and in a larger
cohort than studied by other investigators to date. Further, we will evaluate inflammatory cytokines as
predictors of SBP response to PACs. Guided by strong preliminary data, this proposal will pursue three specific
aims: 1) Determine if PACs lower morning (AM) self-measured home SBP (H-SBP) over 30, 90 and 180 days
among 440 adults with treated and untreated HTN living in New York City public housing; 2) Test if adults with
HTN and increased adiposity have larger decreases in morning H-SBP with PACs compared to adults with less
adiposity; and 3) Determine whether higher baseline inflammatory cytokines predict a greater SBP response to
PACs. This proposal is innovative in its use of self-measured home blood pressure, air pollution monitoring,
and cytokine measurements in an urban public housing community with excess burdens of obesity and HTN
and is significant because it will advance knowledge of whether PACs can be used to reduce PM2.5 exposure—
on an individual level—and lower blood pressure, a meaningful health endpoint causally linked to CV disease.
Ultimately, such knowledge may provide millions of Americans and populations worldwide with access to a
personal strategy to reduce the adverse CV effects of air pollution exposure.
Terms: <21+ years old><Address><Adherence><Adult><Adult Human><Age><Air Pollutants><Air Pollution><American><Attention><Autonomic Dysfunction><B cell differentiation factor><B cell stimulating factor 2><B-Cell Differentiation Factor><B-Cell Differentiation Factor-2><B-Cell Stimulatory Factor-2><BCDF><BP reduction><BSF-2><BSF2><Beta Proprotein Interleukin 1><Biological><Blood><Blood Pressure><Blood Reticuloendothelial System><Cardiovascular Diseases><Cessation of life><Clinical><Clinical Trials><Cohort Studies><Communities><Concurrent Studies><Consensus><Data><Death><Disparities><Disparity><Dose><Double-Blind Method><Double-Blind Study><Double-Blinded><Double-Masked Method><Double-Masked Study><Drugs><Effectiveness><Ensure><Environment><Epidemic><Exposure to><Face><Fingers><Goals><Groups at risk><HPGF><Health><Health Inequity><Hepatocyte-Stimulating Factor><High Prevalence><Home><Hour><Housing><Humidity><Hybridoma Growth Factor><Hypertension><IFN-beta 2><IFNB2><IL-1 beta><IL-1 β><IL-1-b><IL-1β><IL-6><IL1-Beta><IL1-β><IL1B Protein><IL1F2><IL1β><IL6 Protein><Individual><Indoor Air Pollution><Inequalities in Health><Inequities in Health><Inequity><Inflammatory><Interleukin 1beta><Interleukin-1 beta><Interleukin-1β><Interleukin-6><Intervention><Intervention Strategies><Investigators><Knowledge><Link><MGI-2><Measurement><Measures><Mediating><Medication><Meta-Analysis><Monitor><Morbidity><Morbidity - disease rate><Myeloid Differentiation-Inducing Protein><NHLBI><National Heart, Lung, and Blood Institute><New York City><Non obese><Nonobese><Obesity><Outcome><PM2.5><Particulate><Pathway interactions><Patients><People at risk><Persons><Persons at risk><Pharmaceutical Preparations><Physiologic><Physiological><Plasmacytoma Growth Factor><Pollution><Population><Populations at Risk><Predictive Factor><Preinterleukin 1 Beta><Proteins><Public Health><Public Housing><Public Policy><Randomized><Research Personnel><Research Resources><Researchers><Resources><Risk Factors><Seasons><Specific qualifier value><Specified><Spottings><Strategic vision><Temperature><Testing><Time><Twin Multiple Birth><Twins><Urban Community><Vascular Diseases><Vascular Disorder><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Vulnerable Populations><adiposity><adult adiposity><adult obesity><adulthood><adults with obesity><ages><air cleaner><ambient air pollution><biologic><biological adaptation to stress><blood pressure elevation><blood pressure reduction><blood vessel disorder><cardiovascular disease risk><cardiovascular disorder><cardiovascular disorder risk><cardiovascular effects><cardiovascular health><clinical relevance><clinically relevant><cohort><corpulence><cytokine><design><designing><drug/agent><elevated blood pressure><experience><faces><facial><fine particles><fine particulate matter><health inequalities><high blood pressure><high risk><homes><hyperpiesia><hyperpiesis><hypertensive><hypertensive disease><hypertensive disorder><increase in blood pressure><increased blood pressure><indoor air contamination><innovate><innovation><innovative><interferon beta 2><intervention arm><interventional strategy><lower BP><lower blood pressure><lowers blood pressure><meter><mortality><new approaches><non-smoker><nonsmoker><novel><novel approaches><novel strategies><novel strategy><obese individuals><obese people><obese person><obese population><obese subjects><outdoor air pollution><pathway><patient response><patient specific response><portability><primary end point><primary endpoint><randomisation><randomization><randomly assigned><reaction; crisis><reduce BP><reduce blood pressure><reduction in BP><reduction in blood pressure><response><responsive patient><secondary end point><secondary endpoint><sex><stress response><stress; reaction><success><systemic inflammation><systemic inflammatory response><treatment arm><urban under served><urban underserved><vascular dysfunction><vasculopathy><vulnerable group><vulnerable individual><vulnerable people>