Effect of air pollution on the autonomic modulation of heart rate in overweight adults

Base, Luis Henrique; Oliveira, Juliana Regis da Costa e; Maia, Laura Cristina Pereira; Antão, Jennifer Yohanna Ferreira de Lima; Ferreira Filho, Celso; Ferreira, Celso

doi:10.31744/einstein_journal/2020AO5100

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Original Article • Einstein (São Paulo) 18 • 2020 • https://doi.org/10.31744/einstein_journal/2020AO5100 copy

Effect of air pollution on the autonomic modulation of heart rate in overweight adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the effect of air pollution on heart rate variability in overweight individuals.

Methods:

A total of 46 adult individuals, both sexes, aged between 18 and 49 years and with body mass index >25kg/m² were analyzed. All volunteers were students from public schools of two cities in the state of São Paulo. The clinical, demographic and anthropometric data of each individual, as well as heart rate variability through time domain, geometric and frequency indices were collected. For the air quality analysis, the following variables were investigated: concentration of carbon dioxide, particulate matter, temperature and relative humidity. The analysis was carried out with descriptive and analytical statistics, adopting a level of significance of 5%.

Results:

There was a reduction in overall heart rate variability in overweight individuals by the following indices: mean standard deviation of all normal RR intervals, long-term standard deviation of continuous RR intervals, ratio of short-and long-term standard deviation of continuous RR intervals. In addition, the indices responsible for parasympathetic control showed a downward trend in their values, as well as the low frequency index, which represented sympathetic action, although not significant.

Conclusion:

Overweight individuals exposed to air pollution had lower heart rate variability than the Control Group.

Keywords:
Environmental pollution; Air pollution; Cardiovascular system; Autonomic nervous system; Heart rate; Obesity; Overweight

Variables		CG	EG	p value
Variables		(n=23)	(n=23)	p value
Age, years		36 (25-40.5)	41 (29-45.5)	0.187 ^* * Mann-Whitney test;
Formal education, years		5 (4.5-9.5)	6 (2.5-8)	0.635 ^* * Mann-Whitney test;
Body weight, kg		77.5 (69.7-82.4)	76.4 (69-83.4)	0.766 ^* * Mann-Whitney test;
BMI, kg/m²		27.6 (26.8-31.1)	28.6 (26.4-30.7)	0.877 ^* * Mann-Whitney test;
HR, bpm		73 (66-78.5)	72 (63.5-81.5)	0.652 ^* * Mann-Whitney test;
SBP, mmHg		120 (110-130)	120 (120-130)	0.229 ^* * Mann-Whitney test;
DBP, mmHg		80 (80-82.5)	80 (75-85)	0.858 ^* * Mann-Whitney test;
Height, m		1.64±0.09	1.63±0.09	0.617 ^† † student t test;
Abdominal circumference, cm		90±9.21	93.8±9.51	0.182 ^† † student t test;
Sex				0.555 ^‡ ‡ Pearson's χ2 test;
	Men	56.5 (13)	43.4 (10)
	Women	43.4 (10)	56.5 (13)
IPAQ				0.732 ^§ § Fisher's exact test.
	Low	4.4 (1)	30.4 (7)
	Mean	65.2 (15)	60.9 (14)
	High	30.4 (7)	8.7 (2)
Smoking				0.108 ^§ § Fisher's exact test.
	No	100 (23)	73.9 (17)
	Yes	0 (0)	26.1 (6)
Classification of BMI				0.571 ^§ § Fisher's exact test.
	Underweight (<18.5kg/m²)	0 (0)	0 (0)
	Normal weight (18.5>24.9kg/m²)	0 (0)	0 (0)
	Overweight (25>29,9kg/m²)	69.6 (16)	69.6 (16)
	Obesity (≥30kg/m²)	30.4 (7)	30.4 (7)

Variables		Mean/median	CI/IQR		p value
CO₂, ppm					<0.001 ^* * parametric data (median and CI);
	CG	454.5	450.7	458.2
	EG	479.1	473.1	485.1
Temperature, °C					<0.001 ^* * parametric data (median and CI);
	CG	25.3	24.0	26.6
	EG	20.2	19.5	20.9
Humidity, %					0.003 ^† † non-parametrical data (median and IQR).
	CG	46.4	44.9	46.7
	EG	77.6	75.1	78.4
PM 0.3 (x10⁶)					0.001 ^† † non-parametrical data (median and IQR).
	CG	59.5	59.5	62.7
	EG	214.7	211.4	216.8
PM 0.5 (x10⁶)					0.001 ^† † non-parametrical data (median and IQR).
	CG	4.9	4.7	5.4
	EG	92.3	89.5	93.2
PM 1.0 (x10⁶)					0.001 ^† † non-parametrical data (median and IQR).
	CG	1.1	1.0	1.1
	EG	11.6	10.2	12.0
PM 3,0 (x10⁶)					0.001 ^* * parametric data (median and CI);
	CG	0.9	0.9	0.9
	EG	2.3	1.8	2.4

Variables		Mean	IQR (Q1 – Q3)		p value
CO₂, ppm					<0.001
	CG	528.0	520.7	542.2
	EG	569.0	546.0	683.0
Temperature, ° C					<0.001
	CG	18.0	18.0	19.0
	EG	19.0	19.0	20.0
Humidity, %					0.409
	CG	73.9	72.2	75.6
	EG	85.6	69.6	87.3
PM 0,3 (x10⁶)					0.724
	CG	129.6	59.7	136.9
	EG	237.3	32.2	252.6
PM 0.5 (x10⁶)					0.852
	CG	7.9	4.1	8.6
	EG	79.5	1.9	92.1
PM 1.0 (x10⁶)					0.852
	CG	1.1	1.0	1.2
	EG	8.1	0.3	9.7
PM 3.0 (x10⁶)					0.851
	CG	0.8	0.8	0.9
	EG	2.0	0.2	2.3

Variables		Mean/median	CI/IQR		p value
CO₂, ppm					0.005 ^* * non-parametric data (median and IQR);
	CG	471.0	465.0	476.5
	EG	539.0	466.0	554.0
Temperature, ° C					0.295 ^* * non-parametric data (median and IQR);
	CG	17.0	16.0	17.0
	EG	17.0	16.0	17.0
Humidity, %					0.001 ^† † parametric data (mean and CI).
	CG	82.9	80.9	84.8
	EG	88.4	85.6	91.2
PM 0.3 (x10⁶)					0.221 ^* * non-parametric data (median and IQR);
	CG	127.2	66.1	161.8
	EG	101.9	46.7	220.7
PM 0.5 (x10⁶)					0.645 ^* * non-parametric data (median and IQR);
	CG	7.7	5.0	12.1
	EG	8.5	2.6	111.7
PM 1.0 (x10⁶)					0.701 ^* * non-parametric data (median and IQR);
	CG	1.1	1.0	1.5
	EG	0.5	0.4	15.5
PM 3.0 (x10⁶)					0.352 ^* * non-parametric data (median and IQR);
	CG	0.8	0.8	0.9
	EG	0.5	0.3	3.8

HRV indices	CG	EG	p value
	(n=23)	(n=23)
	Mean (CI)	Mean (CI)
SDNN, ms	48.2 (43.2-53.1)	38.7 (33.5-43.8)	0.012 ^* * student t test without adjust;
rMSSD, ms	27.5 (23.5-31.4)	22.6 (19.3-25.8)	0.061 ^* * student t test without adjust;
pNN50, %	7.9 (4.4-11.4)	4.7 (2.9-6.6)	0.079 ^† † student t test after adjust with squared root;
LFms²	738.1 (601.8-874.3)	541.8 (403-680.5)	0.054 ^* * student t test without adjust;
LFnu	73.8 (69-78.5)	71.6 (67.1-76)	0.492 ^* * student t test without adjust;
HFms²	254.8 (183.9-325.6)	208 (145.2-270.7)	0.441 ^‡ ‡ student t test after adjusted log transformation.
HFnu	26 (21.2-30.7)	28.3 (23.8-32.7)	0.489 ^* * student t test without adjust;
LF/HF	3.6 (2.7-4.5)	3.1 (2.3-3.9)	0.460 ^‡ ‡ student t test after adjusted log transformation.
SD1, ms	19.5 (16.7-22.2)	16 (13.7-18.2)	0.062 ^* * student t test without adjust;
SD2, ms	65.1 (58.2-71.9)	52.1 (44.9-59.2)	0.013 ^* * student t test without adjust;
SD1/SD2, ms	0.304 (0.267-0.340)	0.317 (0.279-0.354)	0.625 ^* * student t test without adjust;
RRTri, ms	12.9 (11.6-14.1)	10.3 (8.9-11.6)	0.009 ^* * student t test without adjust;
TINN, ms	214.3 (193.8-234.7)	172.8 (150.5-195)	0.010 ^* * student t test without adjust;

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[1] Corresponding author: Luis Henrique Base, Rua Napoleão de Barros, 715 – Vila Clementino, Zip code: 04024-002 – São Paulo, SP, Brazil, Phone: (55 11) 5576-4848 . E-mail: luishenriquebase81@yahoo.com.br