Association between nitrogen dioxide concentration and hypertension hospitalization: A multicenter time-series analysis in Xinxiang, China

Hypertension is a common chronic disease, and air pollution is strongly associated with hypertension hospitalization. However, the association between nitrogen dioxide (NO2)1 concentration and hypertension hospitalization has rarely been studied. We collected daily data on hypertension hospitalizations, air pollutants, and meteorology from January 1, 2016 to October 31, 2021. After controlling for the effects of seasonal and long-term trends, weather conditions, weekdays, holidays, and during the novel coronavirus crown epidemic, a generalized additive model with over discrete Poisson regression was used to simulate the association between NO2 concentration and hypertension hospitalizations while quantifying hypertension hospitalizations, hospital stays, and hospital costs attributable to NO2. The results showed that each 10 μg/m3 increase in NO2 concentration was significantly associated with the relative risk (RR) of hypertension admission in Xinxiang, with the greatest effect at lag04 (RR = 1.107; 95% confidence interval, 1.046–1.172). Hypertension hospitalizations attributed to NO2 during the study period accounted for 9.70% (484) of the total hypertension hospitalizations, equivalent to 4202 hospital days and 338.55 thousand United States dollars (USD). Increased NO2 concentration increases the risk of hypertension hospitalization in Xinxiang, which poses a significant health and economic burden to society and patients. The findings of this study provide a basis for developing stricter environmental pollutant standards.