Air Pollution linked to high blood Pressure and heart disease risks
Air pollution is now recognised as a key factor contributing to high blood pressure, one of the major drivers of heart and vascular diseases. In Thailand, 1 in 5 people, or around 14 million, are living with hypertension.
The Thai Hypertension Society has previously published an in-depth article exploring the link between air pollution and high blood pressure, highlighting this connection as one of the most pressing yet under-researched public health challenges today.
While fine particulate matter (PM2.5) has long been recognized for its harmful impact on general health, recent research has begun to shed light on its more specific effects—particularly on blood pressure regulation.
A study conducted among Thai military personnel between 2018 and 2020 revealed that for every 1 microgram per cubic meter (µg/m³) increase in PM2.5 levels, the risk of developing hypertension rose by 2%.
This study adds to a growing body of evidence across Asia, where many urban areas are regularly exposed to severe air pollution. Alarming spikes in cardiovascular-related deaths have been observed in correlation with poor air quality.
According to findings published in the European Heart Journal, the cardiovascular impacts of air pollution may be most pronounced in Asian countries.
These studies suggest that not only short-term exposure, but also chronic residence in polluted environments, gradually increases blood pressure over time.
This long-term exposure can silently damage the cardiovascular system, with effects that may not become apparent for years.
Pathophysiological Mechanisms
The Thai Hypertension Society also outlined the pathophysiological mechanisms by which air pollution affects cardiovascular health. When PM2.5 particles enter the bloodstream, they initiate a complex chain reaction at the cellular level.
These particles interact with bodily molecules, generating reactive oxygen species (ROS) and reactive nitrogen species (RNS)—unstable compounds that cause damage to the endothelial cells lining blood vessels.
This cellular damage results in multiple consequences, including:
Endothelial dysfunction (impairing the vessel's ability to relax properly)
Overactivation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to blood vessel constriction
Chronic inflammation, which reduces arterial elasticity and responsiveness to normal regulatory mechanisms
Vulnerable Populations
Certain populations are more vulnerable to the cardiovascular effects of air pollution. Individuals with overweight or obesity, sedentary lifestyles, or poor dietary habits may have reduced ability to counteract oxidative stress, placing them at greater risk for hypertension and related cardiovascular diseases.
Over 7.4 Million Thais Diagnosed with Hypertension
Thailand is facing a rising tide of hypertension cases, with the latest national health survey showing a concerning increase in prevalence.
According to the Sixth National Health Examination Survey (2019–2020), 25.4% of Thai people aged 15 and older—approximately 14 million individuals—were found to have high blood pressure, up from 24.7% (around 13 million) in 2014. The trend shows no sign of slowing.
The Department of Disease Control recently reported that, as of May 6, 2025, only 7.4 million individuals had officially registered for hypertension treatment within the Ministry of Public Health’s system.
Among these, 3.5 million patients remain unable to control their blood pressure, despite being under treatment.
Health authorities emphasize that controlling blood pressure within the normal range is critical. Hypertension is often called a “silent killer” because it typically presents no symptoms, yet unmanaged high blood pressure can lead to serious complications such as stroke, heart disease, and chronic kidney failure, resulting in disability or death.
Understanding Blood Pressure Levels:
Below 120/80 mmHg – Optimal blood pressure
130/80 mmHg and above – At-risk range; lifestyle changes recommended
140/90 mmHg and above – Diagnosed as hypertension; medical evaluation advised
180/110 mmHg and above – Severe hypertension; immediate medical attention required
Protecting Yourself from Hypertension in a Polluted World
As air pollution continues to rise, so do concerns about its long-term impact on public health, particularly the risk of developing hypertension. The Thai Hypertension Society has issued practical guidelines to help individuals reduce their exposure to air pollution and lower their risk of high blood pressure.
Wear an N95 Mask
During periods of high air pollution, wearing an N95 mask is advised. While air purifiers may not be a perfect solution, studies have shown that regular use can reduce systolic blood pressure over time.
Adopt a Heart-Healthy Diet
The Mediterranean diet—rich in antioxidants from fruits, vegetables, and olive oil—can help counteract the damaging effects of air pollution on the cardiovascular system.
Exercise Smartly
Physical activity remains vital for cardiovascular health. However, it's essential to check air quality reports and choose clean-air locations or times for outdoor workouts.
Urban Planning and Community Action
Green spaces don’t just enhance aesthetics; they filter pollutants. Cities that expand public transport and establish low-emission zones have also reported measurable health benefits.
Raise Public Awareness
Public education campaigns are key to ensuring people know when and how to protect themselves during high-pollution periods.
Managing Hypertension: Advice from the Department of Disease Control
On May 16, 2025, Dr Suthat Chotanaphan, Deputy Director-General of the Department of Disease Control, emphasised the importance of effective blood pressure management, especially for those already diagnosed with hypertension. He urged patients to take prescribed medication consistently and not stop without consulting their physician.
Key lifestyle modifications include:
Maintain a healthy weight, aiming for a BMI between 18.5 and 22.9 kg/m²
Follow the "2:1:1 meal formula": 2 parts vegetables, 1 part rice/grains, 1 part lean protein
Limit sodium intake:
General public: <2,000 mg/day
Hypertensive patients: <1,500 mg/day
Exercise regularly: Engage in moderate-intensity activities (e.g., brisk walking, swimming, cycling) for at least 150 minutes per week or 30 minutes daily
Avoid alcohol and tobacco: Refrain from drinking and smoking, and avoid exposure to secondhand smoke
