Effects of a Liquefied Petroleum Gas Stove Intervention on Blood Pressure in Older Adult Women after 24 months Public

Abstract

Background: Globally, solid fuels are frequently burned inside homes for cooking or heating leading to excessive household air pollution (HAP) exposure. HAP is a risk factor for elevated blood pressure. In a randomized controlled trial involving older adult women (OAW) from three low- and middle- income countries, we hypothesized that an 18-month liquified petroleum gas (LPG) stove intervention would result in lower systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP) in participants compared to those using solid fuel cookstoves, at 6 months after intervention completion.

Methods: This study is part of the Household Air Pollution Intervention Network (HAPIN) trial. Nonpregnant women aged 40-79 were recruited across three resource-limited settings in India, Rwanda, and Guatemala and randomized into either the LPG intervention group or the control group. The intervention lasted 18 months. Each participant had blood pressure measurements taken at baseline and 6 months after intervention completion (24-month follow up). An intention-to-treat analysis (ITT) using a linear regression model captured the difference in average SBP, DBP, PP, and MAP due to the intervention. Subgroup ITT effect analysis was performed to identify potential effect modifiers.

Results: At 6 months after intervention completion, there was no statistically significant difference in SBP, DBP, PP, or MAP levels between the control (n=82) and intervention (n=76) groups. The subgroup analysis revealed that the intervention might reduce SBP for participants with baseline SBP less than or equal to 120 (-8.76 mmHg, CI: -14.81, -2.71). However, the intervention was associated with higher SBP among participants with an SBP greater than 120 (15.407, CI: 9.62, 21.19) a DBP greater than 80 (15.537, CI: 8.25, 22.82), an age greater than or equal to 50 (6.988, CI: 0.34, 13.63), or a BMI greater than or equal to 25 (10.01, CI: 3.22, 16.79).

Conclusion: In an LPG stove intervention in an LMIC setting, there was no difference in blood pressure in OAW between the intervention group and the control group at 6 months after the 18-month intervention. The intervention, however, may have an impact based on specific subgroups.

Table of Contents

I. Background

II. Methods

Study Design and Location Trial Population and Inclusion/Exclusion Criteria Outcomes and Measurements Baseline Characteristics Blood Pressure Statistical Analysis Intention-to-treat Analysis Subgroup Analysis

III. Results

Baseline Characteristics Baseline and 24-month Blood Pressure Measurements Intention-to-treat Analysis Subgroup Analysis

IV. Discussion

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology Environmental Health
Mot-clé	Global Health Women's Health Environmental Health Household Air Pollution Blood Pressure
Committee Chair / Thesis Advisor	Thomas Clasen, Emory University
Committee Members	Wenlu Ye, University of California, Berkeley

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