Systolic blood pressure changes in indigenous Bolivian women associated with an improved cookstove intervention

The use of biomass fuels as a primary fuel source is widespread and is linked to significant health effects. High blood pressure is a risk factor for cardiovascular effects including myocardial infarction and stroke. Few studies evaluating the health effects of household air pollution (HAP) have included blood pressure measurements. This study evaluated the effects of changes in cookstove-related particulate matter on blood pressure in 28 women head-of-households pre-intervention and 1 year post-intervention of an improved cookstove in a small, indigenous community in rural Bolivia. Blood pressure and kitchen particulate matter (PM) measurements were taken in August and September 2009 (pre-intervention) and in a 1-year follow-up in September and October of 2010 (post-intervention). Mean systolic blood pressure (SBP) decreased from 114.5 +/- 13.0 mm Hg to 109.0 +/- 10.4 mm Hg, (p = 0.01) after the improved cookstove intervention. Small decreases in diastolic blood pressure (DBP) were also seen, but these changes were not significant (p = 0.50). Decreases in SBP were correlated with reductions in 24-h mean kitchen PM levels (r = 0.59, p = 0.04). Somewhat stronger correlations were found between reductions in cooking PM concentrations and reductions in both SBP (r = 0.66, p = 0.01) and DBP (r = 0.66, p = 0.01). This study finds associations between decreases in both 24-h mean and mean cooking PM levels and decreases in SBP following an improved cookstove intervention.