Environmental exposures and blood pressure in adolescents and adults in the T1D exchange clinic registry

Aims: To examine the associations between environmental determinants of health and blood pressure and whether age, sex, or race moderated the associations among 18,754 adolescents and adults from the type 1 diabetes (T1D) Exchange Clinic Registry. Methods: We used multivariable linear regression. Environmental determinants included exposure to ambient fine particulate matter (PM_2.5, obtained from an integrated model), nitrogen dioxide (NO₂), noise and light pollution, and the normalized difference vegetation index (NDVI, a marker of green space) at the ZIP code level of residence. Results: Higher exposure to PM_2.5 and NO₂, and lower NDVI, was associated with higher systolic and diastolic blood pressure, and higher light pollution exposure were similarly associated with higher diastolic blood pressure. These associations between environmental exposures and blood pressure remained significant after accounting for other covariates (age, sex, race/ethnicity, BMI, and T1D duration). With aging, the negative association between NDVI and blood pressure weakened. Conclusions: These findings emphasize the significance of minimizing exposure to environmental pollutants, including PM_2.5 and NO₂, as well as ensuring access to areas with higher NDVI, to promote cardiovascular health in individuals with T1D.