Andy Hung’s MSc Thesis Proposal

Title: “Impact of traffic-related air pollution on the cardiovascular response to exercise in patients with hypertension”

Supervisor: Dr. Michael Koehle
Committee members: Dr. Robert Petrella, Dr. Christopher Carlsten, Dr. Mark Gelfer

Abstract: Hypertension, also known as high blood pressure, is a condition in which the pressure in the systemic arterial blood vessels is persistently elevated. Globally, hypertension is the single greatest risk factor for cardiovascular morbidity and mortality. There is mounting evidence that air pollution exposure contributes to the development of hypertension; even short-term exposures are associated with immediate cardiovascular effects. On the other hand, exercise is considered a cornerstone therapy for the prevention, treatment, and control of hypertension. However, given the physiological changes that occur during exercise, it has been postulated that exercising during periods of poor air quality could potentially exacerbate the adverse effects of air pollution, abrogating the normal cardiopulmonary response to exercise. A growing body of evidence now suggests that in healthy populations, the short-term benefits of exercise remain even during periods of increased air pollution. Nonetheless, the short-term effects of the interaction between exercise and air pollution remain poorly understood in populations at an increased risk of adverse effects of air pollution (e.g., patients with hypertension). Consequently, current exercise recommendations given to these susceptible populations during periods of increased air pollution are done so in accordance with the precautionary principle. This real-world randomized, crossover study will investigate whether exposure to high levels of traffic-related air pollution (TRAP) impacts the acute cardiovascular response to exercise in patients with hypertension. Participants will complete two exposures, consisting of 30 minutes of exercise in a high- or low-TRAP environment; cardiovascular health outcomes will be measured for 24 hours following exercise. The proposed work will ultimately aid in the development of practical, evidence-based recommendations that can be used by clinicians and patients to maximize the health benefits of exercise.