The association between air pollution and hypertension: An umbrella review of systematic reviews and meta-analyses

Abstract

Summary Although a multitude of meta-analyses have indicated an association between air pollution and hypertension (HTN), substantial heterogeneity exists across these studies. This research aims to systematically assess the cumulative evidence on the link between air pollutants and both HTN and gestational hypertension (GH) through existing systematic reviews. A comprehensive literature search was performed in three databases (Embase, PubMed, and Web of Science) up to September 8, 2025. The AMSTAR 2 tool was adopted to evaluate the methodological quality of the included reviews. Totally, 11 eligible meta-analyses (8 on HTN and 3 on GH) were identified. Collectively, the available evidence supports a plausible role of PM2.5 and PM10 in elevating essential HTN risk; however, the association with GH remains inconclusive due to the limited studies. Further prospective cohort studies and investigations into biological mechanisms are needed to clarify the influences of air pollution on both HTN and GH.