Research findings recently published in the journal JAMA Internal Medicine, conducted by researchers from Duke University with colleagues from several educational institutions in China, indicate that exposure to high and harmful ozone levels can increase blood pressure: a primary risk factor for cardiovascular disease.

Senior author Junfeng Zhang, a professor in global and environmental health at Duke University, stated: “We know that ozone can damage the respiratory system, reduce lung function, and cause asthma attacks.” While exposure to ozone has been correlated with reductions in lung function, this new study of adults in China reveals that it is also strongly correlated with increased risks of heart attack and stroke. The study monitored 89 health adults in China from December 2014 to January 2015, measuring indoor and outdoor ozone levels, in addition to other pollutants. Other measured markers included levels of inflammation, oxidative stress, stiffness in arteries, blood clotting, blood pressure, and lung function.

After analyzing the data, the researchers confirmed that ozone exposure was “linked to markers of blood platelet activation and raised blood pressure;” the former is a high risk factor for blood clotting. The ozone exposure levels during the study were lower than levels that have been associated with impaired lung function: “The main basic for the current air quality standard set by the Environmental Protection Agency.”

Professor Zhang has said that in 2015, a third of the entire U.S. population (approximately 108 million people) lived in geographic regions in which ozone levels were higher than the set EPA standard. Moreover, as global ozone levels will increase due to climate change and the increasing warmth of the atmosphere, there will likely be an increased trend in these findings.

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