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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Wahyudi
Division of Cardiovascular, Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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The Cardiovascular Burden of Fine Particulate Matter in Asia: A Systematic Review and Meta-Analysis of Hypertension Risk Hafizah Latif; Wahyudi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1553

Abstract

Background: The epidemiological transition in Asia has precipitated a double burden of disease, where rapid industrialization intersects with an aging demographic to drive a surge in cardiovascular mortality. Hypertension remains the predominant modifiable risk factor in this context. While the correlation between fine particulate matter (PM2.5) and elevated blood pressure is documented in Western literature, evidence regarding Asian populations remains fragmented. This region faces a unique toxicological phenotype characterized by extreme exposure concentrations, distinct particulate composition including biomass and dust, and specific genetic susceptibilities, necessitating a dedicated regional analysis. Methods: We conducted a systematic review and meta-analysis of observational studies published between 2017 and 2024, searching PubMed, Scopus, and Embase. We critically appraised exposure assessment methods, distinguishing between satellite-based estimates and ground monitoring, and performed a quality audit using the Newcastle-Ottawa Scale. To minimize temporal bias, we stratified analyses by study design into Incident Hypertension (Cohort studies) and Prevalent Hypertension (Cross-sectional studies). Results: Nine pivotal studies encompassing over 600,000 participants from China, Taiwan, India, South Korea, and Thailand were synthesized. The random-effects meta-analysis revealed a significant pooled Hazard Ratio of 1.12 (95% CI 1.06 to 1.18) per 10 micrograms per cubic meter increase in long-term PM2.5. Heterogeneity was significant (I2 equals 90.2%), driven by regional variations. High-altitude cohorts in Tibet and high-exposure regions in India demonstrated synergistic risks with Odds Ratios exceeding 1.50 compared to moderate-exposure regions in Taiwan. Conclusion: Long-term PM2.5 exposure is a potent, independent driver of hypertension in Asia. The data suggest a synergistic interaction between hypoxia and pollution, and a non-linear dose-response curve at high concentrations. Clinicians should consider residence in high-pollution zones a cardiovascular risk enhancer equivalent to traditional risk factors.
Risk of Acute Myocardial Infarction in Patients with Systemic Lupus Erythematosus Compared with the General Population: A Systematic Review and Meta-Analysis Eli Novi; Wahyudi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1611

Abstract

Background: Patients with systemic lupus erythematosus (SLE) are at substantially elevated risk of acute myocardial infarction (AMI) compared with the general population, attributable to a complex interplay of accelerated atherosclerosis, coronary microvascular dysfunction, antiphospholipid antibody-mediated thrombosis, and dysregulated innate immunity. Pooled estimates across published meta-analyses have not been formally synthesised. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed, MEDLINE, and EMBASE were searched through 2 April 2026 for studies reporting the relative risk (RR) of AMI in SLE patients versus the general population. Three eligible meta-analyses providing RR estimates were identified. Data were pooled using the DerSimonian-Laird random-effects model with Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment, implemented in R 4.5.3 (packages meta v8.2-1 and metafor v4.8-0). Heterogeneity was assessed using Cochran’s Q and I². Publication bias was evaluated using Egger’s precision-effect test. A sensitivity analysis incorporating all five eligible comparative studies with mixed effect measures (RR, rate ratio, OR) was performed, alongside subgroup analysis by study design. Results: Three meta-analyses incorporating 24 to 46 primary studies and representing data from approximately 168,000 SLE patients were eligible for the primary pool. The pooled RR of AMI in SLE patients was 2.95 (95% CI 2.57–3.39; p < 0.001). Heterogeneity was negligible (I² = 0.0%; Q = 0.04, p = 0.98; τ² = 0.000). Weights were: Bello et al. 2023 (61.5%), Yazdany et al. 2020 (31.5%), Gu et al. 2019 (7.0%). Sensitivity analysis, including all five comparative studies (mixed measures), yielded a pooled effect of 5.27 (95% CI 2.91–9.53) with substantial heterogeneity (I² = 92.7%, Q = 55.11, p < 0.001), consistent with expected heterogeneity from mixing incompatible effect measures. Subgroup analysis by design showed Q-difference = 55.07 (df = 2, p < 0.001). Egger’s test was non-significant (t = 1.63, p = 0.35). Conclusion: SLE patients face approximately a three-fold elevated risk of AMI compared with the general population, a finding derived from homogeneous, high-quality evidence and confirmed by sensitivity analyses. These findings underscore the need for systematic, SLE-specific cardiovascular risk management, including judicious use of hydroxychloroquine, lipid-lowering therapy, and multidisciplinary cardiorheumatology follow-up.
The Cardiovascular Burden of Fine Particulate Matter in Asia: A Systematic Review and Meta-Analysis of Hypertension Risk Hafizah Latif; Wahyudi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1553

Abstract

Background: The epidemiological transition in Asia has precipitated a double burden of disease, where rapid industrialization intersects with an aging demographic to drive a surge in cardiovascular mortality. Hypertension remains the predominant modifiable risk factor in this context. While the correlation between fine particulate matter (PM2.5) and elevated blood pressure is documented in Western literature, evidence regarding Asian populations remains fragmented. This region faces a unique toxicological phenotype characterized by extreme exposure concentrations, distinct particulate composition including biomass and dust, and specific genetic susceptibilities, necessitating a dedicated regional analysis. Methods: We conducted a systematic review and meta-analysis of observational studies published between 2017 and 2024, searching PubMed, Scopus, and Embase. We critically appraised exposure assessment methods, distinguishing between satellite-based estimates and ground monitoring, and performed a quality audit using the Newcastle-Ottawa Scale. To minimize temporal bias, we stratified analyses by study design into Incident Hypertension (Cohort studies) and Prevalent Hypertension (Cross-sectional studies). Results: Nine pivotal studies encompassing over 600,000 participants from China, Taiwan, India, South Korea, and Thailand were synthesized. The random-effects meta-analysis revealed a significant pooled Hazard Ratio of 1.12 (95% CI 1.06 to 1.18) per 10 micrograms per cubic meter increase in long-term PM2.5. Heterogeneity was significant (I2 equals 90.2%), driven by regional variations. High-altitude cohorts in Tibet and high-exposure regions in India demonstrated synergistic risks with Odds Ratios exceeding 1.50 compared to moderate-exposure regions in Taiwan. Conclusion: Long-term PM2.5 exposure is a potent, independent driver of hypertension in Asia. The data suggest a synergistic interaction between hypoxia and pollution, and a non-linear dose-response curve at high concentrations. Clinicians should consider residence in high-pollution zones a cardiovascular risk enhancer equivalent to traditional risk factors.
Risk of Acute Myocardial Infarction in Patients with Systemic Lupus Erythematosus Compared with the General Population: A Systematic Review and Meta-Analysis Eli Novi; Wahyudi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1611

Abstract

Background: Patients with systemic lupus erythematosus (SLE) are at substantially elevated risk of acute myocardial infarction (AMI) compared with the general population, attributable to a complex interplay of accelerated atherosclerosis, coronary microvascular dysfunction, antiphospholipid antibody-mediated thrombosis, and dysregulated innate immunity. Pooled estimates across published meta-analyses have not been formally synthesised. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed, MEDLINE, and EMBASE were searched through 2 April 2026 for studies reporting the relative risk (RR) of AMI in SLE patients versus the general population. Three eligible meta-analyses providing RR estimates were identified. Data were pooled using the DerSimonian-Laird random-effects model with Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment, implemented in R 4.5.3 (packages meta v8.2-1 and metafor v4.8-0). Heterogeneity was assessed using Cochran’s Q and I². Publication bias was evaluated using Egger’s precision-effect test. A sensitivity analysis incorporating all five eligible comparative studies with mixed effect measures (RR, rate ratio, OR) was performed, alongside subgroup analysis by study design. Results: Three meta-analyses incorporating 24 to 46 primary studies and representing data from approximately 168,000 SLE patients were eligible for the primary pool. The pooled RR of AMI in SLE patients was 2.95 (95% CI 2.57–3.39; p < 0.001). Heterogeneity was negligible (I² = 0.0%; Q = 0.04, p = 0.98; τ² = 0.000). Weights were: Bello et al. 2023 (61.5%), Yazdany et al. 2020 (31.5%), Gu et al. 2019 (7.0%). Sensitivity analysis, including all five comparative studies (mixed measures), yielded a pooled effect of 5.27 (95% CI 2.91–9.53) with substantial heterogeneity (I² = 92.7%, Q = 55.11, p < 0.001), consistent with expected heterogeneity from mixing incompatible effect measures. Subgroup analysis by design showed Q-difference = 55.07 (df = 2, p < 0.001). Egger’s test was non-significant (t = 1.63, p = 0.35). Conclusion: SLE patients face approximately a three-fold elevated risk of AMI compared with the general population, a finding derived from homogeneous, high-quality evidence and confirmed by sensitivity analyses. These findings underscore the need for systematic, SLE-specific cardiovascular risk management, including judicious use of hydroxychloroquine, lipid-lowering therapy, and multidisciplinary cardiorheumatology follow-up.
Co-Authors Eli Novi Hafizah Latif