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Randomized Controlled Trial
. 2015 Jan;104(1):23-30.
doi: 10.1007/s00392-014-0751-x. Epub 2014 Aug 22.

Nighttime aircraft noise impairs endothelial function and increases blood pressure in patients with or at high risk for coronary artery disease

Frank Schmidt  1 , Kristoffer Kolle, Katharina Kreuder, Boris Schnorbus, Philip Wild, Marlene Hechtner, Harald Binder, Tommaso Gori, Thomas Münzel
Affiliations
Randomized Controlled Trial

Nighttime aircraft noise impairs endothelial function and increases blood pressure in patients with or at high risk for coronary artery disease

Frank Schmidt et al. Clin Res Cardiol. 2015 Jan.

Abstract

Aims: Epidemiological studies suggest the existence of a relationship between aircraft noise exposure and increased risk for myocardial infarction and stroke. Patients with established coronary artery disease and endothelial dysfunction are known to have more future cardiovascular events. We therefore tested the effects of nocturnal aircraft noise on endothelial function in patients with or at high risk for coronary artery disease.

Methods: 60 Patients (50p 1-3 vessels disease; 10p with a high Framingham Score of 23%) were exposed in random and blinded order to aircraft noise and no noise conditions. Noise was simulated in the patients' bedroom and consisted of 60 events during one night. Polygraphy was recorded during study nights, endothelial function (flow-mediated dilation of the brachial artery), questionnaires and blood sampling were performed on the morning after each study night.

Results: The mean sound pressure levels L eq(3) measured were 46.9 ± 2.0 dB(A) in the Noise 60 nights and 39.2 ± 3.1 dB(A) in the control nights. Subjective sleep quality was markedly reduced by noise from 5.8 ± 2.0 to 3.7 ± 2.2 (p < 0.001). FMD was significantly reduced (from 9.6 ± 4.3 to 7.9 ± 3.7%; p < 0.001) and systolic blood pressure was increased (from 129.5 ± 16.5 to 133.6 ± 17.9 mmHg; p = 0.030) by noise. The adverse vascular effects of noise were independent from sleep quality and self-reported noise sensitivity.

Conclusions: Nighttime aircraft noise markedly impairs endothelial function in patients with or at risk for cardiovascular disease. These vascular effects appear to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise.

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Figures

Fig. 1
Fig. 1
Effects of nighttime noise on flow-mediated dilation (FMD) in patients with or being at risk for coronary artery disease. Data are mean ± SD of 60 patients, *p < 0.001 adjusted for gender, age, night sequence, PSQI, overall noise sensitivity (NoiSeQ), sleep related noise sensitivity, attitude towards aircraft noise, and the results of the Morning Evening Questionnaire
Fig. 2
Fig. 2
Influence of patient factors on flow-mediated dilation (FMD). a Subjective sleep quality (in cm as measured in the source data, higher values correspond to worse sleep quality; cumulative transformed data on a 0–10 scale are reported in Table 2) does not exhibit a significant correlation with FMD values. b Global noise sensitivity and c sleep related noise sensitivity as assessed by the Dortmund Noise Sensitivity Questionnaire (NoiSeQ) do not modify the effect of noise exposure on endothelial function (FMD). d Likewise patient attitude towards air traffic and aircraft noise does not predict the effect of noise simulation on the primary endpoint. Data are mean ±2 standard errors. Categories including n < 5 are not presented
Fig. 3
Fig. 3
Effects of nighttime aircraft noise on systolic blood pressure a and sleep quality as expressed by the visual analog scale (VAS) b. Data are mean ± SD in 60 patients. Significance levels are *p = 0.03 (A) and *p < 0.001 b respectively adjusted for gender, age, night sequence, PSQI, overall noise sensitivity (NoiSeQ), sleep related noise sensitivity, attitude towards aircraft noise, and the results of the Morning Evening Questionnaire
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