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INTRODUCTION: Exposure to road traffic noise may increase blood pressure and heart rate. It is unclear to what extent exposure to air pollution may influence this relationship. We investigated associations between noise, blood pressure and heart rate, with harmonized data from three European cohorts, while taking into account exposure to air pollution. METHODS: Road traffic noise exposure was assessed using a European noise model based on the Common Noise Assessment Methods in Europe framework (CNOSSOS-EU). Exposure to air pollution was estimated using a European-wide land use regression model. Blood pressure and heart rate were obtained by trained clinical professionals. Pooled cross-sectional analyses of harmonized data were conducted at the individual level and with random-effects meta-analyses. RESULTS: We analyzed data from 88,336 participants, across the three participating cohorts (mean age 47.0 (±13.9) years). Each 10dB(A) increase in noise was associated with a 0.93 (95% CI 0.76;1.11) bpm increase in heart rate, but with a decrease in blood pressure of 0.01 (95% CI -0.24;0.23) mmHg for systolic and 0.38 (95% CI -0.53; -0.24) mmHg for diastolic blood pressure. Adjustments for PM10 or NO2 attenuated the associations, but remained significant for DBP and HR. Results for BP differed by cohort, with negative associations with noise in LifeLines, no significant associations in EPIC-Oxford, and positive associations with noise >60dB(A) in HUNT3. CONCLUSIONS: Our study suggests that road traffic noise may be related to increased heart rate. No consistent evidence for a relation between noise and blood pressure was found. ; The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7/2007–2013) under grant agreement no. 261433 (Biobank Standardisation and Harmonization for Research Excellence in the European Union – BioSHaRE-EU). DataSHIELD development has also been partly funded under a strategic award from MRC and Wellcome Trust underpinning the ALSPAC project (Wellcome/MRC strategic award 092731); and the Welsh and Scottish Farr Institutes funded by MRC, BBMRI-LPC (EU FP7, I3 grant). BioSHaRE, and the involved cohorts LifeLines (BRIF 4568) and HUNT3 (BRIF 2365) are engaged in a Bioresource Research Impact Factor (BRIF) policy pilot study, details of which can be found at https://www.bioshare.eu/content/bioresource-impact-factor. The Lifelines Biobank initiative has been made possible by funds from FES (Fonds Economische Structuurversterking), SNN (Samenwerkingsverband Noord Nederland) and REP (Ruimtelijk Economisch Programma). LifeLines is a facility that is open for all researchers. Information on application and data access procedure is summarized on www.lifelines.net. We thank all the participants of EPIC-Oxford and data collection teams for generously helping us in this research. EPIC-Oxford is supported by Cancer Research UK (C8221/A19170), and the UK Medical Research Council (MR/M012190). The Nord-Trøndelag Health Study (The HUNT Study) is collaboration between HUNT Research Centre (Faculty of Medicine, Norwegian University of Science and Technology NTNU), NordTrøndelag County Council, Central Norway Health Authority, and the Norwegian Institute of Public Health. P.E. is supported by the Imperial College Healthcare NHS Trust and Imperial College Biomedical Research Centre funded by the National Institute for Health Research (NIHR), the Medical Research Council and Public Health England (MRC-PHE) Centre for Environment and Health (MR/L01341X/1), the NIHR Health Protection Research Unit on Health Impact of Environmental Hazards (HPRU-2012-10030-KCL) and he is an NIHR Senior Investigator. ; Peer-reviewed ; Post-print