Long-Term Exposure to Fine Particulate Matter and Hypertension Incidence in China: The China-PAR Cohort Study
Long-Term Exposure to Fine Particulate Matter and Hypertension Incidence in China: The China-PAR Cohort Study
复制标题
中国长期接触细颗粒物与高血压发病率：China-PAR 队列研究
DOI：
10.1161/hypertensionaha.119.12666
复制
发表时间：
2019-06-01
期刊：
影响因子：
8.3
通讯作者：
Gu, Dongfeng
中科院分区：
文献类型：
--
作者：
Huang, Keyong;Yang, Xueli;Gu, Dongfeng
在北美和欧洲进行的研究中，与长期暴露于细颗粒物（PM2.5）相关的高血压风险仍然不清楚，而且这种关系在发展中国家通常发现的较高环境浓度下很少被量化。我们的目的是使用中国大规模前瞻性队列研究PM2.5与高血压事件之间的关系。我们纳入了来自中国-PAR（中国动脉粥样硬化性心血管疾病风险预测）项目的59456名年龄≥18岁的无高血压受试者。2004年至2015年期间，使用基于卫星的时空模型获得了参与者居住地址的环境PM2.5数据。采用分层考克斯比例风险模型计算高血压事件的风险比和95% CI，并调整潜在混杂因素。研究结果显示，2004年至2015年研究参与者地址的平均PM2.5浓度为77.7 g/m3。在364947人年的随访中，我们确定了13981例高血压事件。与PM2.5暴露的最低四分位数相比，最高四分位数的参与者发生高血压的风险增加，风险比（95%CI）为1.77（1.56-2.00）。PM2.5浓度每增加10 g/m3，患高血压的风险增加11%（危险比，1.11; 95%CI，1.05-1.17）。这项队列研究提供了来自中国的第一个证据，证明在相对较高的环境浓度下，长期暴露于PM2.5与高血压事件独立相关。因此，有必要采取严格的PM2.5污染控制策略，以改善空气质量，并有助于降低中国高血压的疾病负担。
The risk of incident hypertension associated with long-term exposure to fine particulate matter (PM2.5) was still unclear by studies conducted in North America and Europe, and this relationship has rarely been quantified at higher ambient concentrations typically found in developing countries. We aimed to investigate the association between PM2.5 and incident hypertension using the large-scale prospective cohorts in China. We included 59 456 participants without hypertension aged ≥18 years from the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) project. Data on ambient PM2.5 at participants’ residential address were obtained during 2004 to 2015 using a satellite-based spatial-temporal model. Hazard ratios and 95% CIs were calculated for incident hypertension using stratified Cox proportional hazards models with adjustment of potential confounders. The findings indicated that average PM2.5 concentration from 2004 to 2015 at study participants’ address was 77.7 &mgr;g/m3. During the follow-up of 364 947 person-years, we identified 13 981 incident hypertension cases. Compared with the lowest quartile exposure of PM2.5, participants in the highest quartile had an increased risk of incident hypertension with a hazard ratio (95% CI) of 1.77 (1.56–2.00). Each 10 &mgr;g/m3 increment of PM2.5 concentration could increase 11% risk of hypertension (hazard ratio, 1.11; 95% CI, 1.05–1.17). This cohort study provided the first evidence from China that long-term exposure to PM2.5 was independently associated with incident hypertension at relatively high ambient concentrations. Stringent strategies on PM2.5 pollution control are warranted to improve the air quality and contribute to the reduction of disease burden of hypertension in China.