Cardiovascular Effects of Long-Term Exposure to Air Pollution: A Population-Based Study With 900 845 Person-Years of Follow-up.
Cardiovascular Effects of Long-Term Exposure to Air Pollution: A Population-Based Study With 900 845 Person-Years of Follow-up.
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DOI：
10.1161/jaha.117.007170
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发表时间：
2017-11-08
影响因子：
5.4
通讯作者：
Chae IH
中科院分区：
文献类型：
--
作者：
Kim H;Kim J;Kim S;Kang SH;Kim HJ;Kim H;Heo J;Yi SM;Kim K;Youn TJ;Chae IH
研究表明，长期暴露于细颗粒物（空气动力学直径≤2.5 μm [PM 2.5]）等空气污染会增加全因和心血管死亡的风险。然而，迄今为止，关于空气污染对特定心血管疾病影响的数据有限。本研究旨在评价韩国首尔居民长期暴露于空气污染对心血管的影响。在2007年至2013年期间对既往无心血管疾病史的健康参与者进行了评估。通过将室外监测器的位置与每个参与者住所的邮政编码联系起来，估计了空气污染物的暴露情况。使用考克斯回归模型进行粗分析和校正分析，以评估复合心血管事件的风险，包括心血管死亡率、急性心肌梗死、充血性心力衰竭和卒中。共对136094名参与者进行了中位7.0年（900845人年）的随访。主要心血管事件的风险随着PM2.5平均浓度的升高而增加，呈线性关系，风险比为1.36（95%置信区间，1.29-1.43）/1 μg/m3 PM2.5。其他污染物包括PM 2.5-10的CO、SO 2和NO 2，但不包括O3，与心血管事件风险增加显著相关。空气污染造成的负担与高血压和糖尿病造成的负担相当。这项基于人群的大规模研究表明，长期暴露于包括PM 2.5在内的空气污染会增加重大心血管疾病和死亡率的风险。空气污染应该被认为是一个重要的可改变的环境心血管危险因素。
Studies have shown that long‐term exposure to air pollution such as fine particulate matter (≤2.5 μm in aerodynamic diameter [PM 2.5]) increases the risk of all‐cause and cardiovascular mortality. To date, however, there are limited data on the impact of air pollution on specific cardiovascular diseases. This study aimed to evaluate cardiovascular effects of long‐term exposure to air pollution among residents of Seoul, Korea. Healthy participants with no previous history of cardiovascular disease were evaluated between 2007 and 2013. Exposure to air pollutants was estimated by linking the location of outdoor monitors to the ZIP code of each participant's residence. Crude and adjusted analyses were performed using Cox regression models to evaluate the risk for composite cardiovascular events including cardiovascular mortality, acute myocardial infarction, congestive heart failure, and stroke. A total of 136 094 participants were followed for a median of 7.0 years (900 845 person‐years). The risk of major cardiovascular events increased with higher mean concentrations of PM 2.5 in a linear relationship, with a hazard ratio of 1.36 (95% confidence interval, 1.29–1.43) per 1 μg/m3 PM 2.5. Other pollutants including PM 2.5–10 of CO, SO 2, and NO 2, but not O3, were significantly associated with increased risk of cardiovascular events. The burden from air pollution was comparable to that from hypertension and diabetes mellitus. This large‐scale population‐based study demonstrated that long‐term exposure to air pollution including PM 2.5 increases the risk of major cardiovascular disease and mortality. Air pollution should be considered an important modifiable environmental cardiovascular risk factor.