Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease.
Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease.
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DOI：
10.1289/ehp.1103898
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发表时间：
2012-03
影响因子：
10.4
通讯作者：
Jiang L
中科院分区：
文献类型：
--
作者：
Langrish JP;Li X;Wang S;Lee MM;Barnes GD;Miller MR;Cassee FR;Boon NA;Donaldson K;Li J;Li L;Mills NL;Newby DE;Jiang L
背景：空气污染暴露增加心血管疾病发病率和死亡率，是一个主要的全球公共卫生问题。目的：我们调查了减少冠心病患者个人暴露于城市空气污染的益处。研究方法：在一项开放随机交叉试验中，98名冠心病患者在不同条件下在中国北京市中心的预定路线上行走：一次使用高效口罩，一次不使用口罩。在整个24小时研究期间，监测症状、运动、个人空气污染暴露、血压、心率和12导联心电图。结果如下：环境空气污染物主要是高浓度的细和超细颗粒物（PM）[PM2.5为74微克/立方米（空气动力学直径<2.5微米的PM）]。与交通来源一致，这种PM含有有机碳和多环芳烃，具有高度氧化性，产生大量自由基。面罩耐受性良好，其使用与24小时内自我报告症状减少和最大ST段压低降低（-142 vs. -156 μV，p = 0.046）相关。当在规定的步行过程中使用面罩时，平均动脉压较低（93 ± 10 vs. 96 ± 10 mmHg，p = 0.025）和心率变异性增加（高频功率：54与40毫秒2，p = 0.005;高频归一化功率：23.5与20.5毫秒，p = 0.001;均方根连续差异：16.7与14.8毫秒，p = 0.007）。然而，口罩的使用似乎并没有影响心率或能量消耗。结论：使用高效口罩减少个人暴露于空气污染似乎可以减轻冠心病患者的症状并改善一系列心血管健康措施。这种减少个人暴露于PM空气污染的干预措施有可能降低这一高度易感人群的心血管事件发生率。
Background: Air pollution exposure increases cardiovascular morbidity and mortality and is a major global public health concern. Objectives: We investigated the benefits of reducing personal exposure to urban air pollution in patients with coronary heart disease. Methods: In an open randomized crossover trial, 98 patients with coronary heart disease walked on a predefined route in central Beijing, China, under different conditions: once while using a highly efficient face mask, and once while not using the mask. Symptoms, exercise, personal air pollution exposure, blood pressure, heart rate, and 12-lead electrocardiography were monitored throughout the 24-hr study period. Results: Ambient air pollutants were dominated by fine and ultrafine particulate matter (PM) that was present at high levels [74 μg/m3 for PM2.5 (PM with aerodynamic diamater <2.5 µm)]. Consistent with traffic-derived sources, this PM contained organic carbon and polycyclic aromatic hydrocarbons and was highly oxidizing, generating large amounts of free radicals. The face mask was well tolerated, and its use was associated with decreased self-reported symptoms and reduced maximal ST segment depression (–142 vs. –156 μV, p = 0.046) over the 24-hr period. When the face mask was used during the prescribed walk, mean arterial pressure was lower (93 ± 10 vs. 96 ± 10 mmHg, p = 0.025) and heart rate variability increased (high-frequency power: 54 vs. 40 msec2, p = 0.005; high-frequency normalized power: 23.5 vs. 20.5 msec, p = 0.001; root mean square successive differences: 16.7 vs. 14.8 msec, p = 0.007). However, mask use did not appear to influence heart rate or energy expenditure. Conclusions: Reducing personal exposure to air pollution using a highly efficient face mask appeared to reduce symptoms and improve a range of cardiovascular health measures in patients with coronary heart disease. Such interventions to reduce personal exposure to PM air pollution have the potential to reduce the incidence of cardiovascular events in this highly susceptible population.
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影响因子：
8.3
作者：
Mundal, R;Kjeldsen, SE;Erikssen, J
通讯作者：
Erikssen, J
影响因子：
8.3
作者：
Kurl, S;Laukkanen, JA;Salonen, JT
通讯作者：
Salonen, JT
影响因子：
10.4
作者：
Miller MR;Borthwick SJ;Shaw CA;McLean SG;McClure D;Mills NL;Duffin R;Donaldson K;Megson IL;Hadoke PW;Newby DE
通讯作者：
Newby DE
影响因子：
8.3
作者：
Kikuya, M;Hozawa, A;Imai, Y
通讯作者：
Imai, Y
影响因子：
0.5
作者：
Agarwal, Neil K.;Sharma, Prerna;Agarwal, Shashi K.
通讯作者：
Agarwal, Shashi K.