Associations between ambient air pollutants and blood pressure among children and adolescents: A systemic review and meta-analysis.
Associations between ambient air pollutants and blood pressure among children and adolescents: A systemic review and meta-analysis.
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DOI：
10.1016/j.scitotenv.2021.147279
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发表时间：
2021-04
期刊：
影响因子：
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通讯作者：
Mengfan Yan;Jiahui Xu;Chaokang Li;Pengyi Guo;Xueli Yang;N. Tang
中科院分区：
文献类型：
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作者：
Mengfan Yan;Jiahui Xu;Chaokang Li;Pengyi Guo;Xueli Yang;N. Tang
许多流行病学研究调查了短期和长期暴露于环境空气污染对儿童和青少年高血压和血压的影响。然而，结果是有争议的。为了向研究人员提供可靠的证据，进行了这项荟萃分析。方法我们检索了四个数据库中所有已发表的研究，检查颗粒物（PM10、PM2.5和PM1.0）、氮氧化物（NO2）、二氧化硫（SO2）、臭氧（O3）和一氧化碳（CO）对儿童和青少年高血压和血压的影响。对于具有显著异质性的文章，采用随机效应模型分析与空气污染每增加10 μg/m3相关的总体风险估计，否则，采用固定效应模型。结果共识别出3918篇文献，其中154篇进行了深入评价，15篇符合纳入标准。高血压风险增加与长期PM10暴露相关（OR = 1.17，95%置信区间[CI]：1.13，1.21）。对于收缩压（SBP），短期PM10（β = 0.26，95%CI：-0.00，0.53）暴露、长期PM2.5（β = 1.80，95%CI：0.94，2.65）和PM10（β = 0.50，95%CI：0.19，0.81）暴露发现了显着结果。相应的舒张压（DBP）估计值为0.32 mmHg（95% CI：0.19，0.45）短期PM10暴露，1.06 mmHg长期暴露于PM2.5、PM10和NO2时，肺动脉压分别为0.32，1.80、0.34 mmHg（95%CI：0.11，0.57）和0.44 mmHg（95%CI：0.25，0.63）。分层分析显示，在≥50%男孩百分比的研究中，PM10对血压的影响更强（SBP为0.57 mmHg [95% CI：0.44，0.70]，DBP为0.44 mmHg [95% CI：0.34，0.54]）和使用模型估计暴露量的文章结论环境空气污染与儿童青少年高血压患病率及血压升高有关。
ObjectiveNumerous epidemiological studies have investigated the effects of short-term and long-term exposure to ambient air pollution on hypertension and blood pressure among children and adolescents. However, the results were controversial. To provide researchers reliable evidence, this meta-analysis was performed.MethodsWe searched all published studies in four databases examining the effects of particulate matter (PM10, PM2.5and PM1.0), nitrogen oxide (NO2), sulfur dioxide (SO2), ozone (O3) and carbon monoxide (CO) on hypertension and blood pressure in children and adolescents. Overall risk estimates associated with per 10 μg/m3increase of air pollution were analyzed by a random-effect model for articles with significant heterogeneity, otherwise, a fixed-effect model was applied. Subgroup analysis was conducted for studies with significant heterogeneity.ResultsOf 3918 identified literatures, 154 were evaluated in-depth with 15 satisfying inclusion criteria. Increased risk of hypertension was associated with long-term PM10exposure (OR = 1.17, 95% confidence interval [CI]:1.13, 1.21). For systolic blood pressure (SBP), significant results were found for short-term PM10(β = 0.26, 95% CI: −0.00, 0.53) exposure, long-term PM2.5(β = 1.80, 95% CI: 0.94, 2.65) and PM10(β = 0.50, 95% CI: 0.19, 0.81) exposure. The corresponding estimates of diastolic blood pressure (DBP) were 0.32 mmHg (95% CI: 0.19, 0.45) for short-term PM10exposure, 1.06 mmHg (95% CI: 0.32, 1.80), 0.34 mmHg (95% CI: 0.11, 0.57) and 0.44 mmHg (95% CI: 0.25, 0.63) for long-term PM2.5, PM10and NO2exposure, respectively. Stratified analyses showed stronger effects of PM10on blood pressure among studies with ≥50% boys' percentage (0.57 mmHg [95% CI: 0.44, 0.70] for SBP, 0.44 mmHg, [95% CI: 0.34, 0.54] for DBP, respectively) and articles using models to estimate exposure (0.90 mmHg [95% CI: 0.20 1.59] for SBP).ConclusionAmbient air pollution was associated with higher hypertension prevalence and elevated blood pressure in children and adolescents.