Air Pollution and Autonomic and Vascular Dysfunction in Patients With Cardiovascular Disease: Interactions of Systemic Inflammation, Overweight, and Gender
Air Pollution and Autonomic and Vascular Dysfunction in Patients With Cardiovascular Disease: Interactions of Systemic Inflammation, Overweight, and Gender
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DOI：
10.1093/aje/kwr511
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发表时间：
2012-07-15
影响因子：
5
通讯作者：
Tang, Xiaoyan
中科院分区：
文献类型：
--
作者：
Huang, Wei;Zhu, Tong;Tang, Xiaoyan
作者对 40 名心血管疾病患者（平均年龄 65.6 岁（标准差，5.8））进行了为期 2 年的随访，这些患者在 2008 年北京奥运会（中国北京）之前和期间接受了心血管反应的重复测量，当时空气污染受到严格控制。连续测量空气动力学直径小于 2.5 m 的颗粒物 (PM2.5)、黑碳、二氧化氮、二氧化硫、臭氧和一氧化碳的环境水平，并验证同时实时测量的个人接触 PM2.5 和一氧化碳的情况。使用线性混合效应模型并调整个体风险因素、时变因素和气象影响。观察到与空气污染暴露相关的心率变异性显着降低和血压升高。具体而言，在之前暴露于 PM2.5、黑碳和二氧化氮 4 小时内，四分位数范围增加了 51.8 g/m(3)、2.02 g/m(3) 和 13.7 ppb，与正常到正常区间的标准差显着降低 4.2（95 置信区间 (CI)：1.9、6.4）、4.2（95 CI：分别为 1.8、6.6）和 3.9（95 CI：2.2、5.7）。在 C 反应蛋白值高于 90% 的受试者、体重指数大于 25 的受试者以及女性中观察到心率变异性下降幅度更大。作者得出的结论是，自主神经和血管功能障碍可能是空气污染暴露增加心血管疾病风险的机制之一，特别是对于患有全身炎症和超重的人来说。
The authors conducted a 2-year follow-up of 40 cardiovascular disease patients (mean age 65.6 years (standard deviation, 5.8)) who underwent repeated measurements of cardiovascular response before and during the 2008 Beijing Olympics (Beijing, China), when air pollution was strictly controlled. Ambient levels of particulate matter with an aerodynamic diameter less than 2.5 m (PM2.5), black carbon, nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide were measured continuously, with validation of concurrent real-time measurements of personal exposure to PM2.5 and carbon monoxide. Linear mixed-effects models were used with adjustment for individual risk factors, time-varying factors, and meteorologic effects. Significant heart rate variability reduction and blood pressure elevation were observed in association with exposure to air pollution. Specifically, interquartile-range increases of 51.8 g/m(3), 2.02 g/m(3), and 13.7 ppb in prior 4-hour exposure to PM2.5, black carbon, and nitrogen dioxide were associated with significant reductions in the standard deviation of the normal-to-normal intervals of 4.2 (95 confidence interval (CI): 1.9, 6.4), 4.2 (95 CI: 1.8, 6.6), and 3.9 (95 CI: 2.2, 5.7), respectively. Greater heart rate variability declines were observed among subjects with C-reactive protein values above the 90th percentile, subjects with a body mass index greater than 25, and females. The authors conclude that autonomic and vascular dysfunction may be one of the mechanisms through which air pollution exposure can increase cardiovascular disease risk, especially among persons with systemic inflammation and overweight.