Residential proximity to major roadways and incident hypertension in post-menopausal women.
Residential proximity to major roadways and incident hypertension in post-menopausal women.
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DOI：
10.1016/j.envres.2015.08.002
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发表时间：
2015-10
影响因子：
8.3
通讯作者：
Wellenius GA
中科院分区：
文献类型：
--
作者：
Kingsley SL;Eliot MN;Whitsel EA;Wang Y;Coull BA;Hou L;Margolis HG;Margolis KL;Mu L;Wu WC;Johnson KC;Allison MA;Manson JE;Eaton CB;Wellenius GA
生活在主要道路附近与心血管疾病发病率和死亡率的风险增加有关，可能是由于暴露于与交通有关的空气和/或噪音污染水平升高。这种关联可能通过增加高血压事件的风险来介导，但以前的研究结果是不确定的。使用考克斯比例风险模型，我们检查了38,360名妇女健康倡议（WHI）临床试验队列参与者的主要道路附近的住宅和高血压事件，这些参与者在入组时没有高血压，随访时间中位数为7.9年。调整参与者的人口统计学和生活方式，试验参与，以及个人和社区社会经济地位的标志物，高血压事件的风险比为1.13（95%置信区间：1.00、1.28）、1.03（0.95，1.11），1.05（0.99，1.11）和1.05（1.00，1.10）分别适用于居住在距离最近主要道路≤50 m、>50-200 m、>200-400 m和>400-1000 m的参与者与距离最近主要道路>1000 m的参与者（ptrend=0.013）。这种关联在WHI研究区域有很大差异，居住在距离主要道路≤ 50米的妇女的风险比在西部为1.61（1.18，2.20），在东北部为1.51（1.22，1.87），在南部为0.89（0.70，1.14），在中西部为0.94（0.75，1.19）。在这个大型的全国性绝经后妇女队列中，住宅靠近主要道路与美国选定地区的高血压事件相关。如果有因果关系，这些结果表明住宅靠近主要道路，作为空气，噪音和其他交通相关污染的标志，可能是高血压的危险因素。
Living near major roadways has been associated with increased risk of cardiovascular morbidity and mortality, presumably from exposure to elevated levels of traffic-related air and/or noise pollution. This association may potentially be mediated through increased risk of incident hypertension, but results from prior studies are equivocal. Using Cox proportional hazards models we examined residential proximity to major roadways and incident hypertension among 38,360 participants of the Women's Health Initiative (WHI) Clinical Trial cohorts free of hypertension at enrollment and followed for a median of 7.9 years. Adjusting for participant demographics and lifestyle, trial participation, and markers of individual and neighborhood socioeconomic status, the hazard ratios for incident hypertension were 1.13 (95% CI: 1.00, 1.28), 1.03 (0.95, 1.11), 1.05 (0.99, 1.11), and 1.05 (1.00, 1.10) for participants living ≤50, >50-200, >200-400, and >400-1000 m versus >1000 m from the nearest major roadway, respectively (ptrend=0.013). This association varied substantially by WHI study region with hazard ratios for women living ≤50m from a major roadway of 1.61 (1.18, 2.20) in the West, 1.51 (1.22, 1.87) in the Northeast, 0.89 (0.70, 1.14) in the South, and 0.94 (0.75, 1.19) in the Midwest. In this large, national cohort of post-menopausal women, residential proximity to major roadways was associated with incident hypertension in selected regions of the U.S. If causal, these results suggest residential proximity to major roadways, as a marker for air, noise and other traffic-related pollution, may be a risk factor for hypertension.