Long-Term Exposure to Fine Particulate Matter and Cardiovascular Disease in China
Long-Term Exposure to Fine Particulate Matter and Cardiovascular Disease in China
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中国长期接触细颗粒物与心血管疾病
DOI：
10.1016/j.jacc.2019.12.031
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发表时间：
2020-02-25
影响因子：
24
通讯作者：
Gu, Dongfeng
中科院分区：
文献类型：
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作者：
Liang, Fengchao;Liu, Fangchao;Gu, Dongfeng
背景长期接触细颗粒物(PM2.5)对心血管疾病(CVD)的影响在中国和其他类似高水平的国家和地区暴露于高水平PM2.5的人群中是罕见的。目的本研究的目的是评估中国长期接触PM2.5对心血管疾病的风险。方法采用中国-PAR(中国动脉粥样硬化性心血管疾病风险预测)全国队列研究，纳入2000年未患心血管疾病的成年人116,972人。参与者被跟踪调查到2015年。在研究期间，1公里空间分辨率的卫星PM2.5浓度被用于暴露评估。结果中国-PAR监测点PM2.5年平均浓度为25.5~114.0 mg/m(3)。PM2.5值每增加10 mg/m(3)，心血管疾病发病率的多变量调整危险比为1.251(95%可信区间：1.220~1.283)，心血管疾病死亡率的多变量调整危险比为1.164(95%可信区间：1.117~1.213)。PM2.5水平越高，暴露PM2.5和心血管疾病风险的浓度-反应函数斜率越大。此外，老年居民、农村居民和从不吸烟的人更容易受到PM2.5暴露的不良影响。结论本研究提供了证据，表明长期接触PM2.5会增加中国患心血管疾病的风险。PM2.5水平越高，影响越明显。这些发现扩大了目前对严重空气污染对健康不利影响的认识，并突出了中国和其他中低收入国家改善空气质量的潜在心血管益处。(C)2020年，由美国心脏病学会基金会提供。
BACKGROUND Evidence of the effects of long-term fine particulate matter (PM2.5) exposure on cardiovascular diseases (CVDs) is rare for populations exposed to high levels of PM2.5 in China and in other countries with similarly high levels.OBJECTIVES The aim of this study was to assess the CVD risks associated with long-term exposure to PM2.5 in China.METHODS A nationwide cohort study, China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China), was used, with 116,972 adults without CVD in 2000 being included. Participants were followed until 2015. Satellitebased PM2.5 concentrations at 1-km spatial resolution during the study period were used for exposure assessment. A Cox proportional hazards model with time-varying exposures was used to estimate the CVD risks associated with PM2.5 exposure, adjusting for individual risk factors.RESULTS Annual mean concentrations of PM2.5 at the China-PAR sites ranged from 25.5 to 114.0 mg/m(3). For each 10 mg/m(3) increase in PM2.5 exposures, the multivariate-adjusted hazard ratio was 1.251 (95% confidence interval: 1.220 to 1.283) for CVD incidence and 1.164 (95% confidence interval: 1.117 to 1.213) for CVD mortality. The slopes of concentration-response functions of PM2.5 exposure and CVD risks were steeper at high PM2.5 levels. In addition, older residents, rural residents, and never smokers were more prone to adverse effects of PM2.5 exposure.CONCLUSIONS This study provides evidence that elevated long-term PM2.5 exposures lead to increased CVD risk in China. The effects are more pronounced at higher PM2.5 levels. These findings expand the current knowledge on adverse health effects of severe air pollution and highlight the potential cardiovascular benefits of air quality improvement in China and other low- and middle-income countries. (c) 2020 by the American College of Cardiology Foundation.