Vulnerability to the Cardiovascular Effects of Ambient Heat in Six US Cities: Results from the Multi-Ethnic Study of Atherosclerosis (MESA).
Vulnerability to the Cardiovascular Effects of Ambient Heat in Six US Cities: Results from the Multi-Ethnic Study of Atherosclerosis (MESA).
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DOI：
10.1097/ede.0000000000000910
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发表时间：
2018-11
期刊：
影响因子：
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通讯作者：
Diez Roux AV
中科院分区：
文献类型：
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作者：
Gronlund CJ;Sheppard L;Adar SD;O'Neill MS;Auchincloss A;Madrigano J;Kaufman J;Diez Roux AV
随着气候变化，气温正在升高。与热有关的健康事件不成比例地影响某些亚群。然而，先前的研究往往缺乏关于个人健康、空调和社区压力源/保护的信息。为了评估1)热量（2天平均温度高于当地75个百分点）是否与心率增加和血压降低相关，控制年龄，时间，季节，每日臭氧和每日颗粒物（PM2.5）， 2)抗高血压药物使用，肾功能，空腹血糖，情感支持，空调拥有和使用，标准化差异植被指数，邻里安全，以及住宅特有的氮氧化物和PM2.5。在2000-2010年期间，对美国6个地区的动脉粥样硬化多种族研究的参与者进行了反复的健康和行为特征分析。这些因素与机场温度、空气质量以及卫星和调查得出的社区特征有关。我们采用固定效应设计，将健康结果回归到在第75百分位数处结的线性温度样条曲线上，每个特征的相互作用项，并对月份、年龄、PM2.5和臭氧进行调整。总的来说，热量与心率无关。然而，当温度升高2摄氏度时，收缩压（SBP）降低1.1 mmHg (95% CI: - 1.6, - 0.6)，舒张压降低0.3 mmHg （95% CI: - 0.6, - 0.1）。在不使用抗高血压药物的人群中，有中央空调的人与没有中央空调的人相比，热相关的收缩压降低量高出2.1 mmHg。在多次比较修正或敏感性分析后，其余修饰因子的置信区间很宽。室外热量与降低血压有关，心血管的脆弱性可能主要因中央空调的拥有量而异。
With climate change, temperatures are increasing. Heat-associated health events disproportionately affect certain subpopulations. However, prior research has often lacked information on individual-level health and air conditioning and neighborhood stressors/protections. To assess whether 1) heat (2-day mean temperature above local 75th percentiles) is associated with increased heart rate and decreased blood pressure, controlling for age, time, season, daily ozone, and daily particulate matter (PM2.5), and 2) associations differ by anti-hypertensive-medication use, renal function, fasting glucose, emotional support, air conditioning ownership and use, normalized difference vegetation index, neighborhood safety, and residence-specific oxides of nitrogen and PM2.5. Health and behavioral characteristics were obtained repeatedly on participants of the Multi-Ethnic Study of Atherosclerosis in six U.S. sites (2000–2010). These were linked with airport temperature, air quality, and satellite- and survey-derived neighborhood characteristics. We used a fixed-effects design, regressing health outcomes on linear temperature splines with knots at the 75th percentiles, interaction terms for each characteristic, and adjustment for month-of-year, age, PM2.5, and ozone. Overall, heat was not associated with heart rate. However, for a 2 degree-Celsius increase in heat, systolic blood pressure (SBP) decreased by 1.1 mmHg (95% CI: −1.6, −0.6) and diastolic by 0.3 mmHg (95% CI: −0.6, −0.1). Among non-users of anti-hypertensive medications, heat-associated decreases in SBP were 2.1 mmHg greater among individuals with central air conditioning vs. without. Confidence intervals around the remaining modifiers were wide after multiple-comparisons corrections or sensitivity analyses. Outdoor heat is associated with decreasing blood pressure, and cardiovascular vulnerability may vary primarily by ownership of central air conditioning.