Long-term exposure to outdoor and household air pollution and blood pressure in the Prospective Urban and Rural Epidemiological (PURE) study.
Long-term exposure to outdoor and household air pollution and blood pressure in the Prospective Urban and Rural Epidemiological (PURE) study.
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DOI：
10.1016/j.envpol.2020.114197
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发表时间：
2020-07
期刊：
影响因子：
--
通讯作者：
Hystad P
中科院分区：
文献类型：
--
作者：
Arku RE;Brauer M;Ahmed SH;AlHabib KF;Avezum Á;Bo J;Choudhury T;Dans AM;Gupta R;Iqbal R;Ismail N;Kelishadi R;Khatib R;Koon T;Kumar R;Lanas F;Lear SA;Wei L;Lopez-Jaramillo P;Mohan V;Poirier P;Puoane T;Rangarajan S;Rosengren A;Soman B;Caklili OT;Yang S;Yeates K;Yin L;Yusoff K;Zatoński T;Yusuf S;Hystad P
暴露在空气污染中与血压升高和高血压有关，但大多数研究都集中在相对低浓度的短期(几小时、几天或几个月)暴露。在前瞻性的城乡流行病学研究中，我们研究了室外PM2.5的长期浓度(3年平均值)与使用固体燃料烹饪产生的家庭空气污染(HAP)和高血压之间的关系。使用卫星和地面方法对来自21个国家和地区的640个城市和农村社区的137,809名年龄在35-70岁的成年人在登记当年的室外PM2.5暴露进行了估计。使用主要用于烹饪的固体燃料作为接触HAP的指标，分析仅限于10个国家27个研究中心的农村参与者(n=43,313)。在调整了一系列潜在的混杂因素后，按照标准化的程序测量了血压，并用混合效应回归模型检验了与空气污染的相关性。在研究社区中，室外PM2.5的基线暴露范围为3至97μg/m~3，与PM2.5中每增加10μg/m~3的高血压的优势比(OR)增加1.04(95%CI：1.01，1.07)相关。这种关联表现出非线性，与第一个四分位数(PM2.5和lt；14μg/m 3)相比，第四个四分位数(PM2.5和gt；62μg/m~3)的相关性最强(OR=1.36，95%CI：1.10，1.69)。血压(β=2.15，95%CI：−0.5 9，4.89)、舒张压(β=1.35，95%CI：−0.2 0，2.89)也有相似的非线性模式，而在整个暴露分布中，OR值没有总体增加。使用固体燃料做饭的个体的血压测量低于清洁燃料使用者(例如，34%的固体燃料使用者患有高血压，而42%的清洁燃料使用者患有高血压)，即使在完全调整的模型中，高血压的风险也略有降低(OR=0.93；95%CI：0.88，0.99)，以及收缩压(−0.51 mm Hg；95%CI：−0.99，−0.03)和舒张压(−0.46 mm Hg；95%CI：−0.75，−0.18)BP的降低。在这项大型国际多中心研究中，长期暴露于室外PM2.5与血压升高和高血压有关，而与HAP呈负相关。
Exposure to air pollution has been linked to elevated blood pressure (BP) and hypertension, but most research has focused on short-term (hours, days, or months) exposures at relatively low concentrations. We examined the associations between long-term (a 3-year average) concentrations of outdoor PM2.5 and household air pollution (HAP) from cooking with solid fuels with BP and hypertension in the Prospective Urban and Rural Epidemiology (PURE) study. Outdoor PM2.5 exposures were estimated at year of enrollment for 137,809 adults aged 35-70 years from 640 urban and rural communities in 21 countries using satellite and ground-based methods. Primary use of solid fuel for cooking was used as an indicator of HAP exposure, with analyses restricted to rural participants (n= 43,313) in 27 study centers in 10 countries. BP was measured following a standardized procedure and associations with air pollution examined with mixed-effect regression models, after adjustment for a comprehensive set of potential confounding factors. Baseline outdoor PM2.5 exposure ranged from 3 to 97 μg/m3 across study communities and was associated with an increased odds ratio (OR) of 1.04 (95% CI: 1.01, 1.07) for hypertension, per 10 μg/m3 increase in PM2.5. This association demonstrated non-linearity and was strongest for the fourth (PM2.5 > 62 μg/m3) compared to the first (PM2.5 < 14 μg/m3) quartiles (OR=1.36, 95% CI: 1.10, 1.69). Similar non-linear patterns were observed for SBP (β=2.15, 95% CI: −0.59, 4.89), DBP (β=1.35, 95% CI: −0.20, 2.89) while there was no overall increase in ORs across the full exposure distribution. Individuals who used solid fuels for cooking had lower BP measures compared to clean fuel users (e.g. 34% of solid fuels users compared to 42% of clean fuel users had hypertension), and even in fully adjusted models had slightly decreased odds of hypertension (OR = 0.93; 95% CI: 0.88, 0.99) and reductions in systolic (−0.51 mmHg; 95% CI: −0.99, −0.03) and diastolic (−0.46 mmHg; 95% CI: −0.75, −0.18) BP. In this large international multi-center study, chronic exposures to outdoor PM2.5 was associated with increased BP and hypertension while there were small inverse associations with HAP.
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影响因子：
10.4
作者：
Burnett RT;Pope CA 3rd;Ezzati M;Olives C;Lim SS;Mehta S;Shin HH;Singh G;Hubbell B;Brauer M;Anderson HR;Smith KR;Balmes JR;Bruce NG;Kan H;Laden F;Prüss-Ustün A;Turner MC;Gapstur SM;Diver WR;Cohen A
通讯作者：
Cohen A
影响因子：
10.4
作者：
Baumgartner J;Schauer JJ;Ezzati M;Lu L;Cheng C;Patz JA;Bautista LE
通讯作者：
Bautista LE
影响因子：
5.1
作者：
Alexander, Donee;Larson, Timothy;Vedal, Sverre
通讯作者：
Vedal, Sverre
影响因子：
8.3
作者：
Honda T;Pun VC;Manjourides J;Suh H
通讯作者：
Suh H
影响因子：
4.8
作者：
GREEN, MS;JUCHA, E;LUZ, Y
通讯作者：
LUZ, Y