Independent and Opposing Associations of Habitual Exercise and Chronic PM2.5Exposures on Hypertension Incidence
Independent and Opposing Associations of Habitual Exercise and Chronic PM2.5Exposures on Hypertension Incidence
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DOI：
10.1161/circulationaha.120.045915
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发表时间：
2020-08-18
期刊：
影响因子：
37.8
通讯作者：
Lao, Xiang Qian
中科院分区：
文献类型：
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作者：
Guo, Cui;Zeng, Yiqian;Lao, Xiang Qian
背景资料：我们在台湾的一个纵向队列中调查了习惯性体力活动（PA）和长期暴露于细颗粒物（PM2.5）与高血压发展的联合关系。研究方法：我们选择了140072名没有高血压的成年人（≥ 18岁），他们在2001年至2016年期间参加了标准的医学筛查计划，进行了360905次医学检查。PM（2.5）暴露估计在每个参与者的地址使用卫星数据为基础的时空模型与1公里（2）的分辨率。使用标准的自填问卷收集关于习惯性PA和广泛的协变量的信息。我们使用具有时间依赖性协变量的考克斯回归模型来检查联合关联。结果：所有观察对象的平均年龄为41.7岁，48.8%为男性。收缩压和舒张压的平均值分别为112.5和68.7 mm Hg。在所有观察结果中，约34.2%为非活动性（0代谢当量值-小时），29.8%为中度PA（中位数[四分位距]; 3.75 [3.38 - 4.38]代谢当量值-小时），36.0%为高PA（15.7 [10.3 - 24.8]代谢当量值-小时）。PM（2.5）的平均+/- SD为26.1 +/- 7.3 μ g/m（3）。心血管疾病、糖尿病和癌症的患病率分别为2.1%、2.9%和1.5%。在对广泛的协变量进行调整后，（包括PA或PM2.5的相互调整），较高的PA水平与较低的高血压风险相关（与无活性PA相比，中度和高度PA的风险比[HR]分别为0.93 [95% CI，0.89-0.97]和0.92 [95% CI，0.88-0.96]），而较高水平的PM（2.5）与较高的高血压风险相关（与低PM（2.5）组相比，中度和高PM（2.5）组的HR分别为1.37 [95%CI，1.32-1.43]和1.92 [95%CI，1.81-2.04]）。PA和PM2.5之间未观察到显著相互作用（HR 1.01 [95% CI，1.00-1.02]）。结论：高PA和低PM（2.5）暴露与高血压风险降低相关。PA与高血压之间的负相关性在暴露于不同浓度PM2.5的人群中保持稳定，而PM（2.5）与高血压之间的正相关性不受PA的影响。我们的研究结果表明，PA是一个合适的高血压预防策略，居住在相对污染的地区。
Background: We investigated the joint associations of habitual physical activity (PA) and long-term exposure to fine particulate matter (PM2.5) with the development of hypertension in a longitudinal cohort in Taiwan. Methods: We selected 140 072 adults (>= 18 years of age) without hypertension who joined a standard medical screening program with 360 905 medical examinations between 2001 and 2016. PM(2.5)exposure was estimated at each participant's address using a satellite data-based spatiotemporal model with 1 km(2)resolution. Information on habitual PA and a wide range of covariates was collected using a standard self-administered questionnaire. We used the Cox regression model with time-dependent covariates to examine the joint associations. Results: The mean age of all observations was 41.7 years, and 48.8% were male. The mean value for systolic and diastolic blood pressure was 112.5 and 68.7mm Hg, respectively. Approximately 34.2% of all observations were inactive (0 metabolic equivalence values-hours), 29.8% had moderate-PA (median [interquartile range]; 3.75 [3.38 to 4.38] metabolic equivalence values-hours), and 36.0% had high-PA (15.7 [10.3 to 24.8] metabolic equivalence values-hours). The mean +/- SD of PM(2.5)was 26.1 +/- 7.3 mu g/m(3). The prevalence of cardiovascular disease, diabetes mellitus, and cancer was 2.1%, 2.9%, and 1.5%, respectively. After adjusting for a wide range of covariates (including a mutual adjustment for PA or PM2.5), a higher PA level was associated with a lower risk of hypertension (hazard ratio [HR] for the moderate- and high-PA was 0.93 [95% CI, 0.89-0.97] and 0.92 [95% CI, 0.88-0.96], respectively, as compared with the inactive-PA), whereas a higher level of PM(2.5)was associated with a higher risk of hypertension (HR for the moderate- and high-PM(2.5)was 1.37 [95% CI, 1.32-1.43] and 1.92 [95% CI, 1.81-2.04], respectively, as compared with the low-PM(2.5)group]. No significant interaction was observed between PA and PM2.5(HR 1.01 [95% CI, 1.00-1.02]). Conclusions: A high-PA and low PM(2.5)exposure were associated with a lower risk of hypertension. The negative association between PA and hypertension remained stable in people exposed to various levels of PM2.5, and the positive association between PM(2.5)and hypertension was not modified by PA. Our results indicated that PA is a suitable hypertension prevention strategy for people residing in relatively polluted regions.