Particulate air pollution and effects on cardiovascular health in American Indian communities

项目概要/摘要 空气污染是心血管健康的一个关键环境决定因素，但大多数研究 在主要是白色的非农村人口中进行。阐明这种反应关系的证据- 船舶仅限于农村，美国印第安部落社区主要位于空气污染水平的地区 国家环境空气质量标准（NAAQS）。为了弥补这一研究空白，我们打算 将美国印第安人社区的环境细颗粒物（PM2.5）浓度与其他地区进行比较， 美国（US），并估计PM2.5与心血管疾病（CVD）之间的关联 在位于北方大平原（北/南达科他州）、南方大平原（俄克拉荷马州）的部落社区， 美国西南大学（亚利桑那州），利用NHLBI资助的强心研究（SHS）的数据 队列。我们将：1）估计对PM2.5总质量贡献最大的六种PM2.5成分的浓度 （硫酸盐，硝酸盐，铵，有机物，黑碳和灰尘）随着时间的推移， 与使用现有经过充分验证的、高度空间分辨率的卫星模型的美国其他县相比; 2） 评估长期暴露于a）总PM2.5和B）六种PM2.5成分与CVD事件的关联， 分别测量PM2.5暴露对任何事件CVD和特定CVD结果的影响（冠状动脉 心脏病（CHD）、心力衰竭、中风）; 3）评估总 PM2.5暴露对SHS中糖尿病状态的心血管事件的影响，并进行探索性分析 代谢综合征（MetS）的修饰，在满足五个条件中至少三个的SHS参与者中诊断， 条件：（1）高腰围，（2）高甘油三酯水平，（3）低HDL胆固醇，（4）高血压， （5）高空腹血糖。 估计美国邻近地区人工智能社区的环境PM2.5趋势，并量化PM2.5， 在SHS中对突发CVD风险的影响将有助于促进对环境健康负担的理解 面对社会弱势群体。我们的发现可用于促进循证预防 以及从地方到国家的各种规模的干预。这项工作可以帮助通知社区为基础的干预- 人工智能社区内的行动，以降低PM2.5水平，改善心血管健康结果和优先事项- 在NAAQS的未来迭代中实现公平代表性。

PROJECT SUMMARY/ABSTRACT Air pollution is a key environmental determinant of cardiovascular health, yet most studies have been conducted in predominantly white, non-rural populations. Evidence elucidating this exposure-response relation- ship is limited for rural, American Indian tribal communities primarily located in regions with air pollution levels below the current National Ambient Air Quality Standards (NAAQS). To address this research gap, we intend to compare ambient fine particulate matter (PM2.5) concentrations in American Indian communities to the rest of the United States (US) and estimate the associations between PM2.5 and incident cardiovascular disease (CVD) in tribal communities located in the Northern Great Plains (North/South Dakota), Southern Great Plains (Okla- homa), and American Southwest (Arizona), leveraging data from the NHLBI-funded Strong Heart Study (SHS) cohort. We will: 1) estimate concentrations of the six PM2.5 constituents contributing the most to total PM2.5 mass (sulfate, nitrate, ammonium, organic matter, black carbon, and dust) over time in largely AI-populated counties compared to other US counties using existing well-validated, highly spatially resolved satellite-based models; 2) evaluate the association of long-term exposure to a) total PM2.5 and b) six PM2.5 constituents with incident CVD, measuring the effect of PM2.5 exposure on any incident CVD and specific CVD outcomes separately (coronary heart disease (CHD), heart failure, stroke); 3) assess effect modification of the association between total PM2.5 exposure on incident CVD by diabetes status in the SHS and conduct an exploratory analysis of effect modification by metabolic syndrome (MetS), diagnosed in SHS participants who meet at least three of five con- ditions: (1) high waist circumference, (2) high triglyceride level, (3) low HDL cholesterol, (4) high blood pressure, and (5) high fasting blood glucose. Estimating ambient PM2.5 trends in AI communities across the contiguous US and quantifying PM2.5 ex- posure effects on incident CVD risk in the SHS will help advance understanding of environmental health burdens faced in socially disadvantaged communities. Our findings can be used to promote evidence-based prevention and intervention at various scales, from local to national. This work can help inform community-based interven- tions within AI communities to decrease PM2.5 levels and improve cardiovascular health outcomes and prioriti- zation of equitable representation in future iterations of NAAQS.