Air pollution and risk of incident hypertension and diabetes in U.S. black women

空气污染与美国黑人女性患高血压和糖尿病的风险

• 批准号: 8184237
• 负责人: Patricia F Coogan
• 金额: $ 54.3万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8184237
• 关键词: Accounting; Acute; Affect; African American; Air; Air Pollutants; Air Pollution; Blood Pressure; Caliber; California; Canada; Cardiovascular Diseases; Cardiovascular system; Chronic; Cohort Studies; Coronary heart disease; Data; Databases; Development; Diabetes Mellitus; Disadvantaged; Disease; Event; Exposure to; Geographic Information Systems; Health; High Prevalence; Human; Hypertension; Incidence; Individual; Inflammation; Investigation; Life; Link; Location; Los Angeles; Measurement; Measures; Methods; Modeling; Monitor; Morbidity - disease rate; Neighborhoods; Nitrogen Dioxide; Noise; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Oxidative Stress; Oxides; Participant; Particulate Matter; Pathway interactions; Pollution; Population; Prevalence; Public Health; Public Policy; Questionnaires; Research; Resources; Risk; Risk Factors; Socioeconomic Status; Surveys; Techniques; Testing; Woman; Women' s Health; air quality regulation; base; cohort; cost; diabetes control; follow-up; insight; interest; land use; lifestyle factors; mortality; novel; pollutant; prospective; residence; trafficking

DESCRIPTION (provided by applicant): Air pollution increases the risk of acute cardiovascular events. Whether it contributes to the risk of hypertension and diabetes, chronic predisposing conditions to cardiovascular disease, is unknown. Hypertension and type 2 diabetes occur much more commonly among U.S. black women than white women, a discrepancy only partly explained by known risk factors. U.S. black women tend to live in neighborhoods with more air pollution than their white counterparts, regardless of socioeconomic status. With state-of-the-art methods, we propose to test the hypotheses that exposure to air pollution increases the risks of incident hypertension and type 2 diabetes in African American women. We will focus on particulate matter of d2.5 <g aerodynamic diameter (PM2.5) and traffic-related pollution as indicated by nitrogen dioxide (NO2) and oxide (NO). We will prospectively test the hypotheses in the Black Women's Health Study (BWHS), an ongoing cohort study of 59,000 U.S. black women. Detailed information on risk factors for disease, lifestyle factors, and disease endpoints was collected at baseline in 1995 and in biennial follow-up questionnaires. Preliminary findings based on Los Angeles participants indicate positive associations of the pollutants of interest with incident hypertension and diabetes, after control for personal and neighborhood socioeconomic status. We will estimate long-term exposure to PM2.5 concentrations based on a new U.S. data layer developed for Health Canada and provided to the study at no cost. We will use dispersion modeling to estimate traffic-related pollutants using the best indicators, NO and NO2. We will model traffic noise levels for the purpose of including noise as a potential confounder in the hypertension analyses. We will use the newly developed spatial cohort survival modeling technique to account for clustering of air pollutants at two geographic levels, regional and local. Exposure measures will be available for the entire BWHS cohort, which is geographically dispersed across the U.S. By the end of the 2007 follow-up cycle, 10,137 incident hypertension cases and 4861 incident type 2 diabetes cases had occurred in the BWHS, allowing for high statistical power. The BWHS cohort is particularly well suited to the study aims because it has high rates of hypertension and diabetes and high levels of exposure to air pollutants. The proposed study will be the first investigation of the effect of air pollution on incidence of hypertension, the first large-scale investigation its effect on incidence of diabetes, and the first study of air pollution effects specifically in African American women. The hypotheses are of critical public health importance, given the high and growing prevalence of hypertension and diabetes in the U.S., the disparity between incidence rates among U.S. black and white women, and the ubiquity of exposure to air pollution. Positive findings will inform public policy on air quality regulation, provide insight into a novel pathway whereby air pollution causes cardiovascular events, illuminate causes of racial disparities in hypertension and diabetes incidence, and spur research on effects of air pollutants on other diseases. PUBLIC HEALTH RELEVANCE: The proposed study will evaluate whether exposure to air pollution increases the risks of incident hypertension and type 2 diabetes in a cohort of 59,000 African American women from across the U.S. The study is of immense public health importance given the high prevalence of hypertension and diabetes, the disparity in the incidence between black and white women, and the ubiquity of exposure to air pollution. Positive findings will inform public policy on air quality regulation, illuminate causes of racial disparities in the incidence of hypertension, and diabetes provide pivotal insight into a novel pathway whereby air pollution causes cardiovascular events, and motivate additional research.

描述（由申请人提供）：空气污染会增加急性心血管事件的风险。它是否会增加高血压和糖尿病以及心血管疾病的慢性诱发因素的风险，目前尚不清楚。高血压和 2 型糖尿病在美国黑人女性中比白人女性更常见，这种差异只能部分由已知的危险因素解释。无论社会经济地位如何，美国黑人女性往往比白人女性生活在空气污染更严重的社区。我们建议采用最先进的方法来检验以下假设：接触空气污染会增加非裔美国女性患高血压和 2 型糖尿病的风险。我们将重点关注 d2.5 <g 空气动力学直径的颗粒物 (PM2.5) 以及以二氧化氮 (NO2) 和氧化物 (NO) 为代表的交通相关污染。我们将前瞻性地检验黑人女性健康研究 (BWHS) 中的假设，这是一项正在进行的针对 59,000 名美国黑人女性的队列研究。有关疾病风险因素、生活方式因素和疾病终点的详细信息是在 1995 年基线和每两年一次的随访调查问卷中收集的。基于洛杉矶参与者的初步研究结果表明，在控制个人和社区的社会经济状况后，目标污染物与高血压和糖尿病的发生呈正相关。我们将根据为加拿大卫生部开发并免费提供给研究的新的美国数据层来估计 PM2.5 浓度的长期暴露。我们将使用扩散模型，使用最佳指标 NO 和 NO2 来估算与交通相关的污染物。我们将对交通噪音水平进行建模，以便将噪音作为高血压分析中的潜在混杂因素。我们将使用新开发的空间群组生存建模技术来解释空气污染物在区域和地方两个地理层面的聚集。暴露测量将适用于地理上分散在美国各地的整个 BWHS 队列。到 2007 年随访周期结束时，BWHS 中已发生 10,137 例高血压病例和 4861 例 2 型糖尿病病例，从而具有较高的统计功效。 BWHS 队列特别适合该研究目标，因为该队列的高血压和糖尿病发病率较高，并且空气污染物暴露水平较高。拟议的研究将是第一个关于空气污染对高血压发病率影响的调查，第一个大规模调查其对糖尿病发病率的影响，也是第一个专门针对非裔美国女性的空气污染影响的研究。鉴于美国高血压和糖尿病的患病率很高且不断增长、美国黑人和白人女性发病率的差异以及空气污染的普遍存在，这些假设对于公共卫生至关重要。积极的研究结果将为空气质量监管的公共政策提供信息，深入了解空气污染导致心血管事件的新途径，阐明高血压和糖尿病发病率种族差异的原因，并促进空气污染物对其他疾病影响的研究。 公共健康相关性：拟议的研究将评估暴露于空气污染是否会增加美国各地 59,000 名非裔美国女性患高血压和 2 型糖尿病的风险。鉴于高血压和糖尿病的高患病率、黑人和白人女性之间的发病率差异以及空气污染的普遍存在，这项研究具有巨大的公共卫生重要性。积极的研究结果将为空气质量监管的公共政策提供信息，阐明高血压和糖尿病发病率种族差异的原因，为空气污染导致心血管事件的新途径提供关键的见解，并激发更多的研究。