Reducing Particulate Matter-Associated Cardiovascular Health Effects for Seniors

减少颗粒物对老年人心血管健康的影响

• 批准号: 10207776
• 负责人: Robert Daniel Brook
• 金额: $ 54.12万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-06 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10207776
• 关键词: Accounting; Acute; Address; Adrenal Glands; Adult; Air; Air Pollution; Airborne Particulate Matter; American; Asia; Blood; Blood Pressure; Blood Vessels; Cardiovascular system; Cessation of life; Chronic; Clinical; Clinical Trials; Cross-Over Studies; Data; Diastolic blood pressure; Double-Blind Method; Effectiveness; Elderly; Environment; Event; Exposure to; Face; Filtration; Glucocorticoids; Grant; Guidelines; Hair; Health; Heart failure; Hospitalization; Hot Spot; Housing; Hydrocortisone; Hypertension; Incidence; Insulin Resistance; Intervention; Intervention Studies; Location; Long-Term Effects; Low income; Mediator of activation protein; Mineralocorticoids; Morbidity - disease rate; Myocardial Infarction; NIH Program Announcements; Outcome; Particulate; Particulate Matter; Pathway interactions; Population; Population Heterogeneity; Populations at Risk; Prevention strategy; Public Health; Randomized; Residential Facilities; Resolution; Rest; Risk; Risk Factors; Salivary; Steroids; Stroke; Time; Translating; Vulnerable Populations; World Health Organization; air filtration; cardiometabolism; cardiovascular health; cardiovascular risk factor; clinically relevant; cost; evidence base; fine particles; hemodynamics; hypothalamic-pituitary-adrenal axis; improved; indexing; indoor particulate matter; insight; insulin sensitivity; mortality; novel; novel strategies; pollutant; portability; primary endpoint; primary outcome; residence; scale up; secondary outcome; success; trend

Project Summary/Abstract Fine particulate matter <2.5 µm (PM2.5) air pollution is the fifth leading risk factor for mortality worldwide. Over 88 thousand deaths per year are attributable to PM2.5 in the US alone, with the largest portion from cardiovascular (CV) causes (myocardial infarctions, strokes, heart failure). Despite improvements across the US, PM2.5 remains above World Health Organization Air Quality Guidelines (<10 µg/m3) in numerous hot-spots (e.g., near roadways). Therefore, it is critical to develop feasible and effective personal strategies to protect “vulnerable” (urban/near-roadway) and “susceptible” (elderly) populations at risk from the harmful effects of PM2.5. Emerging trials have shown that portable indoor air filtration units (AFUs) with high-efficiency particulate arrestance filters can reduce PM2.5 exposures by 30-50% and improve CV health endpoints (e.g., BP, vascular function). Our recent clinical trial results confirm that even low PM2.5 levels pose significant risks to CV health and that portable indoor air filtration units (AFUs) represent a promising preventative strategy. However, no study has addressed whether exposure reductions and health improvements can be sustained over more clinically relevant periods of intervention (i.e., several weeks) which are required to plausibly yield decreases in actual CV events. In addition, the efficacy of the novel practical (i.e., less expensive and more feasible in real- world settings) approach of using a single AFU only in the bedroom to focus on reducing nocturnal PM2.5 exposure is currently unknown. This proposal seeks to conduct a randomized double-blind 3-way crossover intervention study (AFUs in 2 rooms vs. bedroom AFU use alone vs. sham filtration) in 50 adults living in a low-income senior residence impacted by roadway pollutants. Specific Aims are: (1) determine if long-term, 2-room AFU usage provides sustained reductions in PM2.5 exposure and persistent improvements in cardiometabolic outcomes; (2) determine if nocturnal PM2.5 exposure reduction alone improves cardiometabolic outcomes; and (3) demonstrate the key role of adrenal activation as a novel mechanism explaining PM2.5-induced cardiometabolic changes. Our proposal will help validate the benefits of novel strategies to employ AFUs in an elderly vulnerable population. Positive results would represent a key step in forming the evidence base required to promote more wide-scale AFU use; in the long term, given their low cost and burden, AFU use could be up- scaled to help protect diverse populations.

项目总结/文摘