Zanobetti Antonella, Canner Marina Jacobson, Stone Peter H, Schwartz Joel, Sher David, Eagan-Bengston Elizabeth, Gates Karen A, Hartley L Howard, Suh Helen, Gold Diane R
Department of Environmental Health, Exposure Epidemiology and Risk Program, Harvard School of Public Health, 401 Park Dr, Landmark Center, Suite 415, PO Box 15698, Boston, Mass 02215, USA.
Circulation. 2004 Oct 12;110(15):2184-9. doi: 10.1161/01.CIR.0000143831.33243.D8. Epub 2004 Oct 4.
Multiple studies have demonstrated a consistent association between ambient particulate air pollution and increased risk of hospital admissions and deaths for cardiovascular causes. We investigated the associations between fine particulate pollution (PM2.5) and blood pressure during 631 repeated visits for cardiac rehabilitation in 62 Boston residents with cardiovascular disease.
Blood pressure, cardiac risk factor, and exercise data were abstracted from records of rehabilitation visits between 1999 and 2001. We applied mixed-effect models, controlling for body mass index, age, gender, number of visits, hour of day, and weather variables. For an increase from the 10th to the 90th percentile in mean PM2.5 level during the 5 days before the visit (10.5 microg/m3), there was a 2.8-mm Hg (95% CI, 0.1 to 5.5) increase in resting systolic, a 2.7-mm Hg (95% CI, 1.2 to 4.3) increase in resting diastolic, and a 2.7-mm Hg (95% CI, 1.0 to 4.5) increase in resting mean arterial blood pressure. The mean PM2.5 level during the 2 preceding days (13.9 microg/m3) was associated with a 7.0-mm Hg (95% CI, 2.3 to 12.1) increase in diastolic and a 4.7-mm Hg (95% CI, 0.5 to 9.1) increase in mean arterial blood pressure during exercise in persons with resting heart rate > or =70 bpm, but it was not associated with an increase in blood pressure during exercise in persons with heart rate <70 bpm.
In patients with preexisting cardiac disease, particle pollution may contribute to increased risk of cardiac morbidity and mortality through short-term increases in systemic arterial vascular narrowing, as manifested by increased peripheral blood pressure.
多项研究表明，环境空气中的颗粒物污染与因心血管疾病导致的住院和死亡风险增加之间存在持续关联。我们调查了62名患有心血管疾病的波士顿居民在631次心脏康复复诊期间，细颗粒物污染（PM2.5）与血压之间的关联。
从1999年至2001年的康复复诊记录中提取血压、心脏危险因素和运动数据。我们应用混合效应模型，对体重指数、年龄、性别、复诊次数、一天中的时间以及天气变量进行了控制。在复诊前5天，平均PM2.5水平从第10百分位数增加到第90百分位数（10.5微克/立方米）时，静息收缩压升高2.8毫米汞柱（95%可信区间，0.1至5.5），静息舒张压升高2.7毫米汞柱（95%可信区间，1.2至4.3），静息平均动脉血压升高2.7毫米汞柱（95%可信区间，1.0至4.5）。在前两天的平均PM2.5水平（13.9微克/立方米）与静息心率≥70次/分钟的人运动期间舒张压升高7.0毫米汞柱（95%可信区间，2.3至12.1）以及平均动脉血压升高4.7毫米汞柱（95%可信区间，0.5至9.1）相关，但与心率<70次/分钟的人运动期间血压升高无关。
在已有心脏病的患者中，颗粒物污染可能通过短期增加全身动脉血管狭窄（表现为外周血压升高），导致心脏发病和死亡风险增加。
