Lawlor Debbie A, Smith George Davey, Mitchell Richard, Ebrahim Shah
Department of Social Medicine, University of Bristol, Bristol, UK.
Am J Epidemiol. 2006 Apr 1;163(7):608-14. doi: 10.1093/aje/kwj085. Epub 2006 Feb 8.
The authors hypothesized that individuals born in the early 20th century who experienced the hottest and driest summers during infancy would be more likely to have suffered severe infant diarrhea and dehydration, and consequently have had higher blood pressure in adulthood, than those who experienced cooler and wetter summers. In this context, these climate data act as an instrumental variable for the association of early-life dehydration with later blood pressure. For 3,964 randomly selected British women born between 1919 and 1940 and whose blood pressure was measured at age 60-79 years, a one standard deviation (1.3 degrees C) higher mean summer temperature in the first year of life was associated with a 1.12-mmHg (95% confidence interval: 0.33, 1.91) higher adult systolic blood pressure, and a one standard deviation higher mean summer rainfall (33.9 mm) was associated with lower systolic blood pressure (-1.65 mmHg, 95% confidence interval: -2.44, -0.85). Equivalent results for diastolic blood pressure were 0.11 (95% confidence interval: -0.65, 0.86) and -0.32 (95% confidence interval: -0.71, 0.05). The climate variables were not associated with potential confounding factors such as socioeconomic position or lifestyle risk factors. These findings provide some evidence in favor of the hypothesis that dehydration in infancy is associated with higher adult blood pressure.
作者们推测,20世纪初出生的个体中,婴儿期经历过最炎热、最干燥夏季的人比经历过更凉爽、更湿润夏季的人更有可能遭受严重的婴儿腹泻和脱水,因此成年后血压更高。在此背景下,这些气候数据充当了早期脱水与后期血压之间关联的工具变量。对于随机选取的3964名出生于1919年至1940年之间、60至79岁时测量过血压的英国女性,生命第一年夏季平均温度每升高一个标准差(1.3摄氏度),成年收缩压就会升高1.12 mmHg(95%置信区间:0.33,1.91),夏季平均降雨量每升高一个标准差(33.9毫米),收缩压就会降低(-1.65 mmHg,95%置信区间:-2.44,-0.85)。舒张压的等效结果分别为0.11(95%置信区间:-0.65,0.86)和-0.32(95%置信区间:-0.71,0.05)。气候变量与社会经济地位或生活方式风险因素等潜在混杂因素无关。这些发现为婴儿期脱水与成年后高血压有关这一假说提供了一些证据。