Circulation. 2010 Jun 1;121(21):2331-78. doi: 10.1161/CIR.0b013e3181dbece1. Epub 2010 May 10.
In 2004, the first American Heart Association scientific statement on "Air Pollution and Cardiovascular Disease" concluded that exposure to particulate matter (PM) air pollution contributes to cardiovascular morbidity and mortality. In the interim, numerous studies have expanded our understanding of this association and further elucidated the physiological and molecular mechanisms involved. The main objective of this updated American Heart Association scientific statement is to provide a comprehensive review of the new evidence linking PM exposure with cardiovascular disease, with a specific focus on highlighting the clinical implications for researchers and healthcare providers. The writing group also sought to provide expert consensus opinions on many aspects of the current state of science and updated suggestions for areas of future research. On the basis of the findings of this review, several new conclusions were reached, including the following: Exposure to PM <2.5 microm in diameter (PM(2.5)) over a few hours to weeks can trigger cardiovascular disease-related mortality and nonfatal events; longer-term exposure (eg, a few years) increases the risk for cardiovascular mortality to an even greater extent than exposures over a few days and reduces life expectancy within more highly exposed segments of the population by several months to a few years; reductions in PM levels are associated with decreases in cardiovascular mortality within a time frame as short as a few years; and many credible pathological mechanisms have been elucidated that lend biological plausibility to these findings. It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM(2.5) exposure and cardiovascular morbidity and mortality. This body of evidence has grown and been strengthened substantially since the first American Heart Association scientific statement was published. Finally, PM(2.5) exposure is deemed a modifiable factor that contributes to cardiovascular morbidity and mortality.
2004 年，美国心脏协会（AHA）发布了首份关于“空气污染与心血管疾病”的科学声明，该声明指出，颗粒物（PM）空气污染暴露会导致心血管发病率和死亡率上升。此后，大量研究进一步阐明了其中涉及的生理和分子机制，扩展了我们对这一关联的认识。本次更新的 AHA 科学声明的主要目标是全面审查新的证据，证明 PM 暴露与心血管疾病之间存在关联，并特别强调为研究人员和医疗保健提供者阐明这一关联的临床意义。该写作组还试图就当前科学状况的许多方面提供专家共识意见，并就未来研究领域提出更新建议。基于这项审查的结果，得出了一些新的结论，包括以下内容：在数小时至数周的时间内暴露于直径小于 2.5 微米的颗粒物（PM2.5）中可引发与心血管疾病相关的死亡率和非致命性事件；长期暴露（例如，数年）使心血管死亡率的风险增加，其程度甚于数天的暴露，并使人口中暴露程度较高的部分人群的预期寿命缩短数月至数年；在短短数年的时间内，PM 水平的降低与心血管死亡率的降低有关；许多可信的病理机制已经阐明，这些发现具有生物学合理性。写作组认为，整体证据支持 PM2.5暴露与心血管发病率和死亡率之间存在因果关系。自首次发布 AHA 科学声明以来，这方面的证据已经大量增加并得到了显著加强。最后，PM2.5暴露被认为是导致心血管发病率和死亡率的可改变因素。
