Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-Si, Korea.
Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-Si, Korea.
J Am Heart Assoc. 2017 Nov 8;6(11):e007170. doi: 10.1161/JAHA.117.007170.
Studies have shown that long-term exposure to air pollution such as fine particulate matter (≤2.5 μm in aerodynamic diameter [PM]) increases the risk of all-cause and cardiovascular mortality. To date, however, there are limited data on the impact of air pollution on specific cardiovascular diseases. This study aimed to evaluate cardiovascular effects of long-term exposure to air pollution among residents of Seoul, Korea.
Healthy participants with no previous history of cardiovascular disease were evaluated between 2007 and 2013. Exposure to air pollutants was estimated by linking the location of outdoor monitors to the ZIP code of each participant's residence. Crude and adjusted analyses were performed using Cox regression models to evaluate the risk for composite cardiovascular events including cardiovascular mortality, acute myocardial infarction, congestive heart failure, and stroke. A total of 136 094 participants were followed for a median of 7.0 years (900 845 person-years). The risk of major cardiovascular events increased with higher mean concentrations of PM in a linear relationship, with a hazard ratio of 1.36 (95% confidence interval, 1.29-1.43) per 1 μg/m PM. Other pollutants including PM of CO, SO, and NO, but not O, were significantly associated with increased risk of cardiovascular events. The burden from air pollution was comparable to that from hypertension and diabetes mellitus.
This large-scale population-based study demonstrated that long-term exposure to air pollution including PM increases the risk of major cardiovascular disease and mortality. Air pollution should be considered an important modifiable environmental cardiovascular risk factor.
研究表明，长期暴露于空气污染（如细颗粒物[PM]，空气动力学直径≤2.5μm）会增加全因和心血管疾病死亡率的风险。然而，迄今为止，关于空气污染对特定心血管疾病影响的数据有限。本研究旨在评估韩国首尔居民长期暴露于空气污染对心血管的影响。
2007 年至 2013 年期间，评估了无心血管疾病既往史的健康参与者。通过将户外监测器的位置与每位参与者居住地的邮政编码相联系，来估算空气污染物的暴露量。使用 Cox 回归模型进行了粗分析和调整分析，以评估包括心血管疾病死亡率、急性心肌梗死、充血性心力衰竭和中风在内的复合心血管事件的风险。共有 136094 名参与者随访中位数为 7.0 年（900845 人年）。主要心血管事件的风险随着 PM 平均浓度的升高呈线性增加，PM 每增加 1μg/m，风险比为 1.36（95%置信区间，1.29-1.43）。包括 PM、CO、SO 和 NO 在内的其他污染物，但 O 除外，与心血管事件风险增加显著相关。空气污染的负担与高血压和糖尿病相当。
这项大规模的基于人群的研究表明，长期暴露于包括 PM 在内的空气污染会增加主要心血管疾病和死亡率的风险。空气污染应被视为一个重要的可改变的心血管环境风险因素。
