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全球空气污染浓度极值下,大气细颗粒物暴露对短期血压的响应。

Short-Term Blood Pressure Responses to Ambient Fine Particulate Matter Exposures at the Extremes of Global Air Pollution Concentrations.

机构信息

Department of Occupational and Environmental Health, Peking University School of Public Health and First Hospital Peking University, Beijing, China.

Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.

出版信息

Am J Hypertens. 2018 Apr 13;31(5):590-599. doi: 10.1093/ajh/hpx216.

Abstract

BACKGROUND

Fine particulate matter (PM2.5) air pollution is a leading cause of global cardiovascular mortality. A key mechanism may be PM2.5-induced blood pressure (BP) elevations. Whether consistent prohypertensive responses persist across the breadth of worldwide pollution concentrations has never been investigated.

METHODS

We evaluated the hemodynamic impact of short-term exposures to ambient PM2.5 in harmonized studies of healthy normotensive adults (4 BP measurements per participant) living in both a highly polluted (Beijing) and clean (Michigan) location.

RESULTS

Prior 7-day outdoor-ambient and 24-hour personal-level PM2.5 concentration averages were much higher in Beijing (86.7 ± 52.1 and 52.4 ± 79.2 µg/m3) compared to Michigan (9.1 ± 1.8 and 12.2 ± 17.0 µg/m3). In Beijing (n = 73), increased outdoor-ambient exposures (per 10 µg/m3) during the prior 1-7 days were associated with significant elevations in diastolic BP (0.15-0.17 mm Hg). In overweight adults (body mass index ≥25 kg/m2), significant increases in both systolic (0.34-0.44 mm Hg) and diastolic (0.22-0.66 mm Hg) BP levels were observed. Prior 24-hour personal-level exposures also significantly increased BP (0.41/0.61 mm Hg) in overweight participants. Conversely, low PM2.5 concentrations in Michigan (n = 50), on average within Air Quality Guidelines, were not associated with BP elevations.

CONCLUSIONS

Our findings demonstrate that short-term exposures to ambient PM2.5 in a highly polluted environment can promote elevations in BP even among healthy adults. The fact that no adverse hemodynamic responses were observed in a clean location supports the key public health importance of international efforts to improve air quality as part of the global battle against hypertension.

摘要

背景

细颗粒物(PM2.5)空气污染是导致全球心血管死亡率的主要原因。一个关键机制可能是 PM2.5 引起的血压(BP)升高。在全球范围内,PM2.5 污染浓度范围内是否存在一致的升压反应尚未得到调查。

方法

我们评估了短期暴露于环境 PM2.5 对居住在高度污染(北京)和清洁(密歇根)地点的健康正常血压成年人(每个参与者 4 次血压测量)的血流动力学影响。

结果

与密歇根州(分别为 9.1 ± 1.8 和 12.2 ± 17.0 µg/m3)相比,北京(n = 73)的前 7 天室外环境和 24 小时个人水平 PM2.5 浓度平均值高得多(分别为 52.4 ± 79.2 µg/m3)。在北京,前 1-7 天的室外环境暴露量(每 10 µg/m3)增加与舒张压(0.15-0.17 mmHg)显著升高相关。在超重成年人(体重指数≥25 kg/m2)中,收缩压(0.34-0.44 mmHg)和舒张压(0.22-0.66 mmHg)水平均显著升高。超重参与者的前 24 小时个人水平暴露量也显著增加了 BP(0.41/0.61 mmHg)。相比之下,在平均处于空气质量指南范围内的密歇根州(n = 50),PM2.5 浓度低与 BP 升高无关。

结论

我们的研究结果表明,在高度污染的环境中,短期暴露于环境 PM2.5 甚至可以促进健康成年人的血压升高。在清洁的环境中没有观察到不良的血液动力学反应这一事实,支持了国际改善空气质量的努力作为全球对抗高血压斗争的一部分的重要公共卫生意义。

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