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家庭空气污染与血压、动脉僵硬度和中心血液动力学的测量。

Household air pollution and measures of blood pressure, arterial stiffness and central haemodynamics.

机构信息

Institute for Health and Social Policy, McGill University, Montreal, Canada.

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.

出版信息

Heart. 2018 Sep;104(18):1515-1521. doi: 10.1136/heartjnl-2017-312595. Epub 2018 Feb 9.

Abstract

OBJECTIVE

We evaluated the exposure-response associations between personal exposure to air pollution from biomass stoves and multiple vascular and haemodynamic parameters in rural Chinese women.

METHODS

We analysed the baseline information from a longitudinal study in southwestern China. Women's brachial and central blood pressure and pulse pressure, carotid-femoral pulse wave velocity and augmentation index, and their 48-hour personal exposures to fine particulate matter (PM) and black carbon were measured in summer and winter. We evaluated the associations between exposure to air pollution and haemodynamic parameters using mixed-effects regression models adjusted for known cardiovascular risk factors.

RESULTS

Women's (n=205, ages 27-86 years) exposures to PM and black carbon ranged from 14 µg/m to 1405 µg/m and 0.1-121.8 µg/m, respectively. Among women aged ≥50 years, increased PM exposure was associated with higher systolic (brachial: 3.5 mm Hg (P=0.05); central: 4.4 mm Hg (P=0.005)) and diastolic blood pressure (central: 1.3 mm Hg (P=0.10)), higher pulse pressure (peripheral: 2.5 mm Hg (P=0.05); central: 2.9 mm Hg (P=0.008)) and lower peripheral-central pulse pressure amplification (-0.007 (P=0.04)). Among younger women, the associations were inconsistent in the direction of effect and not statistically significant. Increased PM exposure was associated with no difference in pulse wave velocity and modestly higher augmentation index though the CI included zero (1.1%; 95% CI -0.2% to 2.4%). Similar associations were found for black carbon exposure.

CONCLUSIONS

Exposure to household air pollution was associated with higher blood pressure and central haemodynamics in older Chinese women, with no associations observed with pulse wave velocity.

摘要

目的

我们评估了中国农村女性个人暴露于生物质炉灶产生的空气污染与多种血管和血流动力学参数之间的暴露-反应关系。

方法

我们分析了中国西南部一项纵向研究的基线信息。在夏季和冬季测量了女性的肱动脉和中心血压及脉压、颈动脉-股动脉脉搏波速度和增强指数,以及她们 48 小时的细颗粒物(PM)和黑碳个人暴露量。我们使用混合效应回归模型,调整了已知的心血管危险因素,评估了空气污染暴露与血流动力学参数之间的关联。

结果

女性(n=205,年龄 27-86 岁)的 PM 和黑碳暴露范围分别为 14μg/m 至 1405μg/m 和 0.1-121.8μg/m。在≥50 岁的女性中,PM 暴露增加与收缩压(肱动脉:3.5mmHg(P=0.05);中心:4.4mmHg(P=0.005))和舒张压(中心:1.3mmHg(P=0.10))升高、脉压(外周:2.5mmHg(P=0.05);中心:2.9mmHg(P=0.008))升高和外周-中心脉压放大降低(-0.007(P=0.04))有关。在年轻女性中,效应方向的关联不一致,且无统计学意义。PM 暴露增加与脉搏波速度无差异相关,而增强指数略有升高,但置信区间包含零(1.1%;95%CI -0.2%至 2.4%)。黑碳暴露也存在类似的关联。

结论

家庭空气污染暴露与中国老年女性的血压和中心血流动力学升高有关,与脉搏波速度无关。

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