From the ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain.
Department of Epidemiology, Brown University School of Public Health, RI.
Epidemiology. 2019 Jul;30(4):492-500. doi: 10.1097/EDE.0000000000001014.
Evidence linking long-term exposure to particulate air pollution to blood pressure (BP) in high-income countries may not be transportable to low- and middle-income countries. We examined cross-sectional associations between ambient fine particulate matter (PM2.5) and black carbon (BC) with BP (systolic [SBP] and diastolic [DBP]) and prevalent hypertension in adults from 28 peri-urban villages near Hyderabad, India.
We studied 5531 participants from the Andhra Pradesh Children and Parents Study (18-84 years, 54% men). We measured BP (2010-2012) in the right arm and defined hypertension as SBP ≥130 mmHg and/or DBP ≥80 mmHg. We used land-use regression models to estimate annual average PM2.5 and BC at participant's residence. We applied linear and logistic nested mixed-effect models stratified by sex and adjusted by cooking fuel type to estimate associations between within-village PM2.5 or BC and health.
Mean (SD) PM2.5 was 33 µg/m (2.7) and BC was 2.5 µg/m (0.23). In women, a 1 µg/m increase in PM2.5 was associated with 1.4 mmHg higher SBP (95% confidence interval [CI]: 0.12, 2.7), 0.87 mmHg higher DBP (95% CI: -0.18, 1.9), and 4% higher odds of hypertension (95% CI: 0%, 9%). In men, associations with SBP (0.52 mmHg; 95% CI: -0.82, 1.8), DBP (0.41 mmHg; 95% CI: -0.69, 1.5), and hypertension (2% higher odds; 95% CI: -2%, 6%) were weaker. No associations were observed with BC.
We observed a positive association between ambient PM2.5 and BP and hypertension in women. Longitudinal studies in this region are needed to corroborate our findings.
在高收入国家，长期暴露于细颗粒物空气污染与血压（BP）之间的证据可能不适用于中低收入国家。我们研究了印度海得拉巴附近 28 个城郊村庄的成年人中，环境细颗粒物（PM2.5）和黑碳（BC）与 BP（收缩压[SBP]和舒张压[DBP]）和高血压流行之间的横断面关联。
我们研究了来自安得拉邦儿童和父母研究（18-84 岁，54%为男性）的 5531 名参与者。我们在右臂测量 BP（2010-2012 年），并将高血压定义为 SBP≥130mmHg 和/或 DBP≥80mmHg。我们使用土地利用回归模型来估计参与者居住地的年平均 PM2.5 和 BC。我们应用线性和逻辑嵌套混合效应模型，按性别分层，并按烹饪燃料类型进行调整，以估计村内 PM2.5 或 BC 与健康之间的关联。
平均（SD）PM2.5 为 33μg/m（2.7），BC 为 2.5μg/m（0.23）。在女性中，PM2.5 增加 1μg/m 与 SBP 升高 1.4mmHg（95%置信区间[CI]：0.12，2.7）、DBP 升高 0.87mmHg（95%CI：-0.18，1.9）和高血压的几率升高 4%（95%CI：0%，9%）相关。在男性中，与 SBP（0.52mmHg；95%CI：-0.82，1.8）、DBP（0.41mmHg；95%CI：-0.69，1.5）和高血压（几率增加 2%；95%CI：-2%，6%）的关联较弱。BC 与两者均无关联。
我们观察到环境 PM2.5 与 BP 和女性高血压之间存在正相关。该地区需要进行纵向研究来证实我们的发现。
