State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China.
Int J Environ Health Res. 2021 Sep;31(6):729-740. doi: 10.1080/09603123.2019.1682528. Epub 2019 Oct 24.
Hypertension is currently one of the most common chronic diseases with high global prevalence associated with a huge social and economic burden. In recent years, air pollution has become a focus of research, especially the effects of PM2.5 on hypertension. However, few studies have considered the spatial properties of the sample; thus, the results might be unreliable. Based on the China Health and Retirement Longitudinal Study (CHARLS) and the Environmental Status Bulletin for each province in China, we used the extended shared component model (SCM) to fit the spatial variation of hypertension risk and to reveal the impact of PM2.5 on hypertension in males and females. Our results revealed that the crude prevalence of hypertension for the whole population in China was 32.74% in 2015, with the prevalence in men experiencing slightly higher than that in women (32.92% vs. 32.58%). We found that the distribution of hypertension prevalence exhibited obvious spatial aggregation for the whole population in China (Moran's I = 0.39, = 0.001), with similar results in both men (Moran's I = 0.18, = 0.027) and women (Moran's I = 0.52, = 0.001). Furthermore, the smoothed results obtained using the SCM indicated that some eastern and central provinces had relatively higher hypertension risk, while the risk in southeastern provinces was much lower. The risk was also relatively lower in most western provinces, except for some northwestern regions. Notably, our results showed that PM2.5 was a risk factor for hypertension, and the impact of PM2.5 on women was slightly greater than that on men, with odds ratios (OR) of 1.063 (1.041, 1.086) and 1.048 (1.025, 1.071), respectively. Our findings suggest the existence of distinct spatial differences in the prevalence of hypertension and small sex-related differences in the risk of hypertension in China.
高血压是目前最常见的慢性病之一，具有很高的全球患病率，给社会和经济带来了巨大的负担。近年来，空气污染已成为研究的焦点，尤其是 PM2.5 对高血压的影响。然而，很少有研究考虑到样本的空间属性，因此结果可能不可靠。基于中国健康与养老追踪调查（CHARLS）和中国各省环境状况公报，我们使用扩展共享分量模型（SCM）拟合高血压风险的空间变化，并揭示 PM2.5 对男性和女性高血压的影响。结果显示，2015 年中国全人群高血压粗患病率为 32.74%，男性略高于女性（32.92%比 32.58%）。我们发现，中国全人群高血压患病率的分布存在明显的空间聚集（Moran's I = 0.39， = 0.001），男性（Moran's I = 0.18， = 0.027）和女性（Moran's I = 0.52， = 0.001）的结果相似。此外，SCM 的平滑结果表明，一些东部和中部省份的高血压风险相对较高，而东南部省份的风险则较低。西部大部分省份的风险也相对较低，但西北地区除外。值得注意的是，我们的结果表明 PM2.5 是高血压的一个危险因素，而且 PM2.5 对女性的影响略大于男性，比值比（OR）分别为 1.063（1.041，1.086）和 1.048（1.025，1.071）。这些发现表明，中国高血压的流行存在明显的空间差异，高血压的风险在性别上存在较小的差异。
