JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
School of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA.
J Hypertens. 2021 Apr 1;39(4):667-676. doi: 10.1097/HJH.0000000000002689.
The association between indoor air pollution resulting from household solid fuel use for heating and cooking with hypertension or blood pressure (BP) remains less clear. This study aims to rectify these knowledge gaps in a large Chinese population.
During 2005-2009, 44 007 individuals aged 35-70 years with complete information on household solid fuel use for cooking and heating were recruited from 279 urban and rural communities of 12 centers. Solid fuel referred to charcoal, coal, wood, agriculture crop, animal dung or shrub. Annual concentration of ambient atmospheric particulate matter that have a diameter of less than 2.5 μm for all communities was collected. Generalized linear mixed models using community as the random effect were performed to estimate the association with hypertension prevalence or BP after considering ambient atmospheric particulate matter that have a diameter of less than 2.5 μm and a comprehensive set of potential confounding factors at the individual and household level.
A total of 47.6 and 61.2% of participants used household solid fuel for heating and cooking, respectively. Solid fuel use for heating was not associated with an increase in hypertension prevalence (adjusted odds ratio = 1.08, 95% confident interval: 0.98, 1.20) or elevated SBP (0.62 mmHg, 95% confident interval: -0.24, 1.48). No association was found between solid fuel for cooking and hypertension or BP, and no additional risk was observed among participants who had both exposures to solid fuel for heating and cooking compared with those used for heating only.
The current large Chinese study revealed a statistically insignificant increase in the association between solid fuel use for heating and hypertension prevalence or BP. As this cross-sectional study has its inherent limitation on causality, findings from this study would have to be confirmed by prospective cohort studies.
家庭固体燃料用于取暖和烹饪导致的室内空气污染与高血压或血压（BP）之间的关联仍不太清楚。本研究旨在纠正中国大人群中存在的这些知识空白。
在 2005-2009 年期间，从 12 个中心的 279 个城乡社区中招募了 44007 名年龄在 35-70 岁之间、有完整烹饪和取暖用固体燃料使用信息的个体。固体燃料指的是木炭、煤、木材、农作物、动物粪便或灌木。收集了所有社区的直径小于 2.5μm 的环境大气颗粒物的年浓度。考虑到直径小于 2.5μm 的环境大气颗粒物以及个体和家庭层面的一系列潜在混杂因素，采用以社区为随机效应的广义线性混合模型来估计与高血压患病率或 BP 的关联。
共有 47.6%和 61.2%的参与者分别使用家庭固体燃料进行取暖和烹饪。固体燃料用于取暖与高血压患病率的增加无关（调整后的优势比=1.08，95%置信区间：0.98，1.20）或 SBP 升高（0.62mmHg，95%置信区间：-0.24，1.48）。固体燃料用于烹饪与高血压或 BP 之间也没有关联，与仅使用固体燃料取暖的参与者相比，同时暴露于固体燃料取暖和烹饪的参与者没有观察到额外的风险。
目前这项中国大型研究显示，固体燃料用于取暖与高血压患病率或 BP 之间的关联具有统计学上的不显著性增加。由于这项横断面研究对因果关系存在固有局限性，因此需要前瞻性队列研究来证实本研究的结果。
