Yao Yao, Cao Kaixi, Zhang Kehan, Zhu Tinglong, Yue Dahai, Zhang Hao, Zhang Jim, Jin Xurui, Zeng Yi
Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, United States.
Front Cardiovasc Med. 2020 Nov 17;7:587222. doi: 10.3389/fcvm.2020.587222. eCollection 2020.
Prior studies suggested that residential proximity to major roadways was associated with increased risks of cardiovascular diseases in developed countries, for which one explanation is that road proximity could heighten the risks of hypertension. However, the association of residential distance to major roadways with hypertension is still unclear in low- and middle-income countries (LMICs) with levels of air pollution and socioeconomic development distinctively different from developed countries. We derived data from the eighth wave of the Chinese Longitudinal Healthy Longevity Survey, a nationwide prospective cohort. The present study included 12,881 individuals older than 65 years (mean age, 85.2 ± 11.7 years) with 55.8% of them being female. We ascertained the residential proximity to major roadways based on self-reports and hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg. We then used logistic regression to examine the association between residential distance to major roadways and hypertension. The odds ratios (ORs) of hypertension for participants living 50 to 100, 101 to 200, and ≥200 meters from major roads were 1.17 [95% confidence interval (95% CI) = 1.02-1.33], 1.21 (95% CI = 1.05-1.41), and 1.22 (95% CI = 1.10-1.34), respectively, compared to those living within 50 m ( < 0.001). Significant effects of modifications from socioeconomic status and accessibility to health care resources were observed (s for interaction < 0.05). Compared to living within 50 m from a major roadway, the ORs of hypertension for living ≥50 m were higher in manual/agricultural workers, low-education groups, participants without household ventilation, and participants lacking in health education and health care resources. We observed considerable variations across geographic regions with the association in question attenuating in Eastern China but remaining significant in other regions. Residential proximity to major roadways was associated with lower odds of hypertension among older adults in China. The utility of residential proximity to major roadways as a marker of increased risks of hypertension and cardiovascular diseases may need to be revisited in LMICs.
先前的研究表明,在发达国家,居住在主要道路附近与心血管疾病风险增加有关,一种解释是靠近道路可能会增加患高血压的风险。然而,在空气污染水平和社会经济发展与发达国家明显不同的低收入和中等收入国家(LMICs)中,居住距离主要道路与高血压之间的关联仍不明确。我们从中国纵向健康长寿调查的第八波数据中获取数据,这是一项全国性的前瞻性队列研究。本研究纳入了12881名65岁以上的个体(平均年龄85.2±11.7岁),其中55.8%为女性。我们根据自我报告确定了居住距离主要道路的远近,并将高血压定义为收缩压≥140毫米汞柱或舒张压≥90毫米汞柱。然后,我们使用逻辑回归分析来研究居住距离主要道路与高血压之间的关联。与居住在距离主要道路50米以内的参与者相比,居住在距离主要道路50至100米、101至200米以及≥200米的参与者患高血压的优势比(OR)分别为1.17[95%置信区间(95%CI)=1.02-1.33]、1.21(95%CI=1.05-1.41)和1.22(95%CI=1.10-1.34)(P<0.001)。观察到社会经济地位和获得医疗资源的情况对结果有显著的修正作用(交互作用P<0.05)。与居住在距离主要道路50米以内相比,居住在距离主要道路≥50米的体力劳动者/农业工人、低教育程度人群、没有家庭通风设备的参与者以及缺乏健康教育和医疗资源的参与者患高血压的OR更高。我们观察到不同地理区域存在相当大的差异,所讨论的这种关联在中国东部有所减弱,但在其他地区仍然显著。在中国,居住在主要道路附近与老年人患高血压的几率较低有关。在低收入和中等收入国家,居住在主要道路附近作为高血压和心血管疾病风险增加的一个标志的作用可能需要重新审视。