非裔美国人队列中的长期空气污染与血压：杰克逊心脏研究
Long-Term Air Pollution and Blood Pressure in an African American Cohort: the Jackson Heart Study.
作者信息
Weaver Anne M, Wang Yi, Wellenius Gregory A, Bidulescu Aurelian, Sims Mario, Vaidyanathan Ambarish, Hickson DeMarc A, Shimbo Daichi, Abdalla Marwah, Diaz Keith M, Seals Samantha R
机构信息
Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Chapel Hill, North Carolina; Department of Environmental Health, Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
Department of Environmental Health, Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
出版信息
Am J Prev Med. 2021 Mar;60(3):397-405. doi: 10.1016/j.amepre.2020.10.023. Epub 2021 Jan 19.
INTRODUCTION
African Americans are disproportionately affected by high blood pressure, which may be associated with exposure to air pollutants, such as fine particulate matter and ozone.
METHODS
Among African American Jackson Heart Study participants, this study examined associations between 1-year and 3-year mean fine particulate matter and ozone concentrations with prevalent and incident hypertension at Visits 1 (2000-2004, n=5,191) and 2 (2005-2008, n=4,105) using log binomial regression. Investigators examined associations with systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure using linear regression and hierarchical linear models, adjusting for sociodemographic, behavioral, and clinical characteristics. Analyses were conducted in 2017-2019.
RESULTS
No associations were observed between fine particulate matter or ozone concentration and prevalent or incident hypertension. In linear models, an IQR increase in 1-year ozone concentration was associated with 0.67 mmHg higher systolic blood pressure (95% CI=0.27, 1.06), 0.42 mmHg higher diastolic blood pressure (95% CI=0.20, 0.63), and 0.50 mmHg higher mean arterial pressure (95% CI=0.26, 0.74). In hierarchical models, fine particulate matter was inversely associated with systolic blood pressure (-0.72, 95% CI= -1.31, -0.13), diastolic blood pressure (-0.69, 95% CI= -1.02, -0.36), and mean arterial pressure (-0.71, 95% CI= -1.08, -0.33). Attenuated associations were observed with 1-year concentrations and at Visit 1.
CONCLUSIONS
Positive associations were observed between ozone and systolic blood pressure, diastolic blood pressure, and mean arterial pressure, and inverse associations between fine particulate matter and systolic blood pressure, diastolic blood pressure, and mean arterial pressure in an African American population with high (56%) prevalence of hypertension. Effect sizes were small and may not be clinically relevant.
引言
非裔美国人受高血压影响的比例过高，这可能与接触空气污染物有关，如细颗粒物和臭氧。
方法
在非裔美国人杰克逊心脏研究参与者中，本研究使用对数二项回归分析了在第1次访视（2000 - 2004年，n = 5191）和第2次访视（2005 - 2008年，n = 4105）时，1年和3年平均细颗粒物及臭氧浓度与高血压患病率和发病率之间的关联。研究人员使用线性回归和分层线性模型分析了与收缩压、舒张压、脉压和平均动脉压的关联，并对社会人口统计学、行为和临床特征进行了调整。分析于2017 - 2019年进行。
结果
未观察到细颗粒物或臭氧浓度与高血压患病率或发病率之间的关联。在线性模型中，1年臭氧浓度每增加一个四分位间距，收缩压升高0.67 mmHg（95%CI = 0.27, 1.06），舒张压升高0.42 mmHg（95%CI = 0.20, 0.63），平均动脉压升高0.50 mmHg（95%CI = 0.26, 0.74）。在分层模型中，细颗粒物与收缩压（-0.72, 95%CI = -1.31, -0.13）、舒张压（-0.69, 95%CI = -1.02, -0.36）和平均动脉压（-0.71, 95%CI = -1.08, -0.33）呈负相关。在第1次访视时以及与1年浓度的关联中观察到减弱的相关性。
结论
在高血压患病率较高（56%）的非裔美国人群中，观察到臭氧与收缩压、舒张压和平均动脉压之间呈正相关，细颗粒物与收缩压、舒张压和平均动脉压之间呈负相关。效应量较小，可能不具有临床相关性。
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