From the Division of Epidemiology, Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA.
Department of Environmental Health, Boston University School of Public Health, Boston, MA.
Epidemiology. 2023 Mar 1;34(2):271-281. doi: 10.1097/EDE.0000000000001577. Epub 2023 Jan 31.
Evidence of associations between daily variation in air pollution and blood pressure (BP) is varied and few prior longitudinal studies adjusted for calendar time.
We studied 143,658 postmenopausal women 50 to 79 years of age from the Women's Health Initiative (1993-2005). We estimated daily atmospheric particulate matter (PM) (in three size fractions: PM2.5, PM2.5-10, and PM10) and nitrogen dioxide (NO2) concentrations at participants' residential addresses using validated lognormal kriging models. We used linear mixed-effects models to estimate the association between air pollution concentrations and repeated measures of systolic and diastolic BP (SBP, DBP) adjusting for confounders and calendar time.
Short-term PM2.5 and NO2 were each positively associated with DBP {0.10 mmHg [95% confidence interval (CI): 0.04, 0.15]; 0.13 mmHg (95% CI: 0.09, 0.18), respectively} for interquartile range changes in lag 3-5 day PM2.5 and NO2. Short-term NO2 was negatively associated with SBP [-0.21 mmHg (95%CI: -0.30, -0.13)]. In two-pollutant models, the NO2-DBP association was slightly stronger, but for PM2.5 was attenuated to null, compared with single-pollutant models. Associations between short-term NO2 and DBP were more pronounced among those with higher body mass index, lower neighborhood socioeconomic position, and diabetes. When long-term (annual) and lag 3-5 day PM2.5 were in the same model, associations with long-term PM2.5 were stronger than for lag 3-5 day.
We observed that short-term PM2.5 and NO2 levels were associated with increased DBP, although two-pollutant model results suggest NO2 was more likely responsible for observed associations. Long-term PM2.5 effects were larger than short-term.
空气污染日变化与血压（BP）之间关联的证据存在差异，且先前很少有纵向研究对日历时间进行了调整。
我们研究了来自妇女健康倡议（1993-2005 年）的 143658 名 50 至 79 岁的绝经后妇女。我们使用经过验证的对数正态克立格模型，估算了参与者居住地址的大气颗粒物（PM）（在三个粒径分数：PM2.5、PM2.5-10 和 PM10）和二氧化氮（NO2）浓度。我们使用线性混合效应模型，在调整混杂因素和日历时间的情况下，估计空气污染浓度与重复测量的收缩压和舒张压（SBP、DBP）之间的关联。
短期 PM2.5 和 NO2 浓度分别与 DBP 呈正相关{0.10mmHg[95%置信区间（CI）：0.04，0.15]；0.13mmHg（95%CI：0.09，0.18）}，滞后 3-5 天 PM2.5 和 NO2 的四分位距变化。短期 NO2 与 SBP 呈负相关[-0.21mmHg（95%CI：-0.30，-0.13）]。在双污染物模型中，NO2-DBP 关联略有增强，但与单污染物模型相比，PM2.5 关联减弱至无关联。短期 NO2 与 DBP 之间的关联在体重指数较高、邻里社会经济地位较低和糖尿病患者中更为明显。当长期（年度）和滞后 3-5 天 PM2.5 同时存在于同一模型中时，长期 PM2.5 的关联强于滞后 3-5 天。
我们观察到短期 PM2.5 和 NO2 水平与 DBP 升高有关，尽管双污染物模型结果表明，NO2 更有可能导致观察到的关联。长期 PM2.5 的影响大于短期 PM2.5。
