Xia Xi, Chan Ka Hung, Kwok Timothy, Wu ShaoWei, Man Chung Ling, Ho Kin-Fai
Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, China; School of Public Health, Shaanxi University of Chinese Medicine, China; The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK; Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, UK.
Environ Res. 2024 Apr 15;247:118284. doi: 10.1016/j.envres.2024.118284. Epub 2024 Jan 20.
Ambient fine particulate matter (PM) is a leading environmental risk factor globally, and over half of the associated disease burden are caused by cardiovascular disease. Numerous randomized controlled trials (RCT) have investigated the short-term cardiovascular benefits of indoor air purifiers (IAPs), but major knowledge gaps remain on their longer-term benefits. In this 1-year, randomized, double-blinded, parallel controlled trial of 47 elderly (n = 24; n = 23) aged ≥70 years, true-purification reduced household PM levels by 28% and maintained lower exposure throughout the year compared to the sham-purification group. After 12 months of intervention, a significant reduction of diastolic blood pressure was found in the true-purification versus sham-purification group (-4.62 [95% CI: -7.28, -1.96] mmHg) compared to baseline measurement prior to the intervention, whereas systolic blood pressure showed directionally consistent but statistically non-significant effect (-2.49 [95% CI: -9.25, 4.28] mmHg). Qualitatively similar patterns of associations were observed for pulse pressure (-2.30 [95% CI: -6.57, 1.96] mmHg) and carotid intima-media thickness (-10.0% [95% CI: -24.8%, 4.7%]), but these were not statistically significant. Overall, we found suggestive evidence of cardiovascular benefits of long-term IAPs use, particularly on diastolic blood pressure. Evidence on other longer-term cardiovascular traits is less clear. Further trials with larger sample sizes and long-term follow-up are needed across diverse populations to evaluate the cardiovascular benefits of IAPs.
环境细颗粒物（PM）是全球主要的环境风险因素，与之相关的疾病负担有一半以上是由心血管疾病引起的。众多随机对照试验（RCT）研究了室内空气净化器（IAP）对心血管的短期益处，但在其长期益处方面仍存在重大知识空白。在这项针对47名年龄≥70岁老年人（n = 24；n = 23）的为期1年的随机、双盲、平行对照试验中，与假净化组相比，真正的净化使家庭PM水平降低了28%，并在全年保持较低的暴露水平。干预12个月后，与干预前的基线测量相比，真正净化组与假净化组相比舒张压显著降低（-4.62 [95%CI：-7.28，-1.96] mmHg），而收缩压显示出方向一致但无统计学意义的影响（-2.49 [95%CI：-9.25，4.28] mmHg）。脉压（-2.30 [95%CI：-6.57，1.96] mmHg）和颈动脉内膜中层厚度（-10.0% [95%CI：-24.8%，4.7%]）观察到定性相似的关联模式，但这些无统计学意义。总体而言，我们发现了长期使用IAP对心血管有益的提示性证据，特别是对舒张压。关于其他长期心血管特征的证据不太明确。需要在不同人群中进行更大样本量和长期随访的进一步试验，以评估IAP对心血管的益处。
