School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, No. 6 Ankang Road, Guian New Area, Guizhou 561113, China.
Chronic Disease Prevention and Cure Research Institute, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou 555004, China.
Sci Total Environ. 2024 Nov 20;952:175900. doi: 10.1016/j.scitotenv.2024.175900. Epub 2024 Aug 30.
The current evidence regarding the association between long-term exposure to ozone (O) and hypertension incidence is limited and inconclusive, particularly at low O concentrations. Therefore, our research aims to investigate the potential link between long-term O exposure and hypertension in a region with low pollution levels.
From 2010 to 2012, we conducted a cohort prospective study by recruiting nearly 10,000 attendees through multistage cluster random sampling in Guizhou Province, China. These individuals were followed up from 2016 to 2020, and 5563 cases were finally included in the analysis. We employed a high-resolution model with both temporal and spatial accuracy to estimate the maximum daily 8-h average O and utilized annual average O concentrations for three exposure periods (2009_10, 2007_10, 2005_10) as the exposure indicator. Time-dependent covariates Cox regression model was exerted to estimate the hazard ratios (HRs) of hypertension incidence. Generalized linear model was employed to assess the association between O and systolic, diastolic, pulse, and mean arterial pressure. The dose-response curve was explored using a restricted cubic spline function.
1213 hypertension incidents occurred during 39,001.80 person-years, with an incidence density of 31.10/1000 Person Years (PYs). The average O concentrations during the three exposure periods were 66.76 μg/m, 67.85 μg/m, and 67.21 μg/m, respectively. Per 1 μg/m increase in O exposure was associated with 11 % increase in the incidence of hypertension in the single-pollution model, and the association was more pronounced in Han, urban, and higher altitude areas. SBP, PP, and MAP were increased by 0.619 (95 % CI, 0.361-0.877) mm Hg, 0.477 (95 % CI, 0.275-0.679) mm Hg, 0.301 (95 % CI, 0.127-0.475) mm Hg, respectively. Furthermore, we observed a nonlinear exposure-response relationship between O and hypertension incidence.
Long-term exposure to low-level O exposure is associated with an increased risk of hypertension.
目前关于长期暴露于臭氧（O）与高血压发病率之间关联的证据有限且不一致，尤其是在低浓度 O 时。因此，我们的研究旨在调查在污染水平较低的地区长期暴露于 O 与高血压之间的潜在联系。
2010 年至 2012 年，我们通过在中国贵州省进行多阶段聚类随机抽样，招募了近 10000 名参与者，开展了一项队列前瞻性研究。这些个体从 2016 年至 2020 年进行了随访，最终纳入了 5563 例病例进行分析。我们采用具有时间和空间精度的高分辨率模型来估计最大日 8 小时平均 O 和利用三个暴露期（2009_10、2007_10、2005_10）的年平均 O 浓度作为暴露指标。使用时间依赖性协变量 Cox 回归模型来估计高血压发病率的风险比（HRs）。使用广义线性模型来评估 O 与收缩压、舒张压、脉搏和平均动脉压之间的关联。使用限制立方样条函数探索 O 与血压之间的剂量-反应曲线。
在 39001.80 人年中发生了 1213 例高血压事件，发病率密度为 31.10/1000 人年（PYs）。三个暴露期的平均 O 浓度分别为 66.76μg/m、67.85μg/m 和 67.21μg/m。在单污染模型中，O 暴露每增加 1μg/m，高血压发病率增加 11%，这种关联在汉族、城市和高海拔地区更为明显。SBP、PP 和 MAP 分别升高 0.619（95%CI，0.361-0.877）mmHg、0.477（95%CI，0.275-0.679）mmHg 和 0.301（95%CI，0.127-0.475）mmHg。此外，我们观察到 O 与高血压发病率之间存在非线性暴露-反应关系。
长期暴露于低水平 O 与高血压风险增加有关。
