Zheng Xialei, Zou Pu, Zeng Cheng, Liu Jing, He Yuhu
Department of Cardiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
J Hypertens. 2025 Jan 1;43(1):136-144. doi: 10.1097/HJH.0000000000003878. Epub 2024 Sep 12.
Individuals are exposed to various volatile organic compounds (VOCs) in their surroundings. VOCs were associated with some cardiovascular and metabolic diseases, but the effects on blood pressure (BP) have not yet been clarified. This study aimed to ascertain the relationship between the urine levels of VOCs and the prevalence of hypertension (HTN) in the general population.
This analysis utilized data from 4156 participants aged from 20 to 79 years in 2013-2018 National Health and Nutrition Examination Survey (NHANES). Exposure to VOCs was assessed through measurements of urinary VOC metabolites, with 16 VOCs selected for analysis. The relationships between VOCs and the risk of HTN in patients were examined through the weighted logistic regression and the weighted linear regression models. Generalized additive models were employed to analyze potential nonlinear associations between VOCs and the risk of HTN. Additionally, subgroup analyses and intergroup interaction tests were conducted.
A total of 4156 participants with 16 VOCs were finally included for analysis. Multivariable logistic regression showed that ln-transformed urine levels of N -acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) [odds ratio (OR) 1.54; 95% confidence interval (CI) 1.18-2.02], N -acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA; OR 1.33; 95% CI 1.03-1.74), N -acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MHBMA3; OR 1.68; 95% CI 1.29-2.20), and N -acetyl-S-(1-phenyl-2-hydroxyethyl)-L-cysteine + N -acetyl-S-(2-phenyl-2-hydroxyethyl)-L-cysteine (PHEMA; OR 1.55; 95% CI 1.19-2.00) were significantly associated with an increased risk of HTN in US general population. A nonlinear relationship and a threshold effect were only observed between ln ( N -acetyl-S-(2-hydroxypropyl)-L-cysteine or 2HPMA) and HTN. There was a significantly positive correlation between ln(2HPMA) and HTN when ln(2HPMA) at least 5.29. Sub-analysis revealed that there was a more pronounced association in the elderly group (age ≥60 years), the overweight group (BMI ≥25), and the alcohol consumption group.
Our work presents novel epidemiological evidence supporting the establishment of the relationship between environmental pollutants and HTN, highlighting hitherto ignored positive correlations between nonoccupational VOC exposure and the entire population's risk of HTN.
个体在其周围环境中会接触到各种挥发性有机化合物（VOCs）。VOCs与一些心血管和代谢疾病有关，但对血压（BP）的影响尚未明确。本研究旨在确定普通人群中VOCs的尿液水平与高血压（HTN）患病率之间的关系。
本分析利用了2013 - 2018年美国国家健康与营养检查调查（NHANES）中4156名年龄在20至79岁之间参与者的数据。通过测量尿液VOC代谢物来评估VOCs暴露情况，选择了16种VOCs进行分析。通过加权逻辑回归和加权线性回归模型检查VOCs与患者HTN风险之间的关系。采用广义相加模型分析VOCs与HTN风险之间潜在的非线性关联。此外，还进行了亚组分析和组间交互检验。
最终纳入4156名参与者的16种VOCs数据进行分析。多变量逻辑回归显示，N - 乙酰 - S -（2 - 氰基乙基）- L - 半胱氨酸（CYMA）的自然对数转换后的尿液水平[比值比（OR）1.54；95%置信区间（CI）1.18 - 2.02]、N - 乙酰 - S -（3 - 羟丙基）- L - 半胱氨酸（3HPMA；OR 1.33；95% CI 1.03 - 1.74）、N - 乙酰 - S -（4 - 羟基 - 2 - 丁烯基）- L - 半胱氨酸（MHBMA3；OR 1.68；95% CI 1.29 - 2.20）以及N - 乙酰 - S -（1 - 苯基 - 2 - 羟乙基）- L - 半胱氨酸 + N - 乙酰 - S -（2 - 苯基 - 2 - 羟乙基）- L - 半胱氨酸（PHEMA；OR 1.55；95% CI 1.19 - 2.00）与美国普通人群中HTN风险增加显著相关。仅在N - 乙酰 - S -（2 - 羟丙基）- L - 半胱氨酸或2HPMA的自然对数与HTN之间观察到非线性关系和阈值效应。当2HPMA的自然对数至少为5.29时，ln(2HPMA)与HTN之间存在显著正相关。亚组分析显示，在老年组（年龄≥60岁）、超重组（BMI≥25）和饮酒组中这种关联更为明显。
我们的研究提供了新的流行病学证据，支持环境污染物与HTN之间关系的建立，突出了此前被忽视的非职业性VOC暴露与整个人群HTN风险之间的正相关。
