Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China.
China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China.
J Am Heart Assoc. 2024 Oct;13(19):e035341. doi: 10.1161/JAHA.124.035341. Epub 2024 Sep 18.
We aimed to investigate the associations of long-term exposure to ambient formaldehyde with hypertension and angina pectoris symptoms in Chinese adults.
Participants' information was obtained from the WHO SAGE (World Health Organization Study on Global Aging and Adult Health) study. The Cox proportional hazards regression model was applied to estimate the associations of formaldehyde with hypertension and angina pectoris symptoms. Mediating effect analysis was used to investigate the mediating effect of hypertension between formaldehyde exposure and angina pectoris symptoms. Long-term exposure to formaldehyde was positively associated with the risk of angina pectoris symptoms (hazard ratio [HR], 1.66 [95% CI, 1.29-2.13], per interquartile range [IQR], 3.33, 10 molecules/cm) and hypertension (HR, 1.17 [95% CI, 1.02-1.34], per IQR, 3.34, 10 molecules/cm). The associations between formaldehyde and angina pectoris symptoms were greater in participants aged ≥65 years (HR, 1.90 [95% CI, 1.29-2.80]) and in rural areas (HR, 2.71 [95% CI, 1.54-4.77]), whereas the associations of formaldehyde with hypertension were stronger in men (HR, 1.27 [95% CI, 1.02-1.58]), rural areas (HR, 1.22 [95% CI, 0.94-1.59]), and in ever smokers (HR, 1.33 [95% CI, 1.02-1.72]). The mediation effect analysis indicated that 18.44% (95% CI, 2.17-37.65) of the association between formaldehyde exposure and angina pectoris symptoms was mediated by hypertension.
Long-term exposure to ambient formaldehyde was positively associated with hypertension and angina pectoris symptoms. The effects of formaldehyde may be modified by age, sex, urbanicity, and smoking status. Hypertension might play a mediating effect in formaldehyde-induced angina pectoris symptoms.
本研究旨在探讨中国成年人长期暴露于环境甲醛与高血压和心绞痛症状之间的关联。
参与者的信息来自世界卫生组织（WHO）全球老龄化和成人健康研究（SAGE）。应用 Cox 比例风险回归模型来估计甲醛与高血压和心绞痛症状之间的关联。采用中介效应分析来探讨高血压在甲醛暴露与心绞痛症状之间的中介效应。长期暴露于甲醛与心绞痛症状的风险呈正相关（风险比 [HR]，1.66 [95%置信区间，1.29-2.13]，每四分位距 [IQR]，3.33，10 个分子/cm）和高血压（HR，1.17 [95%置信区间，1.02-1.34]，每 IQR，3.34，10 个分子/cm）。在年龄≥65 岁的参与者（HR，1.90 [95%置信区间，1.29-2.80]）和农村地区（HR，2.71 [95%置信区间，1.54-4.77]）中，甲醛与心绞痛症状之间的关联更大，而在男性（HR，1.27 [95%置信区间，1.02-1.58]）、农村地区（HR，1.22 [95%置信区间，0.94-1.59]）和曾吸烟者（HR，1.33 [95%置信区间，1.02-1.72]）中，甲醛与高血压的关联更强。中介效应分析表明，甲醛暴露与心绞痛症状之间的关联有 18.44%（95%置信区间，2.17-37.65）是通过高血压介导的。
长期暴露于环境甲醛与高血压和心绞痛症状呈正相关。甲醛的影响可能会受到年龄、性别、城乡差异和吸烟状况的影响。高血压可能在甲醛引起的心绞痛症状中发挥中介作用。
