State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, National Innovation Platform for Industry-Education Integration in Vaccine Research, Xiamen University, Xiamen, Fujian, China.
Department of Nephrology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China.
BMC Med. 2024 Nov 26;22(1):559. doi: 10.1186/s12916-024-03783-4.
The relationship between ozone (O) exposure and blood pressure (BP) remains inconclusive. Given the scarcity of Chinese epidemiological data, more research on this association is of paramount importance, particularly among middle-aged and older Chinese populations.
This study involved 10,875 participants (median age: 60.0 years) in Xiamen, China, from 2013 to 2019, with 34,939 repeated BP measurements. Air pollutant exposure data, including O, particulate matter, nitrogen dioxide, sulfur dioxide, and carbon monoxide were derived from China High Air Pollutants and High-resolution Air Quality Reanalysis datasets using a k-nearest neighbor algorithm. The relationship between mixed air pollutant exposure and BP was evaluated using Bayesian kernel machine regression model. The effects of daily-specific O exposure on BP were assessed by distributed lag models integrated into a linear mixed-effects framework. The mediating role of total cholesterol (TC), serum total bilirubin (STB), triglyceride (TG), and low-density lipoprotein (LDL) were examined using multilevel mediation analysis with a fully adjusted model.
Mixed air pollutant exposure was positively correlated with BP, with O being a predominant contributor exhibiting an inverse effect. O exposure had immediate effects on pulse pressure (PP), while systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) showed delayed responses, with 3-, 14-, and 8-day lags, respectively. During the study period of up to 30 days, each 10 μg/m increase in maximum daily 8-h average O concentration was associated with reductions in SBP (β = - 1.176 mm Hg), DBP (- 0.237 mm Hg), PP (β = - 0.973 mm Hg), and MAP (β = - 0.544 mm Hg). Stronger correlations were observed in the older participants (aged ≥ 65 years), overweight/obese individuals, smokers and alcohol consumers, and those with hypertension or type 2 diabetes mellitus. STB and LDL mediated these effects, while TC and TG played mitigating roles.
Short-term O exposure is negatively associated with BP in middle-aged and older Chinese individuals. The findings provide preliminary evidence for the impact of O exposure on BP regulation and underscore the urgent need to reassess public health policies in response to O pollution.
臭氧（O）暴露与血压（BP）之间的关系仍不确定。鉴于中国流行病学数据的稀缺性，需要对这种关联进行更多的研究，尤其是在中国的中年和老年人群中。
本研究纳入了 2013 年至 2019 年期间来自中国厦门的 10875 名参与者（中位年龄：60.0 岁），共有 34939 次重复的 BP 测量。使用 k-最近邻算法，从中国高空气污染物和高分辨率空气质量再分析数据集获取空气污染物暴露数据，包括臭氧、颗粒物、二氧化氮、二氧化硫和一氧化碳。使用贝叶斯核机器回归模型评估混合空气污染物暴露与 BP 之间的关系。通过分布式滞后模型评估每日特定臭氧暴露对 BP 的影响，该模型集成到线性混合效应框架中。使用多层中介分析方法，在充分调整的模型中，评估总胆固醇（TC）、血清总胆红素（STB）、甘油三酯（TG）和低密度脂蛋白（LDL）的总胆固醇（TC）、血清总胆红素（STB）、甘油三酯（TG）和低密度脂蛋白（LDL）的中介作用。
混合空气污染物暴露与 BP 呈正相关，其中臭氧是主要贡献者，表现出相反的影响。臭氧暴露对脉压（PP）有即时影响，而收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）则分别在 3、14 和 8 天滞后出现反应。在长达 30 天的研究期间，最大日 8 小时平均 O 浓度每增加 10μg/m，收缩压（β=-1.176mmHg）、舒张压（β=-0.237mmHg）、脉压（β=-0.973mmHg）和平均动脉压（β=-0.544mmHg）均呈下降趋势。在年龄较大（≥65 岁）、超重/肥胖、吸烟者和饮酒者、高血压或 2 型糖尿病患者中，观察到更强的相关性。STB 和 LDL 介导了这些影响，而 TC 和 TG 则起到了缓解作用。
短期臭氧暴露与中国中年和老年个体的 BP 呈负相关。这些发现为臭氧暴露对 BP 调节的影响提供了初步证据，并强调迫切需要重新评估针对臭氧污染的公共卫生政策。
