我国华中地区大气PM2.5长期暴露与成人血压水平的相关性分析

目的:探索华中地区大气PM2.5长期暴露与成人血压(收缩压、舒张压、平均动脉压、脉压)水平的相关性。方法:研究基于心血管病高危人群早期筛查与综合干预项目在华中地区(河南省,湖北省,湖南省)18个城市的横断面调查数据,同时收集该地区研究期间PM2.5日均浓度以估计调查对象PM2.5的长期暴露水平。利用多水平线性回归模型研究华中地区人群PM2.5长期暴露与血压(收缩压、舒张压、平均动脉压、脉压)水平的相关性,并通过交互检验进一步探索个体因素对此相关关系的影响。结果:研究共纳入243 904例调查对象,92 819例(38.1%)为男性。PM2.5每增高10μg/m3,收缩压、舒张压、脉压和平均动脉压分别增加2.47(95%CI:2.34~2.61)mmHg(1mmHg=0.133kPa)、0.69(95%CI:0.62~0.77)mmHg、1.79(95%CI:1.68~1.89)mmHg和1.28(95%CI:1.19~1.37)mmHg。老年人(年龄≥60岁)、男性、高血压患者PM2.5长期暴露与收缩压升高的关联程度更高(P交互<0.05)。结论:PM2.5长期暴露与华中地区人群血压水平显著相关。老年人、男性、患高血压者PM2.5长期暴露后收缩压升高更为显著。

Association Between Long-term Exposure to Ambient PM2.5 and Blood Pressure Among Adults in Central China

Objectives: To explore the association between the long-term exposure to ambient PM2.5 and blood pressure(systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure) among adults in Central China.Methods: The cross-sectional survey data from China Patient-Centered Evaluative Assessment of Cardiac Events(PEACE)Million Persons Project in 18 cities of Central China(Henan, Hubei, Hunan Province) were studied. The daily average PM2.5 concentration in this region during the study period were collected to estimate the long-term exposure to ambient PM2.5. Multi-level linear regression model was used to investigate the association between long-term exposure to ambient PM2.5 and blood pressure(systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure) in the population of Central China, and further evaluate the impact of individual characteristics on the association between long-term exposure to ambient PM2.5 and blood pressure by including interaction terms between long-term exposure to ambient PM2.5 and individual characteristics.Results: A total of 243 904 subjects were included in the study, and 92 819 subjects(38.1%) were male. For an increase of 10 μg/m3 in PM2.5, systolic, diastolic, pulse and mean arterial blood pressure increased by 2.47(95% CI: 2.34-2.61) mmHg,0.69(95% CI: 0.62-0.77) mmHg, 1.79(95%CI:1.68-1.89)mmHg and 1.28(95%CI:1.19-1.37)mmHg, respectively. The association of systolic blood pressure and long-term exposure to ambient PM2.5 was more significant among older adults(age≥60 years), male and participants with hypertension(P for interaction<0.05).Conclusions: Long-term exposure to ambient PM2.5 is closely associated with elevated blood pressure among adults in Central China. The elderly, male and hypertensive subjects are more vulnerable to long-term exposure to ambient PM2.5.