空气污染暴露与高血压发病风险的关联:基于英国生物银行的队列研究

Association between exposure to air pollution and the risk of hypertension:a cohort study based on UK Biobank

目的研究NO_(2)、NO_(x)、PM_(10)、PM_(2.5)和PM_(2.5-10)等空气污染物与高血压发病风险的关系,为预防高血压提供参考。方法基于英国生物银行(UK Biobank,UKB)数据库构建随访队列,采用Cox风险比例回归模型进行关联分析,分别研究空气污染物年平均浓度和空气污染物日累积暴露量与高血压发病风险的关联。此外,本研究还创建了空气污染物的累积暴露加权评分以评估几种空气污染物联合暴露与高血压发病风险的关系。结果Cox比例风险回归模型结果显示,只有NO_(x)的年平均浓度可以增加高血压发病风险。NO_(2)、NO_(x)、PM_(10)、PM_(2.5)和PM_(2.5-10)日累积暴露量每增长50μg/m^(3)·day,HRs(95%CI)值分别为1.06(1.04~1.08)、1.03(1.02~1.04)、1.11(1.07~1.14)、1.18(1.12~1.24)和1.26(1.17~1.37)。空气污染物的累积暴露加权评分与高血压风险呈正向的剂量-反应关系(P<0.001)。结论长期暴露于包括PM_(2.5)、PM_(10)、PM_(2.5-10)、NO_(2)和NO_(x)在内的空气污染物中,无论是暴露于单一污染物还是多种污染物,都与高血压发病风险增加相关。本研究强调了全面评估各种空气污染物对于预防高血压的重要性。

Objective To study the relationship between air pollutants,such as NO_(2),NO_(x),PM_(10),PM_(2.5) and PM_(2.5-10),and the risk of hypertension,and to provide a reference for the prevention of hypertension.Methods We constructed follow-up cohorts on the basis of UK Biobank(UKB)and used Cox proportional-hazards regression models for association analyses.We separately studied the associations of annual mean concentrations of air pollutants and cumulative daily exposures to air pollutants with the risk of hypertension.In addition,a cumulative exposure weighted score for air pollutants was created to assess the association between combined exposure to several air pollutants and the risk of hypertension.Results Cox proportional risk model results showed that only the annual mean concentration of NO_(x) increased the risk of hypertension when using the annual mean concentration of air pollutants as exposure.The HRs(95%CI)of hypertension for a 50μg/m^(3)·day increase in daily cumulative exposure to NO_(2),NO_(x),PM_(10),PM_(2.5) and PM_(2.5-10) were 1.06(1.04-1.08),1.03(1.02-1.04),1.11(1.07-1.14),1.18(1.12-1.24)and 1.26(1.17-1.37),respectively.There was a positive dose-response relationship between the cumulative exposure weighted score of air pollutants and the risk of hypertension(P<0.001).Conclusions Our findings suggest that long-term exposure to various air pollutants including PM_(2.5),PM_(10),PM_(2.5-10),NO_(2) and NO_(x),either individually or jointly,were associated with an increased risk of hypertension significantly.Our study highlights the importance of a comprehensive assessment of various air pollutants in hypertension prevention.