The short-term effects of NO2 on blood pressure and pulse pressure in patients with hypertension
SHI Qin1, ZHENG Shan1, ZHU Wen-zhi1, WANG Min-zhen1, MIAO Qian1, LUO Yan1, NIE Yong-hong2, WENG Jun1, LI Hai-yan2, BAI Ya-na1
1. Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China; 2. Workers'Hospital of Jinchuan Group Co. Ltd, Jinchang 737100, China
Abstract：In order to explore the short-term effects of gaseous pollutants (NO2) on blood pressure (BP) and pulse pressure (PP) in patients with hypertension, the NO2 monitoring data and meteorological observation data were collected from January 1, 2011 to November 30, 2015 in Jinchang, Gansu Province. After controlling the random effect and other confounding factors, a mixed-effect model was used to analyze the association between NO2 and BP and PP in hypertensive patients based on a prospective cohort study. The results showed that: (1) An interquartile range (IQR) increase in NO2 at lag 1day was associated with a 0.457mmHg (95%CI: 0.131~0.784) increase in systolic blood pressure (SBP); with each IQR increase of NO2, diastolic blood pressure (DBP) at lag 7 day and pulse pressure (PP) at lag 4 day increased 0.276mmHg (95%CI:0.025~0.527) and 0.402mmHg (95%CI:0.047~0.758), respectively. All the results was statistically significant. (2) Gender, age, BMI, smoking, drinking, and season may modify the effects of NO2 on BP and PP among hypertensive patients. The effects of NO2 on BP and PP remained consistent with the results in the multi-pollutant model or after adjusting dust weather.
石琴, 郑山, 朱文芝, 王敏珍, 缪茜, 罗妍, 聂永红, 翁俊, 李海燕, 白亚娜. NO2对高血压患者血压和脉压的短期影响[J]. 中国环境科学, 2020, 40(8): 3627-3635.
SHI Qin, ZHENG Shan, ZHU Wen-zhi, WANG Min-zhen, MIAO Qian, LUO Yan, NIE Yong-hong, WENG Jun, LI Hai-yan, BAI Ya-na. The short-term effects of NO2 on blood pressure and pulse pressure in patients with hypertension. CHINA ENVIRONMENTAL SCIENCECE, 2020, 40(8): 3627-3635.
Baccarelli A, Barretta F, Dou C, et al. Effects of particulate air pollution on blood pressure in a highly exposed population in Beijing, China:a repeated-measure study[J]. Environmental Health, 2011,10:108.
[2]
Cakmak S, Dales R, Kauri L M, et al. Metal composition of fine particulate air pollution and acute changes in cardiorespiratory physiology[J]. Environmental Pollution, 2014,189:208-214.
[3]
Zhang Z L, Dong B, Li S S, et al. Exposure to ambient particulate matter air pollution, blood pressure and hypertension in children and adolescents:A national cross-sectional study in China[J]. Environment International, 2019,128:103-108.
[4]
Song J, Lu M X, Lu J G, et al. Acute effect of ambient air pollution on hospitalization in patients with hypertension:A time-series study in Shijiazhuang, China[J]. Ecotoxicology and Environmental Safety, 2019,170:286-292.
[5]
Rumchev K, Soares M, Zhao Y, et al. The association between Indoor air quality and adult blood pressure levels in a high-income setting[J]. International Journal of Environmental Research and Public Health, 2018,15(9):10.
[6]
Brook R D. Cardiovascular effects of air pollution[J]. Clinical Science, 2008,115(5/6):175-187.
[7]
Liu L, Ruddy T, Dalipaj M, et al. Effects of indoor, outdoor, and personal exposure to particulate air pollution on cardiovascular physiology and systemic mediators in seniors[J]. Journal of Occupational and Environmental Medicine, 2009,51(9):1088-1098.
[8]
Luttmann-Gibson H, Suh H H, Coull B A, et al. Systemic inflammation, heart rate variability and air pollution in a cohort of senior adults[J]. Occupational and Environmental Medicine, 2010, 67(9):625-630.
[9]
Jacobs L, Buczynska A, Walgraeve C, et al. Acute changes in pulse pressure in relation to constituents of particulate air pollution in elderly persons[J]. Environmental Research, 2012,117:60-67.
[10]
Nawrot T, Den Hond E, Thijs L, et al. Isolated systolic hypertension and the risk of vascular disease[J]. Current Hypertension Reports, 2003,5(5):372-379.
[11]
Safar Michel E, Levy Bernard I, Struijker-Boudier H. Current Perspectives on Arterial Stiffness and Pulse Pressure in Hypertension and Cardiovascular Diseases[J]. Circulation, 2003,107(22):2864-2869.
[12]
张莹.我国典型城市空气污染特征及其健康影响和预报研究[D].兰州:兰州大学, 2016. Zhang Y. The characteristics of air pollution and its health impact and forecast in typical cities of China[D]. Lanzhou:Lanzhou University, 2016.
[13]
Na Zhu, Hongyan Li, Ming Han, et al. Environmental nitrogen dioxide (NO2) exposure influences development and progression of ischemic stroke[J]. Toxicology Letters, 2012,214(2):120-130.
[14]
Chen R J, Yin P, Meng X, et al. Associations between ambient nitrogen dioxide and daily cause-specific mortality evidence from 272 Chinese cities[J]. Epidemiology, 2018,29(4):482-489.
[15]
Bai L, Chen H, Hatzopoulou M, et al. Exposure to ambient ultrafine particles and nitrogen dioxide and incident hypertension and diabetes[J]. Epidemiology, 2018,29(3):323-332.
[16]
Li D, Wang J B, Yu Z B, et al. Air pollution exposures and blood pressure variation in type-2diabetes mellitus patients:A retrospective cohort study in China[J]. Ecotoxicology and Environmental Safety, 2019,171:206-210.
[17]
Coogan P F, White L F, Yu J, et al. Long-term exposure to NO2 and ozone and hypertension incidence in the Black Women's Health Study[J]. American Journal of Hypertension, 2017,30(4):367-372.
[18]
中国高血压防治指南2018年修订版[J].心脑血管病防治, 2019, 19(1):1-44. Chinese hypertension prevention and control guideline 2018 revision[J]. Cardiocerebrovascular Disease Prevention and Treatment, 2019,19(1):1-44.
[19]
兰岚.金昌市大气污染对人体健康的影响研究[D].兰州.兰州大学, 2013. Lan L. Research on the impact of air pollution on human health in Jinchang City[D]. Lanzhou. Lanzhou University, 2013.
[20]
白亚娜,蒲宏全,代敏,等.中国金昌队列研究进展[J].兰州大学学报(医学版), 2015,41(6):29-33+38. Bai Y N, Pu H Q, Dai M, et al. Research progress of China Jinchang Cohort[J]. Journal of Lanzhou University (Medical Sciences), 2015, 41(6):29-33+38.
[21]
Yue Niu, Renjie Chen, Cong Liu, et al. The association between ambient temperature and out-of-hospital cardiac arrest in Guangzhou, China[J]. Science of the Total Environment, 2016,572(dec.1):114-118.
[22]
崔甍甍,于鲁明,张进军,等.急性心血管疾病发病与气象因素关系的研究[J].中华急诊医学杂志, 2014,23(4):465-469. Cui M M, Yu L M, Zhang J J, et al. The relationship between the incidence of acute cardiovascular disease and meteorological factors[J]. Chinese Journal of Emergency Medicine, 2014,23(4):465-469.
[23]
Nascimento L F C, Francisco J B. Particulate matter and hospital admission due to arterial hypertension in a medium-sized Brazilian city[J]. Cadernos de saúde pública/Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública, 2013,29(8):1565-1571.
[24]
翁俊,韦性富,聂永红,等.颗粒物污染对高血压门急诊就诊人数的影响-时间序列研究[J].中国环境科学, 2018,38(7):2751-2757. Weng J, Wei X F, Nie Y H, et al. Time series study on the effect of air particulate pollution on emergency admissions for hypertension[J]. China Environmental Science, 2018,38(7):2751-2757.
[25]
何继亮.毒理学的新分支--气候变化毒理学[J].环境与健康杂志, 2011,28(9):753-757. He J L. A new branch of toxicology-toxicology of climate change[J]. Journal of Environment and Health, 2011,28(9):753-757.
[26]
Chan S H, Van Hee V C, Bergen S, et al. Long-term air pollution exposure and blood pressure in the sister study[J]. Environmental Health Perspectives, 2015,123(10):951-958.
[27]
Pitchika A, Hampel R, Wolf K, et al. Long-term associations of modeled and self-reported measures of exposure to air pollution and noise at residence on prevalent hypertension and blood pressure[J]. Science of the Total Environment, 2017,593:337-346.
[28]
Yang B-Y, Qian Z M, Howard S W, et al. Global association between ambient air pollution and blood pressure:A systematic review and meta-analysis[J]. Environmental Pollution, 2018,235:576-588.
[29]
Choi You-Jung, Kim Sun-Hwa, Kang Si-Hyuck, et al. Short-term effects of air pollution on blood pressure[J]. Scientific Reports, 2019, 9(1).20298.
[30]
Zheng S, Wang M, Wang S, et al. Short-term effects of gaseous pollutants and particulate matter on daily hospital admissions for cardio-cerebrovascular disease in Lanzhou:Evidence from a heavily polluted City in China[J]. International Journal of Environmental Research and Public Health, 2013,10(2):462-477.
[31]
Chen S Y, Wu C F, Lee J H, et al. Associations between long-term air pollutant exposures and blood pressure in elderly residents of Taipei City:A cross-sectional study[J]. Environmental Health Perspectives, 2015,123(8):779-784.
[32]
李全喜.兰州市气象和环境因子对脑出血和冠心病的影响研究[D].兰州:兰州大学, 2019. Li Q X. Effects of Meteorological and Environmental Factors on Cerebral Hemorrhage and Coronary Heart Disease in Lanzhou City[D]. Lanzhou:Lanzhou University, 2019.
[33]
陶燕,羊德容,兰岚,等.兰州市空气污染对呼吸系统疾病入院人数的影响[J].中国环境科学, 2013,33(1):175-180. Tao Y, Yang D, Lan L, et al. Relationship between air pollutant and respiratory diseases hospitalization in Lanzhou[J]. China Environmental Science, 2013,33(1):175-180.
[34]
Jayaratne E R, Johnson G R, McGarry P, et al. Characteristics of airborne ultrafine and coarse particles during the Australian dust storm of 23September 2009[J]. Atmospheric Environment, 2011,45(24):3996-4001.
[35]
Schwartz J, Bellinger D, Glass T, Exploring potential sources of differential vulnerability and susceptibility in risk from environmental hazards to expand the scope of risk assessment[J]. Am J Public Health, 2011,101:S94-S101.
[36]
Delfino R J, Staimer N, Tjoa T, et al. Circulating biomarkers of inflammation, antioxidant activity, and platelet activation are associated with primary combustion aerosols in subjects with coronary artery disease[J]. Environ Health Perspect, 2008,116:898-906.
[37]
Bind M A, Baccarelli A, Zanobetti A, et al. Air pollution and markers of coagulation, inflammation, and endothelial function:Associations and epigene-environment interactions in an elderly cohort[J]. Epidemiology, 2012,23:332-340.
[38]
Rodosthenous R S, Kloog I, Colicino E, et al. Extracellular vesiclenriched microRNAs interact in the association between long-term particulate matter and blood pressure in elderly men[J]. Environmental Research, 2018,167:640-649.
[39]
Kresovich J K, Zhang Z, Fang F, et al. Histone 3modifications and blood pressure in the beijing truck driver air pollution study[J]. Biomarkers 2017,22(6):584-593.
[40]
Pena M B, Romero K M, Velazquez E J, et al. Relationship Between Daily Exposure to Biomass Fuel Smoke and Blood Pressure in High-Altitude Peru[J]. Hypertension, 2015,65(5):1134-1140.
