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据2010年全球疾病负担评估报道,2010年全球因空气污染导致的过早死亡超过300万,其中中国占40%(120万)。环境细颗粒物(PM2.5)污染已被列为中国第四大致命因素。短期(几小时或几天)或长期接触PM2.5不仅使患者易患呼吸道疾病,而且与多种心血管疾病密切相关,如心律失常、动脉粥样硬化、心肌缺血/梗死、脑卒中及心血管死亡。Chen等最近对加拿大安大略省35 303名成人进行队列研究,发现PM2.5浓度与高血压发生呈正相关。调整年龄、性别、教育、吸烟、体质量指数(BMI)、膳食等多种混杂因素后,PM2.5每增加10μg/m3,发生高血压的风险增加15%(HR=1.15,95%CI1.07～1.24)。Zhao等对中国北京地区代谢综合征患者65例进行的研究显示,空气污染中的黑炭(black carbon)暴露量与血压升高密切相关。黑炭暴露量增加1个单位,10h后收缩压增加0.53(95%CI0.17～0.89)mm Hg,舒张压增加0.37(95%CI0.10～0.65)mm Hg。可见空气污染不仅直接导致心血管死亡,也可能通过动脉粥样硬化或高血压引起心血管疾病,进而导致心血管事件的发生。这两项研究有很重要的公共卫生意义。
According to the 2010 Global Burden of Disease Assessment, premature deaths due to air pollution in the world in 2010 were reported to exceed 3 million, of which 40% (1.2 million) were from China. Environmental PM2.5 pollution has been ranked as the fourth most lethal factor in China. Short-term (hours or days) or long-term exposure to PM2.5 not only predisposes patients to respiratory diseases, but also to a variety of cardiovascular diseases such as arrhythmias, atherosclerosis, myocardial ischemia / infarction, stroke and Cardiovascular death. Chen et al. Recently conducted a cohort study of 35,303 adults in Ontario, Canada and found that there was a positive correlation between PM2.5 concentration and hypertension. After adjusting for confounding factors such as age, gender, education, smoking, body mass index (BMI), diet and other confounding factors, the risk of developing hypertension was increased by 15% for every 10 μg / m3 of PM2.5 (HR = 1.15, 95% CI1). 07 ~ 1.24). Zhao et al. Conducted a study of 65 patients with metabolic syndrome in Beijing, China, showing that exposure to black carbon in air pollution is closely related to elevated blood pressure. Black carbon exposure increased by 1 unit, after 10h systolic blood pressure increased 0.53 (95% CI 0.17 ~ 0.89) mm Hg, diastolic blood pressure increased 0.37 (95% CI 0.10 ~ 0.65) mm Hg. Visible air pollution not only directly leads to cardiovascular death, may also cause cardiovascular disease through atherosclerosis or hypertension, and then lead to the occurrence of cardiovascular events. Both studies have important public health implications.