Long-term effects of PM2.5 and its components on incident hypertension among the middle-aged and elderly: a national cohort study
摘要
The long-term health effects of fine particulate matter (PM2.5) on hypertension remain incomprehensive. We evaluated the relationship of PM2.5 and its components with hypertension incidence in middle-aged and elderly adults.
MethodsWe utilised data from the China Health and Retirement Longitudinal Study collected between 2011 and 2018. We obtained annual modelled data from the dataset of Tracking Air Pollution in China, including black carbon (BC), sulphate (SO42−), organic matter (OM), ammonium (NH4+), and nitrate (NO3−). Time-varying Cox models and quantile g-computation models were employed to explore the associations. Exposure-response curves were portrayed to investigate potential non-linear effects.
ResultsWe enrolled 7,032 individuals with a mean age of 57.14 (range: 45–95) years. Over 36,997 person-years of follow-up (average time: 5.26 years), 3,119 individuals suffered from hypertension. With per interquartile range increment, the hazard ratios and 95% confidence intervals (CIs) of PM2.5 (3.82 [95% CI: 3.48–4.18]), BC (4.17 [95% CI: 3.54–4.92]), SO42− (4.24 [95% CI: 3.50–5.12]), OM (3.76 [95% CI: 3.14–4.50]), NH4+ (3.20 [95% CI: 2.91–3.52]), and NO3− (1.94 [95% CI: 1.77–2.13]) were discovered with lag 1 year. And the mixed effect was 18.0% [95% CI: 16.8%–19.2%], which was mainly driven by BC (66.0%) and SO42− (34.0%). Approximate J-shaped exposure-response relationships were revealed.
ConclusionsThe positive associations of long-term exposure to PM2.5 and its components with hypertension incidence were discovered in adults aged ≥ 45 years. Controlling the emissions of PM2.5 components, especially BC and SO42−, could alleviate the burden of hypertension.