在心力衰竭的医疗保险受益者中,环境空气污染暴露和不良结果
Amgad Mentias1, Milind Y Desai1, Ambarish Pandey2
1Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation Cleveland OH USA.
Journal of the American Heart Association
|July 31, 2024
概括
暴露于细颗粒物 (PM2.5) 会增加心力衰竭 (HF) 患者的风险. 即使低于空气质量标准,这些风险仍然存在,这表明对于现有HF患者来说,没有安全的暴露水平.
科学领域:
- 环境健康 环境健康
- 心血管疾病流行病学
- 公共卫生 公共卫生
背景情况:
- 细颗粒物 (PM2.5) 暴露与动脉样硬化有关.
- 动物研究表明,PM2.5导致心肌纤维化和心力衰竭 (HF).
- 关于PM2.5对先前存在高血压患者的影响的数据有限.
研究的目的:
- 调查环境PM2.5暴露与医疗保险受益者与已确定的HF的不良结果之间的关联.
- 为了确定PM2.5暴露是否构成低于当前空气质量标准的风险.
主要方法:
- 对医疗保险患者的回顾性队列研究,这些患者在医院接受了第一次HF治疗 (2013-2020年).
- 根据居住地邮政编码,将患者数据与1x1公里分辨率的环境PM2.5估计数据联系起来.
- 分析PM2.5水平与所有原因死亡,HF再接收和所有原因再接收负担之间的关联,调整共变量.
主要成果:
- 分析了近260万名患者,随访时间超过630万人年.
- 增加的PM2.5水平与所有原因死亡,HF再入院和再入院负担的风险更高有关.
- 关联在PM2.5水平低于7μg/m3和特定亚组 (年轻人,亚洲人,农村居民) 中更为明显.
结论:
- 环境空气污染,特别是PM2.5,与Medicare HF患者的不良事件增加有关.
- 这些风险甚至存在于低于国家空气质量标准的PM2.5度.
- 这些发现表明,对于已确定的心力衰竭患者的空气污染暴露没有安全门.
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