提高空气质量指数活动指南 预防一般成年人群中心血管事件的指南
Robert D Brook1, Allison R Brook2, Phillip D Levy3
1Division of Cardiovascular Diseases, Department of Internal Medicine, Wayne State University, Detroit, Michigan, USA.
JACC. Advances
|October 21, 2024
概括
每日空气质量指南对预防心血管事件的公共卫生影响有限. 根据个人动脉样硬化心血管疾病 (ASCVD) 风险量身定制活动建议可以提高有效性,特别是在不健康的空气质量日.
科学领域:
- 环境健康 环境健康
- 心血管疾病流行病学
- 公共卫生政策 公共卫生政策
背景情况:
- 目前美国普通成年人每日空气质量指数 (AQI) 活动指南对预防动脉样硬化心血管疾病 (ASCVD) 事件具有可疑的公共卫生相关性.
- 统一建议的有效性有限,需要对公共卫生战略进行重新评估.
研究的目的:
- 探索定制活动指南以计算ASCVD风险的实用性,超越统一的建议.
- 评估个性化公共卫生干预对空气质量和心血管健康的潜在好处.
主要方法:
- 计算了每天需要治疗的数量 (NNT) 来预防一个ASCVD事件,跨越不同的10年ASCVD风险得分 (1%20%).
- 基于个别ASCVD风险水平量身定制活动建议的影响建模.
- 分析了不同AQI级别和ASCVD风险层中的NNT.
主要成果:
- 随着ASCVD风险和AQI水平的增加,NNT下降.
- 在高达151 (中等) 的AQI水平下,在所有ASCVD风险中,NNT是不切实际的高 (>2.755.3万).
- 在不健康的AQI条件下 (151200),NNT<100万只能在目前的指南下 (18%20%) 达到最高ASCVD风险的个体 (15%的暴露减少).
结论:
- 通过AQI指导,ASCVD风险显著影响NNT预防心血管事件.
- 根据ASCVD风险量身定制活动建议,在不健康的AQI时期更严格地减少暴露 (35%-50%),可以显著改善公共卫生效用.
- 未来的政策调整,将重点放在个性化的ASCVD风险上,可以提高AQI活动指导的有效性.
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