日夜复合热与人群血压水平的关联研究  

Association of compound hot extreme with blood pressure in Guangdong province

作　　者：李致兴 林顺伟 许晓君[3] 孟瑞琳[3] 何冠豪 胡建雄 周鹤 曾韦霖[2] 李杏[2] 肖建鹏[2] 刘涛[1,2] 马文军[1,2] LI Zhixing;LIN Shunwei;XU Xiaojun;MENG Ruilin;HE Guanhao;HU Jianxiong;ZHOU He;ZENG Weilin;LI Xing;XIAO Jianpeng;LIU Tao;MA Wenjun(School of Medicine,Jinan University,Guangzhou,Guangdong 510632,China;Guangdong Provincial Institute of Public Health,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou,Guangdong 511430,China;Institute of Chronic and Noncommunicable Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou,Guangdong 511430,China)

机构地区：[1]暨南大学基础医学与公共卫生学院,广东广州510632 [2]广东省疾病预防控制中心广东省公共卫生研究院,广东广州511430 [3]广东省疾病预防控制中心慢性病非传染性疾病预防控制所,广东广州511430

出　　处：《环境与职业医学》2022年第3期247-252,260,共7页Journal of Environmental and Occupational Medicine

基　　金：国家重点研发计划项目(2018YFA0606200);国家自然科学基金项目(42075173);广东省医学科学技术研究基金项目(A2021340)

摘　　要：[背景]随着全球气候变暖,预计本世纪内日夜复合热的发生频率、强度以及持续时间可能会持续增加。[目的]分析日夜复合热事件与人群血压水平的关系,识别相关敏感人群。[方法]本研究为横断面调查,研究对象来源于2002—2015年共6次广东省居民慢性病或营养调查。通过问卷调查人口统计学资料、吸烟饮酒情况等,并测量身高、体重、血压等。本研究选取5、9、10月的数据进行日夜复合热事件与人群血压关联的研究,其中日夜复合热指的是一个炎热的夜晚伴随一个炎热的白天的持续高温状态。同时期的气象数据来源于中国气象科学数据共享服务平台,利用反距离加权插值法获取各研究地点的气温及湿度数据。运用分布滞后非线性模型探究日夜复合热事件与人群血压的关联,并按性别、年龄、城乡、体重指数(BMI)、是否吸烟及饮酒进行分层分析,识别敏感人群。通过调整日夜复合热在滞后维度的自由度以及去除相对湿度进行敏感性分析。[结果]本研究共纳入10967名研究对象,均无高血压史,其平均收缩压和舒张压分别为120.8、74.5 mmHg。在所有研究对象中,经受日热、夜热或日夜复合热的比例分别为9.34%、17.95%及2.90%。相比日热,夜热和日夜复合热均与人群血压水平的降低有统计学关联,且日夜复合热使得血压下降的幅度更大,收缩压变化值及其95%CI为-6.2(-10.3~-2.1)mmHg;舒张压变化值及其95%CI为-2.7(-5.2~-0.2)mmHg。日夜复合热可使男性、≥65岁、BMI<24 kg·m^(-2)者收缩压水平降低,其OR(95%CI)分别为-6.2(-10.7~-1.6)、-19.1(-33.0~-5.1)、-6.7(-11.8~-1.6)mmHg,另外≥65老年人的舒张压也呈下降状态,其OR(95%CI)为-8.4(-15.6~-1.1)mmHg。对地区进行分层分析,发现日夜复合热对农村人群血压(收缩压及舒张压)的效应表现为下降状态,其OR(95%CI)分别为-10.5(-16.6~-4.5)和-4.4(-7.7~-1.1)mmHg,而城市人群的收缩压则[Background]It is projected that the frequency,density,and duration of compound hot extreme may increase in the 21st century in the context of global warming.[Objective]To explore the association between compound hot extreme and blood pressure,and identify sensitive populations.[Methods]This was a cross-sectional study.The study subjects were from six Guangdong Province Chronic Disease and Nutrition Surveys during 2002 through 2015.A questionnaire was administered to the participants with questions about demographic information,drinking and smoking status,and measurements on their height,weight,and blood pressure were also collected.We chose the data of May,September,and October to explore the association between compound hot extreme and blood pressure.Compound hot extreme means a hot day with a proceeding hot night.Daily meteorological data were obtained from China Meteorological Data Service Centre.We employed inverse distance weighting to interpolate the temperature and relative humidity values for each participant.A distributed lag non-linear model was used to estimate the association between compound hot extreme and blood pressure.Stratified analyses by sex,age,area,body mass index(BMI),smoking status,and drinking status were also performed to identify sensitive populations.A sensitivity analysis was conducted by adjusting the degrees of freedom for lag spline and removing relative humidity.[Result]A total of 10967 participants without history of hypertension were included in this study.The average systolic blood pressure(SBP)was 120.8 mmHg and the average diastolic blood pressure(DBP)was 74.5 mmHg.The proportion of participants who experienced hot day,hot night,or compound hot extreme were 9.34%,17.95%and 2.90%,respectively.Compared to hot day,hot night and compound hot extreme were related with decreased blood pressure,and the effect of compound hot extreme was stronger:the changes and 95%CI for SBP was-6.2(-10.3--2.1)mmHg,and for DBP was-2.7(-5.2--0.2)mmHg.Compound hot extreme induced decreased SBP among

关 键 词：血压 日夜复合热 分布滞后非线性模型 极端气候 

分 类 号：R122.2[医药卫生—环境卫生学]