Impact Of Air Pollution On Cardiovascular Disease Based On The Physical Examination Cohort Study

Part one The effects of coal-burning indoor on atherosclerosis and blood pressureObjection:To evaluate the association between exposure to coal burning pollutants and atherosclerosis and blood pressure.Methods:1.752participants were recruited in the analysis.The indoor air quality(PM_2.5,CO,SO₂)was monitored.2.The inflammatory cytokines m RNAs（IL-8,SAA1,TNF-α,CRP）expression were examined by q PCR.3.Unconditional logistic regression model and multiple linear regressions were used to evaluate the association between coal exposure and carotid atherosclerosis and blood pressure,the m RNA expression.4.Stratified analysis by gender,smoking,drinking status and age were used to further analyze the association.5.The job and education were added into the model to further assess the association.Results:426 participants were assigned as the coal-burning group,326participants were assigned as the control group（P<0.05）.The mean concentrations of PM_2.5,CO and SO₂ in the coal-burning group were higher significantly than those in the control group,respectively（P<0.05）.The IL-8,CRP,TNF-αm RNAs levels were higher in the coal-burning group（P<0.05）.People in the coal exposure group had a higher risk of carotid atherosclerosis and systolic blood pressure,especially in the smokers and the younger.Summary:Indoor coal-burning increased the concentration of indoor air pollutants,leading to increase the risk of carotid atherosclerosis and elevation of systolic blood pressure.Part two The effects of indoor air pollution on blood pressure and atherosclerosis based on K-means cluster analysisObjection:To analyze the relationship between indoor air pollution and blood pressure and atherosclerosis.Methods:1.8292 subjects entered the final analysis.The participants were divided into two groups according to whether using the purifiers both at home and in the office.2.Empirical Bayesian kriging interpolation was used to evaluate individual pollutants exposure,and the activity time-weighted pollutants exposure were calculated.3.K-means cluster analysis was used to cluster the total population into various categories according to the activity time-weighted pollutants.4.Linear mixed models were used to evaluate the effects of air purifiers usage on blood pressure.Logistic regression was used to evaluate the effects of air purifiers usage on atherosclerosis.5.Stratified analysis was conducted with gender,age,smoking history and drinking history as stratified factors.6.Sensitivity analysis:the occupation,education and ethnic factor was further added to the model to further assess the association.Results:The participants in the air purifiers group and control group were 4052,4240,respectively.After adjusted by the confounding factors,the systolic blood pressure and diastolic blood pressure in the air purifiers group decreased（P<0.05）,especially for the participants exposed to the lower concentration of ambient air pollutants.especially in the male,45-65 years old subjects and non-smokers and non-drinkers,respectively.After adding education,occupation and ethnic factors into the model,the results for systolic blood pressure were still statistical significance.Summary:The usage of air purifiers played a protective effect on blood pressure,especially for the male,45-65 years old,non-smokers and non-drinkers with the lower exposure to ambient air pollutants.Part three The effects of traffic-related air pollution on valvular heart diseaseObjection:To explore the association between traffic-related air pollution and valvular heart disease.Methods:1.4158 subjects were included in the final analysis.The residential’proximity to major roadways and the traffic density on the major roadways were used as surrogate indicators of traffic-related pollution.2.The logistic regression models were used to assess the associations between the residential’proximity the traffic density and valvular heart disease.3.The stratified analysis by age and sex were conducted.4.The restricted cubic spline analysis was performed to evaluate the association.5.The negative-logarithm transform of the distance to roadways was used to further analyze the association.Results:The prevalence of valvular heart disease was 27.73%.The subjects closer to the major roads had the higher risk of tricuspid regurgitation,and exposed to the high traffic density was associated with the risk of mitral regurgitation,especially in female.The restricted cubic spline analysis found a threshold distance of about300 m,where had the lowest risk of VHD,AR,MR,TR.The association between the negative-logarithm transform of the distance to roadways and VHD was still statistically significance.Summary:Traffic-related air pollution increased the risk of valvular heart disease,especially in female.The threshold distance was about 300 m,where had the lowest risk of valvular heart disease.Conclusion:1.Indoor coal-burning increased the risk of carotid atherosclerosis and elevated the systolic blood pressure.2.The usage of air purifiers played a protective effect on blood pressure,among the participants with the lower exposure to ambient air pollutants.3.Traffic-related air pollution increased the risk of valvular heart disease,especially in female.4.The threshold distance was about 300 m,where had the lowest risk of valvular heart disease.