解放军医学院学报2026，Vol.47Issue(2)：174-185,12.DOI:10.12435/j.issn.2095-5227.25101602
大气颗粒污染物与原发性高血压患者血压变异及昼夜节律的关联研究
Association of particulate matter with blood pressure variability and circadian rhythm in essential hypertension
摘要
Abstract
Background Short-term exposure to air pollutants has been associated with elevated blood pressure.However,few studies have examined the relationship between particulate matter,blood pressure variability(BPV),and circadian rhythms.Objective To investigate the effects of air pollutant levels on BPV and blood pressure circadian rhythm in patients with essential hypertension.Methods Patients admitted to the Department of Cardiology,the First Medical Center of PLA General Hospital from January 2017 to January 2022 and diagnosed with essential hypertension were included.BPV indicators and pollutant data,including particulate matter 2.5(PM2.5)and particulate matter 10(PM10),were collected.Standard deviation(SD)and coefficient of variation(CV)were used to evaluate the ambulatory BPV.A distributed lag model with median regression was constructed to assess lag effects and associations between air pollution components,BPV,and circadian rhythm.Results A total of 1 650 patients were finally included in this study,with a mean age of(62.8±11.0)years;1 056(64.0%)were male.The mean concentrations of PM10 and PM2.5 on the day of admission were(76.8±48.3)μg/m³ and(42.2±32.8)μg/m³,respectively.After adjusting for potential confounders such as age,sex,and holidays,for every 10-μg/m³ increase in PM2.5,the maximum lag effect on daytime systolic blood pressure standard deviation(dSBPSD)and daytime systolic blood pressure coefficient of variation(dSBPCV)was observed at lag 2,with increments of 1.42(95%CI:0.67-2.17)mmHg and 0.93(95%CI:0.34-1.53)%,respectively.For every 10 μg/m³ increase in PM2.5,the maximum lag effect on daytime diastolic blood pressure standard deviation(dDBPSD)was observed at lag 0,with an increment of 2.27(95%CI:0.31-4.23)mmHg.For every 10 μg/m³ increase in PM10,the maximum lag effect on dDBPSD was observed at lag 0,with an increment of 2.09(95%CI:0.84-3.34)mmHg,while the maximum lag effect on nighttime diastolic blood pressure CV was observed at lag 2,with an increment of 1.68(95%CI:0.04-3.29)%.PM2.5 exerted the maximum cumulative effect on SBP dipping and DBP dipping at lag 6,with increments of 4.95(95%CI:0.82-9.10)mmHg and 5.16(95%CI:1.15-9.17)mmHg,respectively.The maximum cumulative lag effect of PM10 on SBP was observed at lag 5,with an increment of 18.13(95%CI:1.05-35.20)mmHg.The maximum cumulative lag effect of PM10 on SBP dipping and nDBP dipping was observed at lag 6,with increments of 6.94(95%CI:0.75-13.13)mmHg and 8.72(95%CI:0.08-17.37)mmHg,respectively.Conclusion A lag effect is observed between PM exposure and BPV.PM may be associated with non-dipping and reverse-dipping circadian rhythm patterns in patients with essential hypertension.关键词
颗粒物/原发性高血压/血压变异/血压昼夜节律/分布式滞后模型/空气污染Key words
particulate matter/essential hypertension/blood pressure variability/air pollutants/distributed lag nonlinear model/blood pressure circadian rhythm/air pollution分类
医药卫生引用本文复制引用
刘杰,王菲,刘亚恬,李新蕊,李丹,王静,唐龙妹,胡舜英..大气颗粒污染物与原发性高血压患者血压变异及昼夜节律的关联研究[J].解放军医学院学报,2026,47(2):174-185,12.基金项目
心血管病医学部青年基金(2025-XXGBYXBNK-QNJJ2-1) （2025-XXGBYXBNK-QNJJ2-1）
