Air pollution and risk of incident hypertension and diabetes in U.S. black women

空气污染与美国黑人女性患高血压和糖尿病的风险

• 批准号: 8184237
• 负责人: Patricia F Coogan
• 金额: $ 54.3万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8184237
• 关键词: Accounting; Acute; Affect; African American; Air; Air Pollutants; Air Pollution; Blood Pressure; Caliber; California; Canada; Cardiovascular Diseases; Cardiovascular system; Chronic; Cohort Studies; Coronary heart disease; Data; Databases; Development; Diabetes Mellitus; Disadvantaged; Disease; Event; Exposure to; Geographic Information Systems; Health; High Prevalence; Human; Hypertension; Incidence; Individual; Inflammation; Investigation; Life; Link; Location; Los Angeles; Measurement; Measures; Methods; Modeling; Monitor; Morbidity - disease rate; Neighborhoods; Nitrogen Dioxide; Noise; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Oxidative Stress; Oxides; Participant; Particulate Matter; Pathway interactions; Pollution; Population; Prevalence; Public Health; Public Policy; Questionnaires; Research; Resources; Risk; Risk Factors; Socioeconomic Status; Surveys; Techniques; Testing; Woman; Women' s Health; air quality regulation; base; cohort; cost; diabetes control; follow-up; insight; interest; land use; lifestyle factors; mortality; novel; pollutant; prospective; residence; trafficking

DESCRIPTION (provided by applicant): Air pollution increases the risk of acute cardiovascular events. Whether it contributes to the risk of hypertension and diabetes, chronic predisposing conditions to cardiovascular disease, is unknown. Hypertension and type 2 diabetes occur much more commonly among U.S. black women than white women, a discrepancy only partly explained by known risk factors. U.S. black women tend to live in neighborhoods with more air pollution than their white counterparts, regardless of socioeconomic status. With state-of-the-art methods, we propose to test the hypotheses that exposure to air pollution increases the risks of incident hypertension and type 2 diabetes in African American women. We will focus on particulate matter of d2.5 <g aerodynamic diameter (PM2.5) and traffic-related pollution as indicated by nitrogen dioxide (NO2) and oxide (NO). We will prospectively test the hypotheses in the Black Women's Health Study (BWHS), an ongoing cohort study of 59,000 U.S. black women. Detailed information on risk factors for disease, lifestyle factors, and disease endpoints was collected at baseline in 1995 and in biennial follow-up questionnaires. Preliminary findings based on Los Angeles participants indicate positive associations of the pollutants of interest with incident hypertension and diabetes, after control for personal and neighborhood socioeconomic status. We will estimate long-term exposure to PM2.5 concentrations based on a new U.S. data layer developed for Health Canada and provided to the study at no cost. We will use dispersion modeling to estimate traffic-related pollutants using the best indicators, NO and NO2. We will model traffic noise levels for the purpose of including noise as a potential confounder in the hypertension analyses. We will use the newly developed spatial cohort survival modeling technique to account for clustering of air pollutants at two geographic levels, regional and local. Exposure measures will be available for the entire BWHS cohort, which is geographically dispersed across the U.S. By the end of the 2007 follow-up cycle, 10,137 incident hypertension cases and 4861 incident type 2 diabetes cases had occurred in the BWHS, allowing for high statistical power. The BWHS cohort is particularly well suited to the study aims because it has high rates of hypertension and diabetes and high levels of exposure to air pollutants. The proposed study will be the first investigation of the effect of air pollution on incidence of hypertension, the first large-scale investigation its effect on incidence of diabetes, and the first study of air pollution effects specifically in African American women. The hypotheses are of critical public health importance, given the high and growing prevalence of hypertension and diabetes in the U.S., the disparity between incidence rates among U.S. black and white women, and the ubiquity of exposure to air pollution. Positive findings will inform public policy on air quality regulation, provide insight into a novel pathway whereby air pollution causes cardiovascular events, illuminate causes of racial disparities in hypertension and diabetes incidence, and spur research on effects of air pollutants on other diseases. PUBLIC HEALTH RELEVANCE: The proposed study will evaluate whether exposure to air pollution increases the risks of incident hypertension and type 2 diabetes in a cohort of 59,000 African American women from across the U.S. The study is of immense public health importance given the high prevalence of hypertension and diabetes, the disparity in the incidence between black and white women, and the ubiquity of exposure to air pollution. Positive findings will inform public policy on air quality regulation, illuminate causes of racial disparities in the incidence of hypertension, and diabetes provide pivotal insight into a novel pathway whereby air pollution causes cardiovascular events, and motivate additional research.

描述（由申请人提供）：空气污染增加了急性心血管事件的风险。这是否有助于高血压和糖尿病的风险，慢性易感心血管疾病的疾病尚不清楚。与白人妇女相比，在美国黑人妇女中，高血压和2型糖尿病的发生更常见，这种差异仅以已知的危险因素来部分解释。无论社会经济地位如何，美国黑人妇女往往生活在空气污染的社区中。通过最先进的方法，我们建议检验暴露于空气污染的假设增加了非裔美国人妇女中事件高血压和2型糖尿病的风险。我们将重点介绍D2.5 <g空气动力学直径（PM2.5）和交通相关污染的颗粒物，如二氧化氮（NO2）和氧化物（NO）所示。我们将前瞻性地检验黑人妇女健康研究（BWHS）的假设，这是一项对59,000名美国黑人妇女的持续研究。关于疾病，生活方式因素和疾病终点的危险因素的详细信息是在1995年基线和双年期随访问卷中收集的。基于洛杉矶参与者的初步发现表明，在控制个人和邻里社会经济地位之后，感兴趣的污染物与事件高血压和糖尿病的污染物之间存在积极关联。我们将根据为加拿大卫生部开发的新的美国数据层估算PM2.5浓度的长期接触，并免费提供给研究。我们将使用分散建模使用NO和NO2的最佳指标来估计与交通相关的污染物。我们将在高血压分析中将噪声作为潜在混杂因素的目的对流量噪声水平进行建模。我们将使用新开发的空间队列生存建模技术来解释在两个地理水平的区域和局部污染物的聚类。整个BWHS队列将采取暴露措施，在2007年随访周期结束之前，在整个美国都分散了曝光措施，10,137例入射高血压病例和4861个事件2型糖尿病病例发生在BWHS中，允许高统计能力。 BWHS队列特别适合该研究的目的，因为它具有高血压和糖尿病的率高以及对空气污染物的高水平。拟议的研究将是对空气污染对高血压发病率的影响的首次研究，首次大规模调查其对糖尿病发病率的影响以及对非裔美国人妇女的空气污染效应的首次研究。鉴于美国高血压和糖尿病的流行率高，美国黑人和白人妇女的发病率之间的差异以及暴露于空气污染的普遍性，这些假设具有至关重要的公共健康重要性。积极的发现将为公共政策提供有关空气质量法规的信息，提供对一种新的途径的见解，空气污染会导致心血管事件，阐明高血压和糖尿病发病率的种族差异以及对空气污染对其他疾病的影响的刺激研究。 公共卫生相关性：拟议的研究将评估暴露于空气污染的风险是否会增加美国各地的59,000名非裔美国妇女在美国的59,000名非裔美国妇女中的风险，鉴于高度高度的高度普遍性和糖尿病的普遍性极高，这是巨大的公共健康重要性，在黑人和白人女性和白人妇女之间的疾病和ubiquiquiquiquiquiquiquiquiquiquiquiquiquique之间的发病率很高。积极的发现将为空气质量法规的公共政策提供依据，阐明高血压发病率的种族差异原因，糖尿病为新颖的途径提供了关键的见解，从而导致空气污染导致心血管事件，并激发其他研究。