Clean Air- Heart: Clinical trial of an air purifier intervention to reduce indoor particulate matter and improve cardiovascular outcomes in COPD

清洁空气-心脏：空气净化器干预措施减少室内颗粒物并改善慢性阻塞性肺病心血管结局的临床试验

• 批准号: 9115166
• 负责人: MEREDITH C MCCORMACK
• 金额: $ 20.25万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9115166
• 关键词: Address; Adult; Affect; Air; Air Pollution; American; Biomass; Blood Pressure; Blood Vessels; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Chronic Obstructive Airway Disease; Clinical Trials; Coagulation Process; Disease; Disease Management; Exposure to; Funding; Health; Health Benefit; Heart; Home environment; Hospitalization; Household; Individual; Indoor Air Pollution; Indoor Air Quality; Indoor pollutant; Inflammation; Inflammatory; Intervention; Intervention Trial; Link; Lung diseases; Measurement; Morbidity - disease rate; National Institute of Environmental Health Sciences; Outcome; Outcome Measure; Parents; Participant; Particulate Matter; Patients; Pollution; Population; Reporting; Research; Research Infrastructure; Research Priority; Resources; Respiratory Failure; Risk Factors; Surrogate Endpoint; Therapeutic; Time; United States; air cleaner; ambient air pollution; base; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; cigarette smoking; cost effective; efficacy testing; endothelial dysfunction; heart rate variability; improved; indoor exposure; mortality; public health relevance; respiratory; response; risk sharing; Address; Adult; Affect; Air; Air Pollution; American; Biomass; Blood Pressure; Blood Vessels; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Chronic Obstructive Airway Disease; Clinical Trials; Coagulation Process; Disease; Disease Management; Exposure to; Funding; Health; Health Benefit; Heart; Home environment; Hospitalization; Household; Individual; Indoor Air Pollution; Indoor Air Quality; Indoor pollutant; Inflammation; Inflammatory; Intervention; Intervention Trial; Link; Lung diseases; Measurement; Morbidity - disease rate; National Institute of Environmental Health Sciences; Outcome; Outcome Measure; Parents; Participant; Particulate Matter; Patients; Pollution; Population; Reporting; Research; Research Infrastructure; Research Priority; Resources; Respiratory Failure; Risk Factors; Surrogate Endpoint; Therapeutic; Time; United States; air cleaner; ambient air pollution; base; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; cigarette smoking; cost effective; efficacy testing; endothelial dysfunction; heart rate variability; improved; indoor exposure; mortality; public health relevance; respiratory; response; risk sharing

 DESCRIPTION (provided by applicant): Outdoor particulate matter (PM) has been associated with increased morbidity and mortality related to cardiovascular and respiratory disease. Despite the well-established effects of outdoor pollution on cardiovascular outcomes, there have been very few studies of indoor pollution and these have mostly focused on effects of indoor biomass. It is critical to understand cardiovascular effects of indoor air as people in the United States spend the great majority (over 85%) of their time indoors and indoor air quality is modifiable at the individual level. Individuals with chronic obstructive lung disease (COPD) are a high research priority as they are susceptible to the health effects of air pollution and are at increased risk for cardiovascular morbidity and mortality. While the effects of indoor pollution related to biomass has been a recent focus of worldwide efforts to reduce the burden of COPD, there is a need to study the effects of indoor pollutants at concentrations typical of US household exposures. In the proposed study, we address unique hypotheses by leveraging the infrastructure of a recently NIEHS R01-funded air cleaner intervention trial. This parent trial provides detailed participant characterization, indoor pollutant measurements, an air purifier versus sham intervention, and respiratory outcomes measures. In the current proposal, we add intermediate outcomes that have been linked to cardiovascular morbidity, including endothelial function, blood pressure, vascular stiffness, heart rate variability, markers of systemic inflammation and coagulation. We will determine the association between in-home PM concentrations and cardiovascular outcomes and determine the effect of an air purifier intervention that reduces indoor PM on these outcomes. Addressing the hypotheses in this proposal will inform our understanding of multisystem health benefits that can result from an air purifier intervention for patients with COPD, including cardiovascular in addition to respiratory outcomes. The findings have high potential to shift our approach to COPD management by defining indoor air pollution interventions as a therapy for individuals with COPD.

 描述（由适用提供）：室外颗粒物（PM）与与心血管和呼吸系统疾病有关的发病率和死亡率增加有关。尽管室外污染对心血管结局产生了公认的影响，但室内污染的研究很少，这些研究主要集中在室内生物量的影响上。了解室内空气的心血管效应至关重要，因为美国的人们在室内花费了绝大多数时间（超过85％），并且室内空气质量在个人层面上都是可修改的。患有慢性阻塞性肺疾病（COPD）的个体是高度研究的重点，因为它们容易受到空气污染的健康影响，并且患心血管发病率和死亡率的风险增加。尽管与生物量有关的室内污染的影响一直是全球范围内努力减少COPD燃烧的努力，但有必要研究室内污染物在美国典型的家庭暴露量下的影响。在拟议的研究中，我们通过利用最近NIEHS R01资助的空气清洁剂干预试验的基础设施来解决独特的假设。该家长试验提供了详细的参与表征，室内污染物测量值，空气净化器与假手术干预以及呼吸结果测量。在当前的提案中，我们增加了与心血管发病率有关的中间结果，包括内皮功能，血压，血管僵硬，心率变异性，全身炎症和凝结的标志物。我们将确定室内PM浓度与心血管结局之间的关联，并确定降低室内PM对这些结果的空气净化器干预的影响。解决该提案中的假设将为我们的理解提供了对多系统健康益处的理解，这可能是由对COPD患者的空气净化器干预造成的，包括心血管，除了呼吸系统效果外。这些发现具有很高的潜力，可以通过将室内空气污染干预措施定义为COPD患者的治疗方法，从而将我们的COPD管理方法转移到COPD管理中。