暖季日夜复合热与成年人血压的关联及生理和行为驱动因素的定组研究
Associations of compound hot extreme in warm season with adults' blood pressure and its potential driving factors: a panel study
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摘要:目的 了解暖季日夜复合热与成年人血压的关联, 探讨可能的生理和行为驱动因素。方法 基于定组设计于2020年5—9月在广东省广州市番禺区对35名健康成年人进行5次连续随访, 使用电子血压计测量其血压水平(每月一次), 利用便携式温湿度仪器收集血压测量前7天其生活环境的温湿度, 通过问卷调查收集其社会人口学资料与行为因素, 使用嵌入分布滞后非线性模型“交叉基”函数的随机效应模型分析日夜复合热与成年人血压的关联, 并探讨这种关联的可能驱动因素。结果 与正常日相比, 日夜复合热显著增加收缩压和舒张压水平, 改变量分别为8.35(95%CI: 2.54~14.15)和6.55(95%CI: 1.49~11.60) mmHg, 未观察到单独热日、单独热夜与血压的显著关联。生理驱动因素方面, 暴露于日夜复合热会显著增加血管紧张素Ⅱ的水平, 改变量为28.29(95%CI: 1.52~55.07) pg/mL, 人体超敏C反应蛋白水平也增加1.24(95%CI: 0.25~2.46) mg/L。在行为驱动因素方面, 暴露于日夜复合热时, 研究对象的啤酒饮用量增加200.69(95%CI: 79.16~322.22)mL。结论 暴露于日夜复合热时, 收缩压和舒张压水平显著增加。血管紧张素Ⅱ与超敏C反应蛋白水平的升高可能是其生理驱动因素, 啤酒饮用量的增加可能是其行为驱动因素。Abstract:Objective To explore the association of compound hot extreme with adult blood pressure and its potential physiological and behavioral driving factors.Methods A panel study design was used, and 35 healthy adults in Panyu District, Guangzhou, Guangdong Province, China were followed up from May to September 2020. Participants were required to carry portable temperature and humidity data recorders during the study period, which were used to collect their real exposure of temperature and humidity of living environment in the past seven days. They were also required to measure blood pressure once a month using an electronic blood pressure monitor. Questionnaires were used to collected their socio-demographic information and behavioral factors. A randomized effects model with cross-basis function of distribution lag non-linear model was used to explore the association of compound hot extreme with adult blood pressure and its potential driving factors.Results Compared to the normal day, compound hot extreme significantly increased systolic and diastolic pressure by 8.35 (95% confidence interval CI: 2.54-14.15) and 6.55 (95% CI: 1.49-11.60) mmHg, respectively. However, independent hot day and independent hot night were not significantly associated with blood pressure. With regard to the physiological drivers, exposure to compound hot extreme was associated with 28.29 (95% CI: 1.52-55.07) pg/mL increase in Ang Ⅱ and 1.24 (95% CI: 0.25-2.46) mg/L increase in hs-CRP. With regard to the behavioral drivers, the consumption of beer increased by 200.69 (95% CI: 79.16-322.22) mL when exposed to compound hot extreme.Conclusion Exposure to compound hot extreme was related to significant increases in systolic and diastolic pressure. The increases in Ang Ⅱ and hs-CRP may be physiological drivers of these associations, while the elevated beer consumption may be a behavioral driver.
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