【摘要】 目的 探讨空气污染对高血压患者血压控制的影响。方法 收集2011—2015年中国健康和营养调查的数据，选取上海市2 860名调查对象，其中831名为高血压患者。通过国家城市空气质量发布平台收集同期上海市的空气污染物监测数据。通过调查问卷获取人口统计学信息、日常生活习惯、患病情况和高血压相关数据。使用logistic回归分析空气污染物对血压达标的影响，并使用混合效应模型研究空气污染物间及其与高血压用药的相互作用。结果 共纳入831名成年高血压患者，血压控制率35.14%。第0 d、前7 d和前60 d的O₃的OR值（95%CI）分别为1.012（1.005～1.020）、1.009（1.002～1.016）和1.013（1.003～1.022）；同期的CO的OR值（95%CI）分别为1.084（1.030～1.140）、1.064（1.030～1.100）和1.126（1.050～1.208）；第0 d和前7 d的SO₂的OR值（95%CI）分别为1.056（1.004～1.110）和1.024（1.003～1.046）。第0 d和前7 d的SO₂（P=0.008;P=0.043）、前60 d的CO（P<0.001）可能对降压药的使用效果有影响；第0 d的CO与当天的SO₂可能对血压达标率存在交互作用（P=0.045）；前7 d的O₃、当天的SO₂与当天的CO可能对血压达标率存在交互作用（P=0.004;P<0.001）。结论 O₃、SO₂与CO与血压控制率相关。近期和远期的O₃与CO暴露可能影响血压控制效果，而近期SO₂暴露可能影响降压药物的效果。建议加强空气污染监测与管理，针对高血压患者提供指导，以改善血压控制效果。更多还原

【Abstract】 Objective To investigate the impact of air pollution on blood pressure control in hypertensive patients. Methods Data from the China Health and Nutrition Survey collected between 2011 and 2015 were analyzed, including 2 860 participants from Shanghai, of which 831 were hypertensive patients. Air pollution monitoring data for Shanghai during the same period were obtained from the National Urban Air Quality Release Platform. Demographic information, daily habits, health status, and hypertension-related data were collected via questionnaires. Logistic regression was employed to analyze the effect of air pollutants on achieving blood pressure targets, and a mixed-effects model was used to study interactions among air pollutants and their interactions with antihypertensive medications. Results A total of 831 adult hypertensive patients were included, with a blood pressure control rate of 35.14%. The odds ratios（OR） and 95% confidence intervals（CI） for O₃ exposure on day 0, the previous 7 days, and the previous 60 days were 1.012（1.005-1.020）, 1.009（1.002-1.016）, and 1.013（1.003-1.022）, respectively. For CO during the same periods, the OR and 95%CI were 1.084（1.030-1.140）, 1.064（1.030-1.100）,and 1.126（1.050-1.208）, respectively. The OR and 95%CI for SO₂ on day 0 and the previous 7 days were 1.056（1.004-1.110） and 1.024（1.003-1.046）, respectively. SO₂ exposure on day 0 and the previous 7 days（P=0.008; P=0.043） and CO exposure in the previous 60 days（P<0.001） may influence the effectiveness of antihypertensive medications; CO on day 0 and SO₂ on the same day may interact regarding blood pressure control rates（P=0.045）; O₃ exposure in the previous 7 days, SO₂ on the same day, and CO on the same day may also interact concerning blood pressure control rates（P=0.004; P<0.001）.Conclusion O₃, SO₂, and CO are associated with blood pressure control rates. Recent and long-term exposure to O₃ and CO may affect blood pressure control, while recent exposure to SO₂ may influence the efficacy of antihypertensive medications. It is recommended to enhance air pollution monitoring and management, providing guidance for hypertensive patients to improve blood pressure control outcomes.更多还原