Short-Term Associations Between Ambient Air Pollution and Outpatient and Emergency Visits for Hypertension: A DLNM-Based Time-Series Analysis in Baise, Guangxi, China

中国广西百色市基于DLNM的时间序列分析:环境空气污染与高血压门诊和急诊就诊量的短期关联

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Abstract

BACKGROUND: Despite growing evidence that short-term ambient air pollution increases hypertension risk, data from China's border regions are limited; this study quantifies the association between daily pollutant concentrations and daily emergency and outpatient visits for hypertension in Baise, a southern border city. METHODS: We collected hypertension case data from two tertiary hospitals in Baise City (1 Jan 2020-30 Dec 2022) and concurrent local air pollutant and meteorological data, and used a distributed lag non-linear model (DLNM) to assess pollutant effects on outpatient and emergency visits, with subgroup analyses by sex, age, and season. RESULTS: Every 10 μg/m(3) increase in PM(2.5) (lag06), PM(10) (lag06), NO(2) (lag06), and every 100 μg/m(3) increase in CO (lag04), the risk of hypertension outpatient/emergency department visits increased by 3.2%, 2.8%, 14.8%, and 3.0%, respectively. Exposure-response curves were approximately linear without a clear threshold. There was no statistically significant effect modification by sex or age, whereas associations were stronger in the cold season than in the warm season. CONCLUSION: Short-term exposure to pollutants such as PM(2.5), PM(10), NO(2), and CO is significantly associated with increased outpatient and emergency visits for hypertension, exhibiting a lag effect. During cold seasons, sensitivity to environmental pollutants among hypertensive patients markedly increases.

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