Objective: To determine the causal association between long-term Nitrogen dioxide (NO2) exposure and the risk of cardiovascular hospitalization. Methods: Based on a sub-cohort of a community-based prospective cohort study, a total of 36 271 participants were recruited from 35 communities randomly selected in Guangzhou in 2015. The annual average exposure of NO2, demographic characteristics, lifestyle factors, and information on the causes of hospitalization was collected. We applied marginal structural Cox models to investigate the effect of NO2 on cardiovascular hospitalization. Demographic and behavioral factors also stratified results. Results: The mean age of participants in the present study was (50.9±17.8) years, and the cardiovascular admission rate was 8.7%, with 203 822 person-years of follow-up. The annual mean NO2 concentration was 48.7 μg/m3 during 2015-2020. For each 10 μg/m3 increase in NO2 concentrations, the HRs (95%CIs) of total cardiovascular hospitalization, cardiovascular hospitalization, and cerebrovascular hospitalization were 1.33 (1.16-1.52), 1.36 (1.16-1.60) and 1.25 (1.00-1.55), respectively. Participants who were never married/married, with secondary education, high exercise frequency, or non-smokers/current smokers may be more susceptible than their counterparts. Conclusion: Long-term exposure to NO2 significantly increased hospitalization risk for cardiovascular disease.
目的： 探讨长期大气二氧化氮（NO2）暴露与心脑血管住院的因果关联。 方法： 依托我国“基于社区人群的健康队列”广州市子队列，将2015年在广州市35个社区招募的36 271名成年参与者纳入研究，收集基本人口学特征、生活行为方式、NO2暴露及心脑血管住院结局信息。采用基于逆概率加权的边际结构模型估计发病风险比（HR）及其95%CI。 结果： 截至2020年12月31日共随访203 822人年，调查对象的年龄为（50.9±17.8）岁，心脑血管住院率为8.7%。2015-2020年，研究对象年均NO2污染暴露为48.7 μg/m3。NO2长期暴露每增加10 μg/m3，心脑血管、心血管及脑血管住院的HR值（95%CI）分别为1.33（1.16~1.52）、1.36（1.16~1.60）及1.25（1.00~1.55）。分层分析结果提示未婚/已婚、文化程度为初中/高中、高运动频率以及从未吸烟/当前吸烟人群可能更加易感。 结论： 长期大气NO2暴露可增加心脑血管住院风险。.