Abstract
Several studies have suggested an association between ambient air temperature and blood pressure. However, this has not been reliably confirmed by longitudinal studies. Also, whether the reaction to temperature stimulation is modified by other factors such as antihypertensive medication is rarely investigated. The present study explores the relationship between ambient temperature and blood pressure, without and with antihypertensive medication, in a study of 1,831 hypertensive patients followed up for three years, in two or four weekly check ups, accumulating 62,452 follow-up records. Both baseline and follow-up blood pressure showed an inverse association with ambient temperature, which explained 32.4% and 65.6% of variation of systolic blood pressure and diastolic blood pressure (P<0.05) respectively. The amplitude of individual blood pressure fluctuation with temperature throughout a year (a 29 degrees centigrade range) was 9.4/7.3 mmHg. Medication with angiotensin converting enzyme inhibitor benazepril attenuated the blood pressure fluctuation by 2.4/1.3 mmHg each year, though the inverse association of temperature and blood pressure remained. Gender, drinking behavior and body mass index were also found to modify the association between temperature and diastolic blood pressure. The results indicate that ambient temperature may negatively regulate blood pressure. Hypertensive patients should monitor and treat blood pressure more carefully in cold days, and it could be especially important for the males, thinner people and drinkers.
Highlights
For hypertensive patients, optimal control of blood pressure (BP) helps maintain low and stable level of BP, and may decrease the risk of adverse events, including stroke and heart failure [1,2,3,4,5]
Daily average temperature was significantly associated with baseline systolic blood pressure (SBP) and diastolic blood pressure (DBP) (b = 20.266 in SBP model, 95% CI: 20.352 to 20.181, P,0.001; b = 20.173 in DBP model, 95% CI: 20.220 to 20.126, P,0.001) after adjustment for gender, age, body mass index (BMI), urine protein, smoking behavior and drinking behavior
Those associations were significant in the individual follow-up analysis (b = 20.214 in SBP model, 95% CI: 20.222 to 20.206, P,0.001; b = 20.144 in DBP model, 95% CI: 20.149 to 20.139, P,0.001) in which multilevel models were used and baseline BP and medication duration were adjusted
Summary
Optimal control of blood pressure (BP) helps maintain low and stable level of BP, and may decrease the risk of adverse events, including stroke and heart failure [1,2,3,4,5]. Except during pregnancy [9], it is unclear whether and to what level, systolic blood pressure (SBP) or diastolic blood pressure (DBP), or both, change with temperature in long-term longitudinal studies. It is unclear whether regulators of hypertension, such as age, smoking behavior and antihypertensive medication, modify the association of BP and temperature. The aim of the present research is to investigate the association between BP and ambient temperature, and further explore potential factors that would modify this association It is based on a three-year surveillance of 1,831 hypertensive patients with 62,452 repeated measurements
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