Cross-Sectional Analysis of the Relationship Between Home Blood Pressure and Indoor Temperature in Winter

Author:

Umishio Wataru1,Ikaga Toshiharu2,Kario Kazuomi3,Fujino Yoshihisa4,Hoshi Tanji5,Ando Shintaro6,Suzuki Masaru7,Yoshimura Takesumi8,Yoshino Hiroshi9,Murakami Shuzo10,

Affiliation:

1. From the Faculty of Science and Technology, Keio University, Yokohama, Japan (W.U.)

2. Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan (T.I.)

3. Department of Cardiology, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.)

4. Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan (Y.F.)

5. Tokyo Metropolitan University, Japan (T.H.)

6. Department of Architecture, Faculty of Environmental Engineering, University of Kitakyushu, Japan (S.A.)

7. Department of Emergency Medicine, Ichikawa General Hospital, Tokyo Dental College, Japan (M.S.)

8. University of Occupational and Environmental Health, Kitakyushu, Japan (T.Y.)

9. Tohoku University, Sendai, Japan (H.Y.)

10. Institute for Building Environment and Energy Conservation, Tokyo, Japan (S.M.).

Abstract

Mortality due to cardiovascular disease rises sharply in winter. Known as excess winter mortality, this phenomenon is partially explained by cold exposure-induced high blood pressure. Home blood pressure, especially in the morning, is closely associated with cardiovascular disease risk. We conducted the first large nationwide survey on home blood pressure and indoor temperature in 3775 participants (2095 households) who intended to conduct insulation retrofitting and were recruited by construction companies. Home blood pressure was measured twice in the morning and evening for 2 weeks. The relationship between home blood pressure and indoor temperature in winter was analyzed using a multilevel model with 3 levels: repeatedly measured day-level variables (eg, indoor ambient temperature and quality of sleep), nested within individual-level (eg, age and sex), and nested within household level. Cross-sectional analyses involving about 2900 participants (1840 households) showed that systolic blood pressure in the morning had significantly higher sensitivity to changes in indoor temperature (8.2 mm Hg increase/10°C decrease) than that in the evening (6.5 mm Hg increase/10°C decrease) in participants aged 57 years (mean age in this survey). We also found a nonlinear relationship between morning systolic blood pressure and indoor temperature, suggesting that the effect of indoor temperature on blood pressure varied depending on room temperature range. Interaction terms between age/women and indoor temperature were significant, indicating that systolic blood pressure in older residents and women was vulnerable to indoor temperature change. We expect that these results will be useful in determining optimum home temperature recommendations for men and women of each age group. Clinical Trial Registration— URL: http://www.umin.ac.jp/ctr/index.htm . Unique identifier: UMIN000030601.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Internal Medicine

Reference49 articles.

1. World Health Organization. Cardiovascular Diseases (CVDs) Fact Sheet. http://www.who.int/mediacentre/factsheets/fs317/en/.Accessed May 5 2018.

2. World Health Organization. About Cardiovascular Diseases. http://www.who.int/cardiovascular_diseases/about_cvd/en/. Accessed May 5 2018.

3. Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe

4. Wilkinson P Landon M Armstrong B Stevenson S Pattenden S McKee M Fletcher T. Cold comfort: The social and environmental determinants of excess winter deaths in England 1986–96 . London United Kingdom: Policy Press; 2001.

5. Seasonal blood pressure variation: implications for cardiovascular risk stratification

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