title: The acute effects of outdoor temperature on blood pressure in a panel of elderly hypertensive patients.
abstract: Higher level of blood pressure (BP) in winter than in summer has been observed, but the association between temperature and BP and its potential modifiers with adjustment of individual confounders and time trends was rarely explored. We aimed to investigate the association between outdoor temperature and BP and its potential modification factors in a longitudinal panel study in Shanghai, China. From January 2011 to December 2012, we scheduled 54 follow-ups for BP measurements per subject via home visit every other week for 50 elderly hypertensive patients. We applied linear mixed-effect models to analyze the association between temperature and BP after controlling for individual characteristics, antihypertensive medication, comorbidities, and time trends. We evaluated the potential effect modifiers by stratification analyses. For a 1 °C decrease in the average temperature on concurrent day and previous day, systolic BP increased by 0.19 mmHg (95 % confidence interval = 0.06, 0.31) and diastolic BP increased by 0.12 mmHg (95 % confidence interval = 0.03, 0.21). The effect of temperature on BP was stronger among those with older age, female sex, low socioeconomic status, and obese physique. The effect was weak and even null for those taking the angiotensin receptor blockers, angiotensin-converting enzyme inhibitor, or its combination with calcium antagonists. Further, the effect was almost restricted within those having chronic comorbidities. Our results demonstrated that an acute decrease in outdoor temperature was significantly associated with a rise in BP among elderly hypertensive patients, in Shanghai, China. Individual characteristics, antihypertensive medications, and comorbidities may modify this effect.
authors: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, P.O. Box 249, 130 Dong'An Road, 200032, Shanghai, China.
authors: Renjie
authors: R
authors: Chen
authors: Tianping Community Health Centre, 110 Taiyuan Road, 200031, Shanghai, China. 13601676240@163.com.
authors: Jianxiong
authors: J
authors: Lu
authors: Tianping Community Health Centre, 110 Taiyuan Road, 200031, Shanghai, China.
authors: Qun
authors: Q
authors: Yu
authors: Shanghai Key Laboratory of Meteorology and Health, 951 Jingxiu Road, 200135, Shanghai, China.
authors: Li
authors: L
authors: Peng
authors: Shanghai Key Laboratory of Meteorology and Health, 951 Jingxiu Road, 200135, Shanghai, China.
authors: Dandan
authors: D
authors: Yang
authors: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, P.O. Box 249, 130 Dong'An Road, 200032, Shanghai, China.
authors: Cuicui
authors: C
authors: Wang
authors: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, P.O. Box 249, 130 Dong'An Road, 200032, Shanghai, China. haidongkan@gmail.com.
authors: Haidong
authors: H
authors: Kan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002681:China; D002947:Cities; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D012621:Seasons; D013696:Temperature
chemical_list: D000959:Antihypertensive Agents
keywords: Antihypertensive medication; Blood pressure; Comorbidity; Epidemiology; Temperature