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Li Y, Zhou E, Yu Y, Wang B, Zhang L, Lei R, Xue B, Tian X, Niu J, Liu J, Zhang K, Luo B. Butyrate attenuates cold-induced hypertension via gut microbiota and activation of brown adipose tissue. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 943:173835. [PMID: 38851345 DOI: 10.1016/j.scitotenv.2024.173835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE Chronic exposure to cold temperature is known to elevate blood pressure, leading to a condition known as cold-induced hypertension (CIH). Our previous research suggested correlations between alterations in gut microbiota, decrease in butyrate level, and the onset and progression of CIH. However, the role of butyrate in CIH and the underlying mechanisms need further investigation. METHODS We exposed Specific Pathogen Free (SPF) rats to continuous cold temperature (4 ± 1 °C) for 6 weeks to establish a CIH rat model. Rats were divided into different groups by dose and duration, and the rats under cold were administered with butyrate (0.5 or 1 g/kg/day) daily. We assessed hypertension-associated phenotypes, pathological morphological changes, and endocrine-related phenotypes of brown adipose tissue (BAT). The effects of butyrate on gut microbiota and intestinal content metabolism were evaluated by 16s RNA sequencing and non-targeted metabolomics, respectively. RESULTS The systolic blood pressure (SBP) of rats exposed to cold after supplemented with butyrate were significantly lower than that of the Cold group. Butyrate may increase the species, abundance, and diversity of gut microbiota in rats. Specifically, butyrate intervention enriched beneficial bacterial genera, such as Lactobacillaceae, and decreased the levels of harmful bacteria genera, such as Actinobacteriota and Erysipeiotrichaceae. Cold exposure significantly increased BAT cells and the number of mitochondria. After butyrate supplementation, the levels of peroxisome proliferator-activated receptor gamma coactivator 1a and fibroblast growth factor 21 in BAT were significantly elevated (P < 0.05), and the volume and number of lipid droplets increased. The levels of ANG II and high-density lipoprotein were elevated in the Cold group but decreased after butyrate supplementation. CONCLUSION Butyrate may attenuate blood pressure in CIH by promoting the growth of beneficial bacteria and the secretion of beneficial derived factors produced by BAT, thus alleviating the elevation of blood pressure induced by cold. This study demonstrates the anti-hypertensive effects of butyrate and its potential therapeutic mechanisms, offering novel insights to the prevention and treatment of CIH in populations living or working in cold environments.
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Affiliation(s)
- Yanlin Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Erkai Zhou
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Yunhui Yu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Baode Xue
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Xiaoyu Tian
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Jingping Niu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Jiangtao Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China.
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA.
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, People's Republic of China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, People's Republic of China.
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Ye XF, Wang WYY, Wang XY, Huang QF, Sheng CS, Li Y, Wang JG. Seasonal variation in ambulatory blood pressure control in patients on clinic blood pressure-guided antihypertensive treatment. J Hypertens 2024; 42:909-916. [PMID: 38230620 DOI: 10.1097/hjh.0000000000003666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND We investigated seasonal variation in ambulatory blood pressure control in hypertensive patients on clinic blood pressure-guided antihypertensive treatment. METHODS The study participants were hypertensive patients enrolled in an 8-week therapeutic study. Antihypertensive treatment was initiated with long-acting dihydropyridine calcium channel blockers amlodipine 5 mg/day or the gastrointestinal therapeutic system (GITS) formulation of nifedipine 30 mg/day, with the possible up-titration to amlodipine 10 mg/day or nifedipine-GITS 60 mg/day at 4 weeks of follow-up. RESULTS The proportion of up-titration to higher dosages of antihypertensive drugs at 4 weeks of follow-up was higher in patients who commenced treatment in autumn/winter ( n = 302) than those who commenced treatment in spring/summer ( n = 199, 24.5 vs. 12.0%, P < 0.001). The control rate of clinic blood pressure, however, was lower in autumn/winter than in spring/summer at 4 (56.7 vs. 70.7%, P = 0.003) and 8 weeks of follow-up (52.5 vs. 74.9%, P < 0.001). At 8 weeks, patients who commenced treatment in autumn/winter, compared with those who commenced treatment in spring/summer, had a significantly ( P ≤0.03) smaller daytime (mean between-season difference -3.2/-2.8 mmHg) but greater nighttime SBP/DBP reduction (3.6/1.6 mmHg). Accordingly, at 8 weeks, the prevalence of nondippers was significantly ( P < 0.001) higher in spring/summer than in autumn/winter for both SBP (54.8 vs. 30.0%) and DBP (53.4 vs. 28.8%). CONCLUSION Clinic blood pressure-guided antihypertensive treatment requires a higher dosage of medication in cold than warm seasons, which may have led to over- and under-treatment of nighttime blood pressure, respectively.
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Affiliation(s)
- Xiao-Fei Ye
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Yuan-Yue Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin-Yu Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi-Fang Huang
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang-Sheng Sheng
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ji-Guang Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zhang Y, Ding Y, Yu C, Sun D, Pei P, Du H, Yang L, Chen Y, Schmidt D, Avery D, Chen J, Chen J, Chen Z, Li L, Lv J. Predictive value of 8-year blood pressure measures in intracerebral hemorrhage risk over 5 years. Eur J Prev Cardiol 2024:zwae147. [PMID: 38629743 DOI: 10.1093/eurjpc/zwae147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/21/2024] [Accepted: 04/16/2024] [Indexed: 05/07/2024]
Abstract
AIMS The relationships between long-term blood pressure (BP) measures and intracerebral hemorrhage (ICH), as well as their predictive ability on ICH, were unclear. We aimed to investigate the independent associations of multiple BP measures with subsequent 5-year ICH risk, as well as the incremental value of these measures over a single-point BP measurement in ICH risk prediction. METHODS We included 12,398 participants from the China Kadoorie Biobank (CKB) who completed three surveys every four to five years. The following long-term BP measures were calculated: mean, minimum, maximum, standard deviation, coefficient of variation, average real variability, and cumulative BP exposure (cumBP). Cox proportional hazard models were used to examine the associations between these measures and ICH. The potential incremental value of these measures in ICH risk prediction was assessed using Harrell's C statistics, continuous net reclassification improvement (cNRI), and relative integrated discrimination improvement (rIDI). RESULTS The hazard ratios (95% confidence intervals) of incident ICH associated with per SD increase in cumSBP and cumDBP were 1.62 (1.25, 2.10) and 1.59 (1.23, 2.07), respectively. When cumBP was added to the conventional 5-year ICH risk prediction model, the C-statistic change was 0.009 (-0.001, 0.019), the cNRI was 0.267 (0.070, 0.464), and the rIDI was 18.2% (5.8%, 30.7%). Further subgroup analyses revealed a consistent increase in cNRI and rIDI in men, rural residents, and participants without diabetes. Other long-term BP measures showed no statistically significant associations with incident ICH and generally did not improve model performance. CONCLUSION The nearly 10-year cumBP was positively associated with an increased 5-year risk of ICH and could significantly improve risk reclassification for the ICH risk prediction model that included single-point BP measurement.
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Affiliation(s)
- Yiqian Zhang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yinqi Ding
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education
| | - Dianjianyi Sun
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Dan Schmidt
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Daniel Avery
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Jianwei Chen
- Liuyang Centers for Disease Control and Prevention, Liuyang, Changsha, Hunan, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Liming Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education
| | - Jun Lv
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University
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Xu Y, Han Y, Chen W, Chatzidiakou L, Yan L, Krause A, Li Y, Zhang H, Wang T, Xue T, Chan Q, Barratt B, Jones RL, Liu J, Wu Y, Zhao M, Zhang J, Kelly FJ, Zhu T. Susceptibility of hypertensive individuals to acute blood pressure increases in response to personal-level environmental temperature decrease. ENVIRONMENT INTERNATIONAL 2024; 185:108567. [PMID: 38460242 DOI: 10.1016/j.envint.2024.108567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/24/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Environmental temperature is negatively associated with blood pressure (BP), and hypertension may exacerbate this association. The aim of this study is to investigate whether hypertensive individuals are more susceptible to acute BP increases following temperature decrease than non-hypertensive individuals. METHODS The study panel consisted of 126 hypertensive and 125 non-hypertensive (n = 251) elderly participants who completed 940 clinical visits during the winter of 2016 and summer of 2017 in Beijing, China. Personal-level environmental temperature (PET) was continuously monitored for each participant with a portable sensor platform. We associated systolic BP (SBP) and diastolic BP (DBP) with the average PET over 24 h before clinical visits using linear mixed-effects models and explored hourly lag patterns for the associations using distributed lag models. RESULTS We found that per 1 °C decrease in PET, hypertensive individuals showed an average (95 % confidence interval) increase of 0.96 (0.72, 1.19) and 0.28 (0.13, 0.42) mmHg for SBP and DBP, respectively; and non-hypertensive participants showed significantly smaller increases of 0.28 (0.03, 0.53) mmHg SBP and 0.14 (-0.01, 0.30) mmHg DBP. A lag pattern analysis showed that for hypertensive individuals, the increases in SBP and DBP were greatest following lag 1 h PET decrease and gradually attenuated up to lag 10 h exposure. No significant BP change was observed in non-hypertensive individuals associated with lag 1-24 h PET exposure. The enhanced increase in PET-associated BP in hypertensive participants (i.e., susceptibility) was more significant in winter than in summer. CONCLUSIONS We found that a decrease in environmental temperature was associated with acute BP increases and these associations diminished over time, disappearing after approximately 10 hours. This implies that any intervention measures to prevent BP increases due to temperature drop should be implemented as soon as possible. Such timely interventions are particularly needed for hypertensive individuals especially during the cold season due to their increased susceptibility.
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Affiliation(s)
- Yifan Xu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing, China
| | - Yiqun Han
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing, China; Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing, China
| | - Lia Chatzidiakou
- Yusuf Hamied Department of Chemistry, University of Cambridge, UK
| | - Li Yan
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Anika Krause
- Yusuf Hamied Department of Chemistry, University of Cambridge, UK
| | - Yilin Li
- Yusuf Hamied Department of Chemistry, University of Cambridge, UK
| | - Hanbin Zhang
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Teng Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing, China
| | - Tao Xue
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Queenie Chan
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Ben Barratt
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Roderic L Jones
- Yusuf Hamied Department of Chemistry, University of Cambridge, UK
| | - Jing Liu
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Beijing, China
| | - Meiping Zhao
- College of Chemistry, Peking University, Beijing, China
| | - Junfeng Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Frank J Kelly
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK.
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing, China.
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Yan X, Li J, Wu J, Lin S, Wang Z, Pei L, Zheng C, Wang X, Cao X, Hu Z, Tian Y. Association between short-term daily temperature variability and blood pressure in the Chinese population: From the China hypertension survey. ENVIRONMENT INTERNATIONAL 2024; 184:108463. [PMID: 38324925 DOI: 10.1016/j.envint.2024.108463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/04/2024] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND We aimed to evaluate the impacts of short-term daily temperature variability (DTV) on blood pressure (BP) among participants with normotension, prehypertension, and hypertension, respectively, and explore the effects in different climate zones and seasons. METHODS A representative population sample (n = 397,173) covering the subtropical, temperate continental, and temperate monsoon zones was obtained from the China Hypertension Survey. DTV was calculated as the standard deviation of daily minimum and maximum temperatures during the exposure days. The linear mixed effect regression model was used to estimate the associations between DTV exposure and BP among normotension, prehypertension, and hypertension, respectively, and further stratified analysis was performed by climate zones and seasons. RESULTS After adjustment for confounders, per interquartile range (IQR) increase in DTV (2.28 °C) at 0-6 days of exposure was associated with an increase of 0.41 mmHg (95 % confidence interval [CI]: 0.07, 0.75) in systolic BP (SBP) and 0.41 mmHg (95 % CI: 0.09, 0.72) in pulse pressure (PP) among hypertensive participants in the subtropical zone. Similarly, DTV exposure was associated with an increase of 0.31 mmHg (95 % CI: 0.06, 0.55) in SBP and 0.59 mmHg (95 % CI: 0.24, 0.94) in PP among prehypertensive participants in the temperate continental zone. Additionally, during the warm season, DTV was positively associated with SBP among populations with prehypertension and hypertension, and with PP among all three populations. CONCLUSION Short-term DTV exposure was associated with an increase in SBP and PP among hypertensive and prehypertensive participants in the subtropical zone and the temperate continental zone. In addition, positive associations of DTV with SBP and PP were observed among participants with prehypertension and hypertension in the warm season. Comprehensive health education and effective intervention strategies should be implemented to mitigate the effects of temperature variations on BP, particularly among prehypertensive and hypertensive populations.
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Affiliation(s)
- Xiaojin Yan
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Jiajia Li
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Jilei Wu
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Shiqi Lin
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Peking Union Medical College & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 102308, China.
| | - Lijun Pei
- Institute of Population Research, Peking University, Beijing 100871, China.
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Peking Union Medical College & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Peking Union Medical College & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Peking Union Medical College & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Zhen Hu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Peking Union Medical College & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 102308, China
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Peking Union Medical College & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 102308, China
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Jingesi M, Lan S, Hu J, Dai M, Huang S, Chen S, Liu N, Lv Z, Ji J, Li X, Wang P, Cheng J, Peng J, Yin P. Association between thermal stress and cardiovascular mortality in the subtropics. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2093-2106. [PMID: 37878088 DOI: 10.1007/s00484-023-02565-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
Hazardous thermal conditions resulting from climate change may play a role in cardiovascular disease development. We chose the Universal Thermal Climate Index (UTCI) as the exposure metric to evaluate the relationship between thermal conditions and cardiovascular mortality in Shenzhen, China. We applied quasi-Poisson regression non-linear distributed lag models to evaluate the exposure-response associations. The findings suggest that cardiovascular mortality risks were significantly increased under heat and cold stress, and the adverse effects of cold stress were stronger than heat stress. Referencing the 50th percentile of UTCI (25.4°C), the cumulative risk of cardiovascular mortality was 75% (RRlag0-21 =1.75, 95%CI: 1.32, 2.32) higher in the 1st percentile (3.5°C), and 40% (RRlag0-21=1.40, 95%CI: 1.09, 1.80) higher in the 99th percentile (34.1°C). We observed that individuals older than 65 years were more vulnerable to both cold and heat stress, and females were identified as more susceptible to heat stress than males. Moreover, increased mortality risks of hypertensive disease and cerebrovascular disease were observed under cold stress, while heat stress was related to higher risks of mortality for hypertensive disease and ischemic heart disease. We also observed a stronger relationship between cold stress and ischemic heart disease mortality during the cold season, as well as a significant impact of heat stress on cerebrovascular disease mortality in the warm season when compared to the analysis of the entire year. These results confirm the significant relationship between thermal stress and cardiovascular mortality, with age and sex as potential effect modifiers of this association. Providing affordable air conditioning equipment, increasing the amount of vegetation, and establishing comprehensive early warning systems that take human thermoregulation into account could all help to safeguard the well-being of the public, particularly vulnerable populations, in the event of future extreme weather.
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Affiliation(s)
- Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Shuhua Lan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Ning Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Xiaoheng Li
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Rd, Shenzhen, 518020, Guangdong, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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7
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Li Y, Xia Y, Zhu H, Shi C, Jiang X, Ruan S, Wen Y, Gao X, Huang W, Li M, Xue R, Chen J, Zhang L. Impacts of exposure to humidex on cardiovascular mortality: a multi-city study in Southwest China. BMC Public Health 2023; 23:1916. [PMID: 37794404 PMCID: PMC10548730 DOI: 10.1186/s12889-023-16818-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Many studies have reported the association between ambient temperature and mortality from cardiovascular disease (CVD). However, the health effects of humidity are still unclear, much less the combined effects of temperature and humidity. In this study, we used humidex to quantify the effect of temperature and humidity combined on CVD mortality. METHODS Daily meteorological, air pollution, and CVD mortality data were collected in four cities in southwest China. We used a distributed lag non-linear model (DLNM) in the first stage to assess the exposure-response association between humidex and city-specific CVD mortality. A multivariate meta-analysis was conducted in the second stage to pool these effects at the overall level. To evaluate the mortality burden of high and low humidex, we determined the attributable fraction (AF). According to the abovementioned processes, stratified analyses were conducted based on various demographic factors. RESULTS Humidex and the CVD exposure-response curve showed an inverted "J" shape, the minimum mortality humidex (MMH) was 31.7 (77th percentile), and the cumulative relative risk (CRR) was 2.27 (95% confidence interval [CI], 1.76-2.91). At extremely high and low humidex, CRRs were 1.19 (95% CI, 0.98-1.44) and 2.52 (95% CI, 1.88-3.38), respectively. The burden of CVD mortality attributed to non-optimal humidex was 21.59% (95% empirical CI [eCI], 18.12-24.59%), most of which was due to low humidex, with an AF of 20.16% (95% eCI, 16.72-23.23%). CONCLUSIONS Low humidex could significantly increase the risk of CVD mortality, and vulnerability to humidex differed across populations with different demographic characteristics. The elderly (> 64 years old), unmarried people, and those with a limited level of education (1-9 years) were especially susceptible to low humidex. Therefore, humidex is appropriate as a predictor in a CVD early-warning system.
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Affiliation(s)
- Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500, China
| | - Hongbin Zhu
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Yue Wen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No.6, Longxiang Road, Wuhou District, Chengdu, 610041, China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No.826, Huichuan Road, Ziliujing District, Zigong, 643000, China
| | - Mingjiang Li
- Panzhi hua Center for Disease Control and Prevention, No.996, Jichang Road, Dong District, Panzhi hua, 617067, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No.996, Binhebei Road,Lizhou District, Guangyuan, 628017, China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China.
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China.
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8
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Zhai G, Tian Y, Zhang Y, Zhou W. The effect of ambient temperature and risk of cardiovascular disease hospitalization in China: a meta-analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1423-1433. [PMID: 37432460 DOI: 10.1007/s00484-023-02509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/23/2023] [Accepted: 06/06/2023] [Indexed: 07/12/2023]
Abstract
The effect of ambient temperature on relative risk (RR) of cardiovascular disease (CVD) is different in China than in other countries due to the different geographical environment, climate the different inter- and intra-individual characteristics of the population within China. It is therefore important to integrate information to evaluate the impact of temperature on RR of CVD in China. We performed a meta-analysis to evaluate the effect of temperature on RR of CVD. The Web of Science, Google Scholar, and China National Knowledge Infrastructure databases were searched back to 2022 and nine studies were included in the study. The Cochran Q test and I2 statistics were used to assess heterogeneity, while Egger's test was used to assess publication bias. The pooled estimated size of the relationship between ambient temperature and CVD hospitalization in the random effect model was 1.2044 (95%CI: 1.0610-1.3671) for the cold effect and 1.1982 (95%CI: 1.0166-1.4122) for the heat effect. The Egger's test showed a potential publication bias for the cold effect, whereas there was no apparent publication bias for the heat effect. There is a significant effect of ambient temperature on RR of CVD for both the cold effect and heat effect. The effect of socioeconomic factors should be considered more thoroughly in future studies.
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Affiliation(s)
- Guangyu Zhai
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Yiwen Tian
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, China.
| | - Yuqi Zhang
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Wenjuan Zhou
- Gansu Provincial Hospital, Network Center, Lanzhou, 730000, Gansu, People's Republic of China
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9
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Barbosa ECD, Farina GS, Basso CS, Camafort M, Coca A, Nadruz W. Seasonal variation in blood pressure: what is still missing? Front Cardiovasc Med 2023; 10:1233325. [PMID: 37663410 PMCID: PMC10469506 DOI: 10.3389/fcvm.2023.1233325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Seasonal variation of blood pressure (BP) is a topic in cardiology that has gained more attention throughout the years. Although it is extensively documented that BP increases in seasons coupled with lower temperatures, there are still many gaps in this knowledge field that need to be explored. Notably, seasonal variation of BP phenotypes, such as masked and white coat hypertension, and the impact of air pollution, latitude, and altitude on seasonal variation of BP are still poorly described in the literature, and the levels of the existing evidence are low. Therefore, further investigations on these topics are needed to provide robust evidence that can be used in clinical practice.
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Affiliation(s)
- Eduardo Costa Duarte Barbosa
- Hypertension Leagueof Porto Alegre, Porto Alegre, Brazil
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
- Department of Hypertension and Cardiometabolism, São Francisco Hospital, Santa Casa de Misericórdia de Porto Alegre, Feevale University, Porto Alegre, Brazil
| | - Giovani Schulte Farina
- Hypertension Leagueof Porto Alegre, Porto Alegre, Brazil
- Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University, Dresden, Germany
| | - Carolina Souza Basso
- Hypertension Leagueof Porto Alegre, Porto Alegre, Brazil
- School of Medicine, Lutheran University of Brazil, Canoas, Brazil
| | - Miguel Camafort
- Hypertension and Vascular Risk Unit, Hospital Clínic (IDIBAPS), Department of Internal Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Coca
- Hypertension and Vascular Risk Unit, Hospital Clínic (IDIBAPS), Department of Internal Medicine, University of Barcelona, Barcelona, Spain
| | - Wilson Nadruz
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
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10
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Yao M, Niu Y, Liu S, Liu Y, Kan H, Wang S, Ji JS, Zhao B. Mortality Burden of Cardiovascular Disease Attributable to Ozone in China: 2019 vs 2050. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:10985-10997. [PMID: 37466930 DOI: 10.1021/acs.est.3c02076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Due to a combination of lifestyle risk factors, the burden of cardiovascular disease (CVD) has been increasing in China, affecting an estimated 330 million people. Environmental risk factors can exacerbate these risks or independently contribute to CVD. Ozone is an overlooked and invisible risk factor, and it plays a significant role in the development of CVD. Our study provides a novel quantification of the ozone-attributable CVD mortality burden based on daily maximum 8-h average ozone concentration during May to October (6mDMA8) in Chinese adults in 2050, projected under Shared Socioeconomic Pathways 585 and 126, and using the updated WHO air quality guideline level. The study also considers the contributions made by changes in ozone exposure, population aging, population size, and baseline death rates of CVD between 2019 and 2050. While adopting a sustainable and green pathway (SSP 126) can reduce the projected magnitude of premature CVD deaths to 359,200 in 2050, it may not be sufficient to reduce the CVD mortality burden significantly. Therefore, it is crucial to implement strategies for stricter ozone control and reducing the baseline death rate of CVD to mitigate the impacts of ozone on Chinese adults.
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Affiliation(s)
- Mingyao Yao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Shuchang Liu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich 8092, Switzerland
| | - Yumeng Liu
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 200032, China
| | - Shuxiao Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Tsinghua University, Beijing 100084, China
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11
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Hou X, Wang L, Zhu D, Guo L, Weng J, Zhang M, Zhou Z, Zou D, Ji Q, Guo X, Wu Q, Chen S, Yu R, Chen H, Huang Z, Zhang X, Wu J, Wu J, Jia W. Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China. Nat Commun 2023; 14:4296. [PMID: 37463878 DOI: 10.1038/s41467-023-39864-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
The current epidemic status of diabetic retinopathy in China is unclear. A national prevalence survey of diabetic complications was conducted. 50,564 participants with gradable non-mydriatic fundus photographs were enrolled. The prevalence rates (95% confidence intervals) of diabetic retinopathy and vision-threatening diabetic retinopathy were 16.3% (15.3%-17.2%) and 3.2% (2.9%-3.5%), significantly higher in the northern than in the southern regions. The differences in prevalence between those who had not attained a given metabolic goal and those who had were more pronounced for Hemoglobin A1c than for blood pressure and low-density lipoprotein cholesterol. The participants with vision-threatening diabetic retinopathy had significantly higher proportions of visual impairment and blindness than those with non-vision-threatening diabetic retinopathy. The likelihoods of diabetic retinopathy and vision-threatening diabetic retinopathy were also associated with education levels, household income, and multiple dietary intakes. Here, we show multi-level factors associated with the presence and the severity of diabetic retinopathy.
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Affiliation(s)
- Xuhong Hou
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, Beijing, China
| | - Jianping Weng
- Department of Endocrinology, the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiguang Zhou
- Institute of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, the Second Xiangya Hospital and the Diabetes Center, Central South University, Changsha, Hunan Province, China
| | - Dajin Zou
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Qiuhe Ji
- Department of Endocrinology, Xijing Hospital, Xi'an, Shaanxi Province, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Siyu Chen
- Department of Endocrinology and Metabolism, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu Province, China
| | - Rong Yu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Hongli Chen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiarui Wu
- Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
- Center for Excellence in Molecular Science, Chinese Academy of Sciences, Shanghai, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
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12
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Chen T, Ge J, Luo X. Effects of indoor temperature and its fluctuation on blood pressure and its variability. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02469-5. [PMID: 37410169 DOI: 10.1007/s00484-023-02469-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 02/13/2023] [Accepted: 04/03/2023] [Indexed: 07/07/2023]
Abstract
Cardiovascular diseases (CVDs) are the number one health threat globally. Adverse indoor thermal environments are associated with excess mortality caused by CVDs in the cold season. While many studies have focused on the impact of indoor temperature on CVDs, none has considered the fluctuation of indoor temperature. To quantify the effect of indoor temperature on blood pressure and the effect of indoor temperature fluctuation on blood pressure variability (BPV), 172 middle-aged and elderly people in areas that experience both hot summers and cold winters in China completed a household survey regarding their characteristics and living habits. A hierarchical linear model (HLM) was used to analyze the impact of indoor temperature on home blood pressure. A multiple linear model was used to analyze the effect of indoor temperature fluctuation on day-to-day home blood pressure variability. The results showed that there was a significant negative correlation between morning temperature below 18 °C and blood pressure, especially systolic blood pressure (SBP). At the same time, morning temperature fluctuations have an independent influence on BPV, and a deviation of morning temperature fluctuation greater than 1.1 °C significantly increased BPV. Morning temperature and its fluctuation threshold for the rise of SBP and its variability of middle-aged and elderly people were clarified, which can provide a basis for the design, operation, and evaluation of residential thermal environmental health performance for the middle-aged and elderly population in this area, thereby reducing the cardiovascular health risk of the corresponding population.
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Affiliation(s)
- Ting Chen
- College of Civil Engineering and Architecture, Zhejiang University, Zhejiang, 330009, China
| | - Jian Ge
- College of Civil Engineering and Architecture, Zhejiang University, Zhejiang, 330009, China
| | - Xiaoyu Luo
- College of Civil Engineering and Architecture, Zhejiang University, Zhejiang, 330009, China.
- Center for Balance Architecture, Zhejiang University, Zhejiang, 330009, China.
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13
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Zhu X, Chen R, Zhang Y, Hu J, Jiang Y, Huang K, Wang J, Li W, Shi B, Chen Y, Li L, Li B, Cheng X, Yu B, Wang Y, Kan H. Low ambient temperature increases the risk and burden of atrial fibrillation episodes: A nationwide case-crossover study in 322 Chinese cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163351. [PMID: 37030388 DOI: 10.1016/j.scitotenv.2023.163351] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Non-optimum ambient temperature has recently been acknowledged as an independent risk factor for disease burden, but its impact on atrial fibrillation (AF) episodes was rarely evaluated. OBJECTIVES To examine the associations between ambient non-optimum temperature and symptom onset of AF episodes and calculate the corresponding disease burden. METHODS We conducted an individual-level, time-stratified, case-crossover analysis based on a nationwide registry, which comprises of 94,711 eligible AF patients from 1993 hospitals in 322 Chinese cities from January 2015 to December 2021. Multiple moving 24 h average temperatures prior to the symptom onset of AF episodes were calculated as lag days. The associations were analyzed using conditional logistic regression combined with distributed lag non-linear models with a duration of lag 0-7 days, after controlling for criteria air pollutants. Stratification analyses were performed to explore possible effect modifiers. RESULTS There was a monotonically increasing relationship of AF onset risk with decreasing temperature. The excess AF risk occurred at lag 1 d and lasted for 5 days. Nationally, the cumulative relative risk of AF episode onset associated with extremely low temperature (-9.3 °C) over lag 0-7 d was 1.25 (95 % confidence interval: 1.08, 1.45), compared with the reference temperature (31.5 °C). The exposure-response curve was steeper in the south than in the north where there was levelling-off at lower temperature. Nationally, 7.59 % of acute AF episodes could be attributable to non-optimum temperatures. The attributable fraction was larger for southern residents, males and patients <65 years. CONCLUSION This nationwide study provides novel and robust evidence that declining ambient temperature could increase the risk of AF episode onset. We also provide the first-hand evidence that a considerable proportion of acute AF episodes could be attributable to non-optimum temperatures.
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Affiliation(s)
- Xinlei Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yong Zhang
- Department of Emergency, Wuhan Asia General Hospital, Wuhan, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Kai Huang
- Department of Cardiology, Institute of Cardiovascular Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianan Wang
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Li
- Department of Cardiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Bei Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yundai Chen
- Senior Department of Cardiology, the Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Lang Li
- Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Bao Li
- Department of Cardiology, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaoshu Cheng
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Bo Yu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Yan Wang
- Department of Cardiology, Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai, China.
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14
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Liu P, Chen Z, Xia X, Wang L, Li X. Potential role of ambient temperature as a trigger for intracerebral hemorrhage: a time-stratified case-crossover study in Tianjin, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:80988-80995. [PMID: 37310604 DOI: 10.1007/s11356-023-27942-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/23/2023] [Indexed: 06/14/2023]
Abstract
The adverse effects of ambient temperature on human health are receiving increasing attention, yet evidence of its impact on intracerebral hemorrhage (ICH) onset is limited. Here, the relationship between ambient temperature and ICH was evaluated. A time-stratified case-crossover analysis was performed based on 4051 ICH patients admitted to five stroke units in Tianjin between January 2014 and December 2020. Conditional logistic regression was applied to evaluate the associations between the daily mean temperature (Tm) or daily temperature range (DTR) and ICH onset. We found a negative association between Tm and ICH onset (OR = 0.977, 95% CI 0.968-0.987) but not between DTR and ICH onset. In stratified analyses, men and individuals aged ≥ 60 years were more susceptible to low-ambient temperature effects; corresponding adjusted ORs were 0.970 (95% CI 0.956-0.983) and 0.969 (95% CI 0.957-0.982), respectively. Tm significantly affected patients with deep ICH (OR = 0.976, 95% CI 0.965-0.988), but had no effect on lobar ICH. There was also seasonal heterogeneity in the effect of Tm on ICH onset, with Tm being negatively associated with ICH onset only in the warm season (OR = 0.961, 95% CI 0.941-0.982). Results suggest that the low-ambient temperature might trigger ICH onset, especially for the male and elderly population, providing important health guidance to prevent cold exposure-induced ICH.
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Affiliation(s)
- Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China
| | - Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China.
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15
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Sun Y, Zhang M, Chen S, Zhang W, Zhang Y, Su S, Zhang E, Sun L, Yang K, Wang J, Yue W, Wu Q, Liu R, Yin C. Potential impact of ambient temperature on maternal blood pressure and hypertensive disorders of pregnancy: A nationwide multicenter study based on the China birth cohort. ENVIRONMENTAL RESEARCH 2023; 227:115733. [PMID: 36965789 DOI: 10.1016/j.envres.2023.115733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/17/2023] [Accepted: 03/20/2023] [Indexed: 05/08/2023]
Abstract
Limited evidence exists regarding the association between ambient temperature and blood pressure (BP) level of pregnant women. To investigate the associations of ambient temperature with maternal BP and hypertensive disorders of pregnancy (HDP), we studied 105,063 participants in 38 centers of 17 provinces from November 2017 to December 2021. BP was measured with standardized automated digital sphygmomanometers. Ambient temperature was classified into five classes as very hot, moderate hot, mild, moderate cold, and very cold. Generalized linear mixed models were used to investigate the ambient temperature-BP/HDP associations, controlling for multiple covariates. No significant associations of first-trimester ambient temperature with maternal BP and HDP prevalence were observed. Compared with mild temperature, second-trimester very cold and second-trimester moderate cold were statistically associated with the increase of 1.239 mmHg (95% CI: 0.908, 1.569) and 0.428 mmHg (95% CI: 0.099, 0.757) for second-trimester systolic blood pressure (SBP), respectively. Similar trends were also observed in the association between second-trimester cold exposure and second-trimester diastolic blood pressure (DBP), in the association between second-trimester cold exposure and third-trimester SBP/DBP as well as in the association between third-trimester cold exposure and third-trimester SBP/DBP although some estimates were not statistically significant. Furthermore, in the second and third trimester, very cold [second trimester: adjusted odds ratio (aOR) = 1.298; third trimester: aOR = 1.236) and moderate cold (second trimester: aOR = 1.208; third trimester: aOR = 1.146) exposures also increased the odds of HDP, and these associations were stronger among participants aged ≥35 years or from North China. The second and third trimesters are the critical exposure windows for ambient temperature exposure-BP/HDP associations. During this period, exposure to cold ambient temperature was associated with elevated BP as well as increased HDP prevalence among most Chinese pregnant women, those aged ≥35 years or from North China being more vulnerable.
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Affiliation(s)
- Yongqing Sun
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Man Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Shirui Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Yue Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Shaofei Su
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Enjie Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Lijuan Sun
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Kai Yang
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Jingjing Wang
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Wentao Yue
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Qingqing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Ruixia Liu
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Chenghong Yin
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
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16
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Fan P, Xue X, Hu J, Qiao Q, Yin T, Yang X, Chen X, Hou Y, Chen R. Ambient temperature and ambulatory blood pressure: An hourly-level, longitudinal panel study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:160854. [PMID: 36521627 DOI: 10.1016/j.scitotenv.2022.160854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Variations of blood pressure (BP) related to air temperature have been reported previously; however, no evidence is available regarding the association of hourly ambient temperature with ambulatory blood pressure. METHODS We conducted a longitudinal panel study among 1895 patients from an outpatient department who received repeated ambulatory blood pressure monitoring in Urumqi, China between July 2020 and December 2021. We obtained hourly ambient temperature from the nearest monitoring station to the residential address, and measured 4 ambulatory blood pressure indicators. Linear mixed-effect model combined with distributed lag models were applied to investigate the cumulative associations of hourly temperature with BP. RESULTS A total of 97,466 valid blood pressure measurements were evaluated. We observed almost linear and monotonically decreasing relationships between temperature and blood pressure. The effects occurred in the same hour, attenuated thereafter and became insignificant approximately 36 h. A 10 °C decrease in temperature was significantly associated with increments of 0.84 mmHg in systolic blood pressure, 0.56 mmHg in diastolic blood pressure, 1.38 mmHg in mean arterial pressure, and 0.66 mmHg in pulse pressure over lag 0 to 36 h. Stronger associations were found among patients of female sex, age between 18 and 65 years, overweight or obesity, minority, less education or in the cold season, as well as those without hypertension or with coronary heart disease, or did not take anti-hypertension medication. CONCLUSION Our study provides robust evidence that hourly ambient temperature is inversely associated with ambulatory blood pressure. It also highlights a linear relationship between decreased ambient temperature and elevated BP, which may have implications for the prevention and management of hypertension in susceptible populations.
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Affiliation(s)
- Ping Fan
- Department of Heart Function, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China; Department of Function, Bazhou people's Hospital, Korla, China
| | - Xiaowei Xue
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Qingxia Qiao
- Department of Function, Bazhou people's Hospital, Korla, China
| | - Tingting Yin
- Department of Heart Function, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China
| | - Xiaoling Yang
- Department of Science and Education, Bazhou people's Hospital, Korla, China
| | - Xiyin Chen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yuemei Hou
- Shanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South Campus, Shanghai, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
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17
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Li H, Ma H, Li J, Li X, Huang K, Cao J, Li J, Yan W, Chen X, Zhou X, Cui C, Yu X, Liu F, Huang J. Hourly personal temperature exposure and heart rate variability: A multi-center panel study in populations at intermediate to high-risk of cardiovascular disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:160983. [PMID: 36535481 DOI: 10.1016/j.scitotenv.2022.160983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Several studies reported temperature exposure was associated with altered cardiac automatic function, while this effect of temperature on hourly heart rate variability (HRV) among populations with cardiovascular risks was seldom addressed. METHODS We conducted this panel study in four Chinese cities with three repeated visits among 296 participants at intermediate to high-risk of cardiovascular disease (CVD). Real-time temperature level and 24-h ambulatory electrocardiogram were monitored during each seasonal visit. Linear mixed-effects models were used to investigate associations between individual temperature and HRV parameters, and the seasonal effects and circadian effect were also evaluated. RESULTS We found the overall downward trend of hourly HRV associated with acute exposure to higher temperature. For each 1 °C increment in temperature of 1-3 h prior to HRV measurements (lag 1-3 h), hourly standard deviation of normal-to-normal intervals (SDNN) decreased by 0.38% (95% confidence interval [CI]: 0.22, 0.54), 0.28% (95% CI: 0.12, 0.44), and 0.20% (95% CI: 0.04, 0.36), respectively. Similar inverse associations between temperature and HRV were observed in stratified analyses by temperature level. Inverse associations for cold and warm seasons were also observed, despite some effects gradually decreased and reversed in the warm season as lag times extended. Moreover, HRV showed a more significant reduction with increased temperature during daytime than nighttime. Percent change of hourly SDNN was -0.41% (95% CI: -0.62, -0.21) with 1 °C increment of lag 1 h during daytime, while few obvious changes were revealed during nighttime. CONCLUSIONS Generally, increasing temperature was significantly associated with reduced HRV. Inverse relationships for cold and warm seasons were also observed. Associations during daytime were much more prominent than nighttime. Our findings clarified the relationship of temperature with HRV and provided evidence for prevention approaches to alleviate cardiac automatic dysfunction among populations at intermediate to high-risk of CVD.
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Affiliation(s)
- Hongfan Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Han Ma
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jinyue Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xiahua Li
- Function Test Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Weili Yan
- Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Xiaotian Chen
- Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Xiaoyang Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Chun Cui
- Primary Health Professional Committee, Shaanxi Province Health Care Association, Xi'an 710061, China
| | - Xianglai Yu
- Beilin District Dongguannanjie Community Health Service Center, Xi'an 710048, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China.
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China.
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18
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Huang N, Zhuang Z, Song Z, Wang W, Li Y, Zhao Y, Xiao W, Dong X, Jia J, Liu Z, Smith CE, Huang T. Associations of Modified Healthy Aging Index With Major Adverse Cardiac Events, Major Coronary Events, and Ischemic Heart Disease. J Am Heart Assoc 2023; 12:e026736. [PMID: 36870958 PMCID: PMC10111455 DOI: 10.1161/jaha.122.026736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Background The Healthy Aging Index (HAI) has been regarded as useful in capturing the health status of multiple organ systems. However, to what extent the HAI is associated with major cardiovascular events remains largely unknown. The authors constructed a modified HAI (mHAI) to quantify the association of physiological aging with major vascular events and explored how the effects of a healthy lifestyle can modify this association. Methods and Results The participants with either missing values of any individual mHAI component or major illnesses such as heart attack, angina and stroke, and self-reported cancer at baseline were excluded. The mHAI components include systolic blood pressure, reaction time, forced vital capacity, serum cystatin c, and serum glucose. The authors used Cox proportional hazard models to quantify the association of mHAI with major adverse cardiac events, major coronary events, and ischemic heart disease. Cumulative incidence at 5 and 10 years was estimated, and joint analyses were stratified by age group and 4 mHAI categories. The mHAI was significantly correlated with major cardiovascular events, which is a better reflection of the aging level of the body than chronological age. An mHAI was calculated in 338 044 participants aged 38 to 73 years in the UK Biobank. Each point increase in the mHAI was associated with a 44% higher risk of major adverse cardiac events (adjusted hazard ratio [aHR], 1.44 [95% CI, 1.40-1.49]), 44% higher risk of major coronary events (aHR, 1.44 [95% CI, 1.40-1.48]), and 36% higher risk of ischemic heart disease (aHR, 1.36 [95% CI, 1.33-1.39]). The percentage of population-attribution risk was 51% (95% CI, 47-55) for major adverse cardiac events, 49% (95% CI, 45-53) for major coronary events, and 47% (95% CI, 44-50) for ischemic heart disease, which means that a substantial portion of these events could be prevented. Systolic blood pressure was the factor most significantly associated with major adverse cardiac events (aHR, 1.94 [95% CI, 1.82-2.08]; percentage of population-attribution risk, 36%), major coronary events (aHR, 2.01 [95% CI, 1.85-2.17]; percentage of population-attribution risk, 38%), and ischemic heart disease (aHR, 1.80 [95% CI, 1.71-1.89]; percentage of population-attribution risk, 32%). A healthy lifestyle significantly attenuated mHAI associations with incidence of vascular events. Conclusions Our findings indicate that higher mHAI is associated with increased major vascular events. A healthy lifestyle may attenuate these associations.
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Affiliation(s)
- Ninghao Huang
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Zhenhuang Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Zimin Song
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Wenxiu Wang
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Yueying Li
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Yimin Zhao
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Wendi Xiao
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Xue Dong
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China
| | - Jinzhu Jia
- Department of Biostatistics, School of Public Health Peking University Beijing China
| | - Zhonghua Liu
- Department of Biostatistics Columbia University NY New York
| | - Caren E Smith
- Nutrition and Genomics Laboratory JM-USDA Human Nutrition Research Center on Aging at Tufts University Boston MA
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health Peking University Beijing China.,State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science Beijing Normal University Beijing China.,Key Laboratory of Molecular Cardiovascular Sciences (Peking University) Ministry of Education Beijing China.,Center for Intelligent Public Health, Academy for Artificial Intelligence Peking University Beijing China
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19
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Management of seasonal variation in blood pressure through the optimal adjustment of antihypertensive medications and indoor temperature. Hypertens Res 2023; 46:806-808. [PMID: 36577848 DOI: 10.1038/s41440-022-01151-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022]
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20
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Wu Q, Yang M, Wu K, Su H, Huang C, Xu Z, Ho HC, Zheng H, Zhang W, Tao J, Dang TAT, Hossain MZ, Khan MA, Bogale D, Cheng J. Abnormal ambient temperature change increases the risk of out-of-hospital cardiac arrest: A systematic review and meta-analysis of exposure types, risk, and vulnerable populations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 861:160554. [PMID: 36574560 DOI: 10.1016/j.scitotenv.2022.160554] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/08/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There is growing evidence in support of a short-term association between ambient temperature and cardiac arrest attacks that is a serious manifestation of cardiovascular disease and has a high incidence and low survival rate. However, it remains unrecognized about the hazardous temperature exposure types, exposure risk magnitude, and vulnerable populations. OBJECTIVES We comprehensively summarize prior epidemiological studies looking at the short-term associations of out-of-hospital cardiac arrest (OHCA) with various temperature exposures among different populations. METHODS We searched PubMed and Web of Science databases from inception to October 2021 for eligible English language. Temperature exposure was categorized into three types: heat (included high temperature, extreme heat, and heatwave), cold (included low temperature and extreme cold), and temperature variation (included diurnal temperature range and temperature change between two adjacent days). Meta-analysis weighted by inverse variance was used to pool effect estimates. RESULTS This study included 15 studies from 8 countries, totaling around 1 million OHCA events. Extreme heat and extreme cold were significantly associated with an increased risk of OHCA, and the pooled relative risks (RRs) were 1.071 [95 % confidence interval (CI): 1.019-1.126] and 1.662 (95%CI: 1.138-2.427), respectively. The risk of OHCA was also elevated by heatwaves (RR = 1.248, 95%CI: 1.091-1.427) and more intensive heatwaves had a greater effect. Notably, the elderly and males seemed to be more vulnerable to the effects of heat and cold. However, we did not observe a significant association between temperature variation and the risk of OHCA (1.005, 95%CI: 0.999-1.012). CONCLUSION Short-term exposure to heat and cold may be novel risk factors for OHCA. Considering available studies in limited regions, the temperature effect on OHCA should be urgently confirmed in different regions.
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Affiliation(s)
- Qiyue Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Min Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Keyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, QLD, Australia
| | - Hung Chak Ho
- Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Thi Anh Thu Dang
- Institute for Community Health Research, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Alfazal Khan
- Matlab Health Research Centre, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Daniel Bogale
- College of Health Sciences, Arsi University, Asela, Ethiopia
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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21
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Yuan Z, Li Q, Su T, Yang J, Chen J, Peng Y, Zhou S, Bao H, Luo S, Wang H, Liu J, Han N, Guo Y, Ji Y, Wang HJ. Effects of fine ambient particulate matters on de novo hypertensive disorders of pregnancy and blood pressure before 20 weeks. ENVIRONMENTAL RESEARCH 2023; 218:115023. [PMID: 36502896 DOI: 10.1016/j.envres.2022.115023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/13/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
The effects of fine particulate matter (PM) on de novo hypertensive disorders of pregnancy (HDP) were inconsistent during the first and second trimesters. This study aimed to assess the trimester-specific effects of PM2.5 and PM1 prior to diagnosis of de novo HDP. The exposure of fine PM was predicted by satellite remote sensing data according to maternal residential addresses. De novo HDP was defined as gestational hypertension and preeclampsia during the current pregnancy. A logistic regression model was performed to assess the association of PM2.5 and PM1 with HDP during the first and early second trimesters (0-13 weeks and 14-20 weeks). The generalized estimating equation model was conducted to assess the effect of PM2.5 and PM1 on blood pressure. The present study included 22,821 pregnant women (mean age, 29.1 years) from 2013 to 2017. PM2.5 and PM1 were significantly associated with an increased risk of de novo HDP during the first trimester (OR = 1.070, 95% CI: 1.013-1.130; OR = 1.264, 95% CI: 1.058-1.511 for per 10 μg/m3) and early second trimester (OR = 1.045, 95% CI: 1.003-1.088; OR = 1.170, 95% CI: 1.002-1.366 for per 10 μg/m3). Significant trends of increased de novo HDP risk was also observed with the increment of PM (all P for trend <0.05). The stratified analyses demonstrated that the associations between exposure to fine PM and the risk of HDP were more pronounced among the pregnant women with maternal age above 35 and low maternal education level (all OR >1.047). Each 10 μg/m3 increase of PM1 and PM2.5 before diagnosis of de novo HDP elevated 0.204 (95% CI: 0.098-0.310) and 0.058 (95%CI: 0.033-0.083) mmHg of systolic blood pressure. Exposure to PM2.5 and PM1 during the first and early second trimester were positively associated with the risk of de novo HDP. The fine PM before diagnosis of de novo HDP elevated the systolic blood pressure.
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Affiliation(s)
- Zhichao Yuan
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Tao Su
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, 101101, China
| | - Jie Yang
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, 101101, China
| | - Junjun Chen
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China; Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, 21218, United States
| | - Yuanzhou Peng
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Heling Bao
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Na Han
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, 101101, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China; National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China.
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22
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Ye XF, Huang QF, Li Y, Wang JG. Seasonal variation in the effect of antihypertensive treatment with the irbesartan/hydrochlorothiazide combination. Hypertens Res 2023; 46:507-515. [PMID: 36418530 DOI: 10.1038/s41440-022-01084-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/26/2022] [Accepted: 10/01/2022] [Indexed: 11/24/2022]
Abstract
There is increasing awareness of seasonal variation in blood pressure (BP). In the present analysis, we investigated seasonal variation in the antihypertensive treatment effect of the irbesartan/hydrochlorothiazide combination in patients with stage 2 and 3 hypertension. The study participants were hypertensive patients enrolled in a 12-week therapeutic study. Antihypertensive treatment was initiated with irbesartan/hydrochlorothiazide 150/12.5 mg/day, with possible uptitration to 300/12.5 mg/day and 300/25 mg/day at 4 and 8 weeks of follow-up, respectively. The month of treatment commencement was classified as spring/summer (May to August) and autumn/winter (September to December). Of the 501 enrolled patients, 313 and 188 commenced antihypertensive treatment in spring/summer and autumn/winter, respectively. The mean changes in systolic/diastolic BP at 8 and 12 weeks of follow-up were greater in patients who commenced treatment in autumn/winter (-32.3/-16.5 and -34.2/-16.7 mmHg, respectively) than those who commenced treatment in spring/summer (-28.4/-13.9 and -27.1/-12.8 mmHg, respectively), with a between-season difference of 3.9 (95% confidence interval [CI], 1.4-6.4, P = 0.002)/2.6 (95% CI, 0.9-4.2, P = 0.002) mmHg and 7.0 (95% CI, 4.7-9.3, P < 0.0001)/3.9 (95% CI, 2.4-5.4, P < 0.0001) mmHg, respectively. Further subgroup analyses according to several baseline characteristics showed a greater between-season difference in the changes in systolic BP in patients aged ≥55 years than in those <55 years (n = 255, 12.6 mmHg vs. n = 246, 6.9 mmHg, P = 0.02), especially in patients who did not use antihypertensive medication at baseline (n = 94, 15.4 mmHg vs. n = 132, 5.4 mmHg, P = 0.006). In conclusion, there is indeed seasonality in the antihypertensive treatment effect, with a greater BP reduction in patients who commenced treatment in cold than warm seasons.
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Affiliation(s)
- Xiao-Fei Ye
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi-Fang Huang
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ji-Guang Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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23
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Jiang Y, Feng H, Jiao Z, Du Y, Li Y, Liu X, Tong S, Shao X, Li B, Sun H, Meng F, Shen Y, Li M, Zhao Q, Li D, Gao L, Fu X, Li F, Cui S, Zhang L, Zhang X, Liu L, Cao Y, Sun Y, Zhu C, Sun D, Zhang W, Gao Y. Environment and chronic disease in rural areas of Heilongjiang, China (ECDRAHC). BMJ Open 2023; 13:e063850. [PMID: 36653051 PMCID: PMC9853217 DOI: 10.1136/bmjopen-2022-063850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Environmental factors such as long-term exposure to cold can increase the risk of chronic diseases. However, few studies have focused on the impact of environmental factors and lifestyle changes on chronic diseases. To fully explore the association between exposure to environmental factors and the prevalent risk of various chronic diseases, we conducted a large cohort study (Environment and Chronic Disease in Rural Areas of Heilongjiang, China (ECDRAHC)). The ECDRAHC collected detailed questionnaire data covering 10 sections, physical measurements and blood and urine samples. In this study, we describe the design and implementation of the cohort study and present the findings for the first 10 000 participants. PARTICIPANTS The ECDRAHC study was carried out in rural areas where the annual average temperature is 2.9°C, and aimed to recruit 40 000 participants who are long-term residents aged 35-74 years. The participants will be followed up every 5 years. Currently, ECDRAHC has reached 26.7% (n=10 694) of the targeted population. FINDINGS TO DATE A total of 10 694 adults aged 35-74 years were recruited, including 61.7% women. The prevalence of current smokers was 46.8% in men and 35.4% in women. The mean blood pressure was 140.2/89.9 mm Hg and 135.7/85.0 mm Hg in men and women, respectively. The mean body mass index was 24.74 kg/m2 in men and 24.65 kg/m2 in women, with >7.3% being obese (>30 kg/m2). The main non-communicable diseases found in phase 1 were hypertension, diabetes, hypertriglyceridaemia and metabolic syndrome, with a higher prevalence of 51.0%, 21.6%, 46.8% and 42.6%, respectively. FUTURE PLANS We plan to complete the follow-up for the first phase of the ECDRAHC in 2024. The second and third phase of the cohort will be carried out steadily, as planned. This cohort will be used to investigate the relationship between environmental factors, lifestyle, and genetic and common chronic diseases.
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Affiliation(s)
- Yuting Jiang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Hongqi Feng
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Zhe Jiao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Yang Du
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Yuanyuan Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Xiaona Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Simeng Tong
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Xinhua Shao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - BingYun Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Hongna Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Fangang Meng
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Yuncheng Shen
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Mang Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Qiaoshi Zhao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Dandan Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Lin Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Xiaoyan Fu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Fuyuan Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Silu Cui
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Liwei Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Xiaoye Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Lixiang Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Yanhong Cao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Yafei Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Chenpeng Zhu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Wei Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, People's Republic of China,National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Harbin, People's Republic of China,Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, People's Republic of China,Center for Chronic Disease Prevention and Control, Harbin Medical University, Harbin, People's Republic of China
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Kinuta M, Hisamatsu T, Fukuda M, Taniguchi K, Komukai S, Nakahata N, Kanda H. Associations of indoor and outdoor temperatures and their difference with home blood pressure: The Masuda Study. Hypertens Res 2023; 46:200-207. [PMID: 36229531 DOI: 10.1038/s41440-022-01059-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 02/03/2023]
Abstract
Ambient temperature and blood pressure (BP) are closely related; however, few studies have examined the association of out-of-office BP with indoor or outdoor temperature. The effect of the difference between indoor and outdoor temperatures on BP also remains unknown. Therefore, this study aimed to investigate the association of indoor and outdoor temperatures and their difference with home BP. We studied healthy 352 participants (mean age, 49.8 years; 46.0% women) from a population-based cohort using 2-year data on temperature and self-measured home BP. We measured home BP and indoor temperature at the same time in the morning and evening every day. Outdoor temperature during the same period was based on national data. We observed 82,900 home BP measurements in the morning and 66,420 in the evening. In the mixed-effects model adjusted for age, sex, and possible confounders, indoor temperature was inversely associated with systolic and diastolic BP in the morning and evening. A 1 °C increase in indoor temperature reduced systolic and diastolic BP by 0.37 and 0.22 mmHg, respectively, in the morning and by 0.45 and 0.30 mmHg, respectively, in the evening (all P-values<0.001). The magnitude of associations was stronger for indoor than outdoor temperature. Similarly, a 1 °C increase in indoor temperature above outdoor temperature decreased systolic and diastolic BP by 0.33 and 0.12 mmHg, respectively, in the morning and by 0.45 and 0.26 mmHg, respectively, in the evening independent of outdoor temperature (all P-values <0.001). In conclusion, controlling indoor temperature is important to stabilize home BP levels.
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Affiliation(s)
- Minako Kinuta
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takashi Hisamatsu
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Mari Fukuda
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kaori Taniguchi
- Department of Environmental Medicine and Public Health, Izumo, Shimane University Faculty of Medicine, Izumo, Japan
| | - Sho Komukai
- Division of Biomedical Statistics, Department of Integrated Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Noriko Nakahata
- Department of Health and Nutrition, The University of Shimane Faculty of Nursing and Nutrition, Izumo, Japan
| | - Hideyuki Kanda
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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25
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Chen Z, Liu P, Xia X, Wang L, Li X. Temperature variability increases the onset risk of ischemic stroke: A 10-year study in Tianjin, China. Front Neurol 2023; 14:1155987. [PMID: 37122307 PMCID: PMC10140412 DOI: 10.3389/fneur.2023.1155987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Background Epidemiological evidence suggests a correlation between ambient temperature and ischemic stroke. However, evidence on the impact of daily temperature variability on the onset of ischemic stroke is lacking and limited. Objective We aimed to investigate the short-term association between temperature variability and ischemic stroke occurrence in Tianjin. Methods We performed a 10-year analysis of ischemic stroke patients hospitalized in two affiliated hospitals of Tianjin Medical University from 2011 to 2020. Daily meteorological data were collected from the Tianjin Meteorological Bureau. Temperature variability was calculated from the standard deviation (SD) of daily minimum and maximum temperatures over exposure days. A quasi-Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) was used to estimate the effect of temperature variability on daily stroke onset, while controlling for daily mean temperature, relative humidity, long-term trend and seasonality, public holiday, and day of the week. Results Temperature variability was positively associated with ischemic stroke. A 1°C increase in temperature variability at 0-1 days (TV0-1) was associated with a 4.1% (1.9-6.3%) increase of ischemic stroke onset. In a stratified analysis, men, people aged ≤65 years, and individuals with pre-existing hypertension, hyperlipidemia, hyperhomocysteinemia were more susceptible to temperature variability. Furthermore, the influence pattern of temperature variability on ischemic stroke was different in the cold season (November-April) and the warm season (May-October). Conclusion Our findings suggested that short-term temperature variability exposure could increase the risk of ischemic stroke, which may provide new insights into the impact of climate change on health.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Lin Wang
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
- *Correspondence: Xin Li,
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26
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Temperature, cardiovascular mortality, and the role of hypertension and renin-angiotensin-aldosterone axis in seasonal adversity: a narrative review. J Hum Hypertens 2022; 36:1035-1047. [PMID: 35618875 DOI: 10.1038/s41371-022-00707-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/25/2022] [Accepted: 05/12/2022] [Indexed: 12/14/2022]
Abstract
Environmental temperature is now well known to have a U-shaped relationship with cardiovascular (CV) and all-cause mortality. Both heat and cold above and below an optimum temperature, respectively, are associated with adverse outcomes. However, cold in general and moderate cold specifically is predominantly responsible for much of temperature-attributable adversity. Importantly, hypertension-the most important CV risk factor-has seasonal variation such that BP is significantly higher in winter. Besides worsening BP control in established hypertensives, cold-induced BP increase also contributes to long-term BP variability among normotensive and pre-hypertensive patients, also a known CV risk factor. Disappointingly, despite the now well-stablished impact of temperature on BP and on CV mortality separately, direct linkage between seasonal BP change and CV outcomes remains preliminary. Proving or disproving this link is of immense clinical and public health importance because if seasonal BP variation contributes to seasonal adversity, this should be a modifiable risk. Mechanistically, existing evidence strongly suggests a central role of the sympathetic nervous system (SNS), and secondarily, the renin-angiotensin-aldosterone axis (RAAS) in mediating cold-induced BP increase. Though numerous other inflammatory, metabolic, and vascular perturbations likely also contribute, these may also well be secondary to cold-induced SNS/RAAS activation. This review aims to summarize the current evidence linking temperature, BP and CV outcomes. We also examine underlying mechanisms especially in regard to the SNS/RAAS axis, and highlight possible mitigation measures for clinicians.
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27
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Zhou Y, Zhao L, Meng X, Cai QJ, Zhao XL, Zhou XL, Hu AH. Seasonal variation of ambulatory blood pressure in Chinese hypertensive adolescents. Front Pediatr 2022; 10:1022865. [PMID: 36467472 PMCID: PMC9715761 DOI: 10.3389/fped.2022.1022865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/19/2022] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Blood pressure (BP) exhibits seasonal variation with lower levels at higher temperatures and vice versa. This phenomenon affects both sexes and all age groups. So far, only a few research studies have investigated this condition in adolescents and none of them were based on hypertensive population or ever applied ambulatory blood pressure monitor (ABPM). Therefore, we carried out the first study that used ABPM to record seasonal variation of blood pressure in hypertensive adolescents. METHODS From March 2018 to February 2019, 649 ABPMs from hypertensive adolescents between 13 and 17 years who were referred to wear an ABPM device in Beijing and Baoding were extracted. Seasonal change in ambulatory BP value, dipping status, and prevalence of different BP phenotypes were analyzed and compared. RESULTS Mean age of participants was 14.9 ± 1.5 years and 65.8% of them were boys. Of the participants, 75.3% met the criteria of overweight or obesity. From summer to winter, average 24-hour, day-time, and night-time BP showed significant rise, which was 9.8/2.8, 9.8/3.0, and 10.9/3.4 mmHg, respectively. This seasonal effect on BP was not dependent on the obesity degree. In addition, higher prevalence of nondippers and risers existed in winter while white coat hypertension was more frequent in warmer seasons. CONCLUSION Hypertensive adolescents showed evident seasonal change in their ABPM results, which was featured by elevated BP level and more frequent abnormal dipping patterns in winter. On the contrary, higher prevalence of white coat hypertension was found in warmer seasons. Physicians should take seasonal variation into consideration when managing adolescent hypertension.
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Affiliation(s)
- Yi Zhou
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Lin Zhao
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Xu Meng
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Qiu-Jing Cai
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiao-Lei Zhao
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xian-Liang Zhou
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Ai-Hua Hu
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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28
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Zhang Q, Peng L, Hu J, Li H, Jiang Y, Fang W, Yan H, Chen J, Wang W, Xiang D, Su X, Yu B, Wang Y, Xu Y, Wang L, Li C, Chen Y, Zhao D, Ge W, Bell ML, Gasparrini A, Ge J, Huo Y, Kan H. Low temperature and temperature decline increase acute aortic dissection risk and burden: A nationwide case crossover analysis at hourly level among 40,270 patients. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 28:100562. [PMID: 35991537 PMCID: PMC9386641 DOI: 10.1016/j.lanwpc.2022.100562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency with high mortality, so identifying modifiable risk factors of AAD is of great public health significance. The associations of non-optimal temperature and temperature variability with AAD onset and the disease burden have not been fully understood. Methods We conducted a time-stratified case-crossover study using a nationwide registry dataset from 1,868 hospitals in 313 Chinese cities. Conditional logistic regression and distributed lag models were used to investigate associations of temperature and temperature changes between neighboring days (TCN) with the hourly AAD onset and calculate the attributable fractions. We also evaluated the heterogeneity of the associations. Findings A total of 40,270 eligible AAD cases were included. The exposure-response curves for temperature and TCN with AAD onset risk were both inverse and approximately linear. The risks were present on the concurrent hour (for temperature) or day (for TCN) and lasted for almost 1 day. The cumulative relative risks of AAD were 1.027 and 1.026 per 1°C lower temperature and temperature decline between neighboring days, respectively. The associations were significant during the non-heating period, but were not present during the heating period in cities with central heating. 23.13% of AAD cases nationwide were attributable to low temperature and 1.58% were attributable to temperature decline from the previous day. Interpretation This is the largest nationwide study demonstrating robust associations of low temperature and temperature decline with AAD onset. We, for the first time, calculated the corresponding disease burden and further showed that central heating may be a modifier for temperature-related AAD risk and burden. Funding This work was supported by the National Natural Science Foundation of China (92043301 and 92143301), Shanghai International Science and Technology Partnership Project (No. 21230780200), the Medical Research Council-UK (MR/R013349/1), and the Natural Environment Research Council UK (NE/R009384/1).
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Affiliation(s)
- Qingli Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Weiyi Fang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Hongbing Yan
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Weimin Wang
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Dingcheng Xiang
- Department of Cardiology, General Hospital of the PLA Southern Theater Command, Guangzhou, China
| | - Xi Su
- Department of Cardiology, Wuhan ASIA Heart Hospital, Wuhan, China
| | - Bo Yu
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yan Wang
- Department of Cardiology, Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Lefeng Wang
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chunjie Li
- Department of Emergency, Tianjin Chest Hospital, Tianjin, China
| | - Yundai Chen
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Dong Zhao
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Wenzhen Ge
- Regeneron Pharmaceuticals Inc., New York, 10591, USA
| | - Michelle L. Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
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29
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Styler M, Singhal S, Halkidis K, Patel P, Ward KM, Jain M. The Impact of Winter Months on Venous Thromboembolism (VTE) Patients: A Retrospective Analysis of Hospital Outcomes in the United States. Cureus 2022; 14:e29091. [PMID: 36249631 PMCID: PMC9556336 DOI: 10.7759/cureus.29091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 11/09/2022] Open
Abstract
Objective: We aimed to analyze the Health Care Utilization Project’s (HCUP) Nationwide Inpatient Sample (NIS) and compare mortality rates in hospitals by month to determine if there is seasonal variability in outcomes associated with venous thromboembolism (VTE). Methods: The Nationwide Inpatient Sample database was queried from 1998 to 2011. Inclusion criteria were a diagnosis of deep vein thrombosis (DVT) (ICD-9 {International Classification of Diseases, Ninth Revision, Clinical Modification} 453.4, 453.8) and/or VTE (ICD-9 415.1) in patients aged 18 years or more. Admission data was then analyzed to compare mortality rates in teaching and non-teaching hospitals over that time and by month. Demographics, Charlson Comorbidity Index, length of stay (LOS), hospital region, and admission types (emergent/urgent versus elective admissions) were assessed. Linear and logistic models were generated for complex survey design to analyze predictors of mortality and LOS. Results: A total of 1,449,113 DVT/VTE cases were identified in the Nationwide Inpatient Sample (weighted n= 7,150,613), 54.7% female, 56.38% white, 49% in teaching hospitals. Higher mortality was found in the months of November 6.52%, December 6.9%, January 6.94%, and February 6.93% versus overall mortality of 6.4% over 12 months. Higher mortality was noted in these winter months in all regions, along with a significantly increased LOS. Mortality in the total cohort was found to be higher in January, with odds ratio (OR) 1.11 (1.08-1.15), p<0.0001; February, OR 1.11 (1.07-1.15), p<0.0001; and December, OR 1.10 (1.06-1.14), p<0.0001 compared to June. Mortality was significantly lower in the Midwest or North Central regions (OR 0.78 {0.72-0.83}, p<0.0001) and West (OR 0.80 {0.73-0.87}, p<0.0001) compared to the Northeast. Mortality was also significantly higher in teaching hospitals than in non-teaching hospitals (OR 1.16 {1.10-1.22}, p<0.0001), with mortality trending higher in teaching hospitals each month. Emergent/urgent admission, larger hospital size, female sex, age, and urban location were also significantly associated with increased mortality. Conclusions: This national study identified an increased risk of mortality associated with hospitalizations for DVT/VTE in the winter months, independent of hospital teaching status or region.
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Narita K, Hoshide S, Kario K. Seasonal Variation in Day-by-Day Home Blood Pressure Variability and Effect on Cardiovascular Disease Incidence. Hypertension 2022; 79:2062-2070. [PMID: 35770661 DOI: 10.1161/hypertensionaha.122.19494] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although day-by-day home blood pressure (BP) variability (BPV) has been associated with cardiovascular disease (CVD) risk, it remains unclear whether this association differs from season to season. The present study aimed to assess seasonal variation in day-by-day home BP variability and its association with CVD risk. METHODS We analyzed the data from a nationwide, prospective observational study, the J-HOP study (Japan Morning Surge-Home Blood Pressure), in which 14 consecutive days of home BP monitoring were conducted. The values of SD (SDsystolic BP [SBP]), coefficient of variationSBP, and average real variabilitySBP of home SBP were used as indices of day-by-day home BPV. RESULTS Among 4231 participants (mean age, 64.9±10.9 years, 46.7% male, 91.5% hypertensives), all 3 day-by-day home BPV indices were lower in summer than winter after adjusting for confounding factors. In winter, SDSBP, coefficient of variationSBP, and average real variabilitySBP were significantly associated with increased risk of CVD events (coronary artery disease, stroke, heart failure, and aortic dissection; adjusted hazard ratio [95%CI] per 1-SD of SDSBP, 1.26 [1.02-1.54]; coefficient of variationSBP, 1.24 [1.02-1.52]; average real variabilitySBP, 1.44 [1.17-1.77]). These relationships were also observed in the analysis of quartiles of BPV parameters (adjusted hazard ratio [95%CI] compared to the first quartile, fourth quartile of SDSBP 2.26 [1.06-4.85]; coefficient of variationSBP 2.96 [1.43-6.15]; average real variabilitySBP 2.73 [1.25-5.93]). In other seasons, however, there were no significant associations between day-by-day home BPV and CVD event risk. CONCLUSIONS Our findings indicate that day-by-day home BPV measured in winter is more strongly associated with future CVD incidence than that measured in other seasons.
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Affiliation(s)
- Keisuke Narita
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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Park C, Yang J, Lee W, Kang C, Song IK, Kim H. Excess out-of-hospital cardiac arrests due to ambient temperatures in South Korea from 2008 to 2018. ENVIRONMENTAL RESEARCH 2022; 212:113130. [PMID: 35339469 DOI: 10.1016/j.envres.2022.113130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/05/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
Out-of-hospital cardiac arrest (OHCA) is a notable public health issue with negative outcomes, such as high mortality and aftereffects. Additionally, the adverse effects of extreme temperatures on health have become more important under climate change; however, few studies have investigated the relationship between temperature and OHCA. In this study, we examined the association between temperature and OHCA and its underlying risk factors. We conducted a two-stage time-series analysis using a Poisson regression model with a distributed lag non-linear model (DLNM) and meta-analysis, based on a nationwide dataset from South Korea (2008-2018). We found that 17.4% of excess OHCA was attributed to cold, while 0.9% was attributed to heat. Based on central estimates, excess OHCA attributed to cold were more prominent in the population with hypertension comorbidity (31.0%) than the populations with diabetes (24.3%) and heart disease (17.4%). Excess OHCA attributed to heat were larger in the populations with diabetes (2.7%) and heart disease comorbidity (2.7%) than the population with hypertension (1.2%) based on central estimates. Furthermore, the time-varying excess OHCA attributed to cold have decreased over time, and although those of heat did not show a certain pattern during the study period, there was a weak increasing tendency since 2011. In conclusion, we found that OHCAs were associated with temperature, and cold temperatures showed a greater impact than that of hot temperatures. The effects of cold and hot temperatures on OHCA were more evident in the populations with hypertension, diabetes, and heart diseases, compared to the general population. In addition, the impacts of heat on OHCA increased in recent years, while those of cold temperatures decreased. Our results provide scientific evidence for policymakers to mitigate the OHCA burden attributed to temperature.
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Affiliation(s)
- Chaerin Park
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Juyeon Yang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, United States
| | - Cinoo Kang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - In-Kyung Song
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
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Chen Z, Liu P, Xia X, Wang L, Li X. The underlying mechanisms of cold exposure-induced ischemic stroke. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 834:155514. [PMID: 35472344 DOI: 10.1016/j.scitotenv.2022.155514] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/13/2022] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
Growing evidence suggests that cold exposure is to some extent a potential risk factor for ischemic stroke. At present, although the mechanism by which cold exposure induces ischemic stroke is not fully understood, some potential mechanisms have been mentioned. First, the seasonal and temperature variability of cerebrovascular risk factors (hypertension, hyperglycemia, hyperlipidemia, atrial fibrillation) may be involved. Moreover, the activation of sympathetic nervous system and renin-angiotensin system and their downstream signaling pathways (pro-inflammatory AngII, activated platelets, and dysfunctional immune cells) are also major contributors. Finally, the influenza epidemics induced by cold weather are also influencing factors that cannot be ignored. This article is the first to systematically and comprehensively describe the underlying mechanism of cold-induced ischemic stroke, aiming to provide more preventive measures and medication guidance for stroke-susceptible individuals in cold season, and also provide support for the formulation of public health policies.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China.
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Liu J, Li Y, Li J, Zheng D, Liu C. Sources of automatic office blood pressure measurement error: a systematic review. Physiol Meas 2022; 43. [PMID: 35952651 DOI: 10.1088/1361-6579/ac890e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/11/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Accurate and reliable blood pressure (BP) measurement is important for the prevention and treatment of hypertension. The oscillometric-based automatic office blood pressure measurement (AOBPM) is widely used in hospitals and clinics, but measurement errors are common in BP measurements. There is a lack of systematic review of the sources of measurement errors. APPROACH A systematic review of all existing research on sources of AOBPM errors. A search strategy was designed in six online databases, and all the literature published before October 2021 was selected. Those studies that used the AOBPM device to measure BP from the upper arm of subjects were included. MAIN RESULTS A total of 1365 studies were screened, and 224 studies were included in this final review. They investigated 22 common error sources with clinical AOBPM. Regarding the causes of BP errors, this review divided them into the following categories: the activities before measurement, patient's factors, measurement environment, measurement procedure, and device settings. 13 sources caused increased systolic and diastolic BP (SBP and DBP), 2 sources caused the decrease in SBP and DBP, only 1 source had no significant effect on BPs, and the other errors had a non-uniform effect (either increase or decrease in BPs). The error ranges for SBP and DBP were -14 to 33 mmHg and -6 to 19 mmHg, respectively. SIGNIFICANCE The measurement accuracy of AOBPM is susceptible to the influence of measurement factors. Interpreting BP readings need to be treated with caution in clinical measurements. This review made comprehensive evidence for the need for standardized BP measurements and provided guidance for clinical practitioners when measuring BP with AOBPM devices.
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Affiliation(s)
- Jian Liu
- School of Instrument Science and Engineering, Southeast University, Sipailou 2, Nanjing, Jiangsu, 210096, CHINA
| | - Yumin Li
- School of Instrument Science and Engineering, Southeast University, Sipailou 2, Nanjing, Jiangsu, 210096, CHINA
| | - Jianqing Li
- School of Instrument Science and Engineering, Southeast University, Sipailou road2, Nanjing, Jiangsu, 210096, CHINA
| | - Dingchang Zheng
- Research Centre of Intelligent Healthcare, Coventry University, West Midlands, Coventry, CV1 5FB, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Chengyu Liu
- School of Instrument Science and Engineering, Southeast University, Sipailou 2, Nanjing, Jiangsu, 210096, CHINA
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Zhou S, Ma J, Dong X, Li N, Duan Y, Wang Z, Gao L, Han L, Tu S, Liang Z, Liu F, LaBresh KA, Smith SC, Jin Y, Zheng ZJ. Barriers and enablers in the implementation of a quality improvement program for acute coronary syndromes in hospitals: a qualitative analysis using the consolidated framework for implementation research. Implement Sci 2022; 17:36. [PMID: 35650618 PMCID: PMC9158188 DOI: 10.1186/s13012-022-01207-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/27/2022] [Indexed: 11/11/2022] Open
Abstract
Background Ischemic heart disease causes a high disease burden globally and numerous challenges in treatment, particularly in developing countries such as China. The National Chest Pain Centers Program (NCPCP) was launched in China as the first nationwide, hospital-based, comprehensive, continuous quality improvement (QI) program to improve early diagnosis and standardized treatment of acute coronary syndromes (ACS) and improve patients’ clinical outcomes. With implementation and scaling up of the NCPCP, we investigated barriers and enablers in the NCPCP implementation process and provided examples and ideas for overcoming such barriers. Methods We conducted a nationally representative survey in six cities in China. A total of 165 key informant interviewees, including directors and coordinators of chest pain centers (CPCs) in 90 hospitals, participated in semi-structured interviews. The interviews were transcribed verbatim, translated into English, and analyzed in NVivo 12.0. We used the Consolidated Framework for Implementation Research (CFIR) to guide the codes and themes. Results Barriers to NCPCP implementation mainly arose from nine CFIR constructs. Barriers included the complexity of the intervention (complexity), low flexibility of requirements (adaptability), a lack of recognition of chest pain in patients with ACS (patient needs and resources), relatively low government support (external policies and incentives), staff mobility in the emergency department and other related departments (structural characteristics), resistance from related departments (networks and communications), overwhelming tasks for CPC coordinators (compatibility), lack of available resources for regular CPC operations (available resources), and fidelity to and sustainability of intervention implementation (executing). Enablers of intervention implementation were inner motivation for change (intervention sources), evidence strength and quality of intervention, relatively low cost (cost), individual knowledge and beliefs regarding the intervention, pressure from other hospitals (peer pressure), incentives and rewards of the intervention, and involvement of hospital leaders (leadership engagement, engaging). Conclusion Simplifying the intervention to adapt routine tasks for medical staff and optimizing operational mechanisms between the prehospital emergency system and in-hospital treatment system with government support, as well as enhancing emergency awareness among patients with chest pain are critically important to NCPCP implementation. Clarifying and addressing these barriers is key to designing a sustainable QI program for acute cardiovascular diseases in China and similar contexts across developing countries worldwide. Trial registration This study was registered in the Chinese Clinical Trial Registry (ChiCTR 2100043319), registered 10 February 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-022-01207-6.
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Affiliation(s)
- Shuduo Zhou
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Junxiong Ma
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Xuejie Dong
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Yuqi Duan
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Zongbin Wang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Liqun Gao
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Lu Han
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Shu Tu
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Zhisheng Liang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Fangjing Liu
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | | | - Sidney C Smith
- Division of Cardiovascular Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China. .,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China. .,Institute for Global Health and Development, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
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Wu Z, Lan S, Chen C, Zhang X, Zhang Y, Chen S. Seasonal Variation: A Non-negligible Factor Associated With Blood Pressure in Patients Undergoing Hemodialysis. Front Cardiovasc Med 2022; 9:820483. [PMID: 35369290 PMCID: PMC8971928 DOI: 10.3389/fcvm.2022.820483] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate a seasonal variation in blood pressure (BP) for patients undergoing hemodialysis (HD). Methods In this retrospective study, we exported all BP measurements from the information system to investigate a seasonal variation of BP. We also investigated a seasonal variation in BP for patients of different gender types, of different age groups, with diabetic nephropathy (DN), and with non-DN having HD. Multiple linear regression models were used to explore the associations between BP and climatic parameters. Results In 2019, a total of 367 patients had received HD therapy in the Longwen HD unit. We included nearly 40,000 pre-dialysis BP measurements. The result of our study demonstrated a clear seasonal variation in pre-dialysis BP in general patients with HD, in male and female patients, and patients with DN and non-DN. December seemed to be a peak in the values of pre-dialysis systolic BP (SBP) and diastolic BP (DBP). The nadir values of pre-dialysis SBP and DBP were observed in June and July, respectively. A difference between peak and nadir values of BP is 3.81/2.20 mmHg in patients undergoing HD. Maximal seasonal variation in BP is 9.03/5.08 mmHg for patients with DN. A significant association of SBP and DBP with climatic parameters was found in this study. Pre-dialysis BP was inversely correlated with outdoor temperature, daytime length, and relative humidity. Conclusion A clear seasonal variation in BP is observed for patients with HD. Pre-dialysis SBP and DBP are inversely associated with outdoor temperature, daytime length, and relative humidity. The magnitude of a seasonal variation in BP increases in patients with DN.
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Affiliation(s)
- Zhibin Wu
- Department of Nephrology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Shan Lan
- Department of Nephrology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Chengqiang Chen
- Hemodialysis Unit, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Xiuan Zhang
- Department of Nephrology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Yazhen Zhang
- Hemodialysis Unit, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Shanying Chen
- Department of Nephrology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
- *Correspondence: Shanying Chen
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Lv LS, Zhou CL, Jin DH, Ma WJ, Liu T, Xie YJ, Xu YQ, Zhang XE. Impact of ambient temperature on life loss per death from cardiovascular diseases: a multicenter study in central China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:15791-15799. [PMID: 34633619 PMCID: PMC8827384 DOI: 10.1007/s11356-021-16888-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In the context of global climate change, studies have focused on the ambient temperature and mortality of cardiovascular diseases (CVDs). However, little is known about the effect of ambient temperature on year of life lost (YLL), especially the life loss per death caused by ambient temperature. In this study, we aimed to assess the relationship between ambient temperature and life loss and estimate the impact of ambient temperature on life loss per death. METHODS We collected daily time series of mortality and meteorological data from 70 locations in Hunan province, central China, in periods ranging from Jan. 1, 2013, to Dec. 31, 2017. Crude rates of YLL were calculated per 100,000 people per year (YLL/100,000 population) for each location. A distributed lag nonlinear model and multivariate meta-regression were used to estimate the associations between ambient temperature and YLL rates. Then, the average life loss per death attributable to ambient temperature was calculated. RESULTS There were 711,484 CVD deaths recorded within the study period. The exposure-response curve between ambient temperature and YLL rates was inverted J or U-shaped. Relative to the minimum YLL rate temperature, the life loss risk of extreme cold temperature lasted for 10 to 12 days, whereas the risk of extreme hot temperature appeared immediately and lasted for 3 days. On average, the life loss per death attributable to non-optimum ambient temperatures was 1.89 (95% CI, 1.21-2.56) years. Life loss was mainly caused by cold temperature (1.13, 95% CI, 0.89‑1.37), particularly moderate cold (1.00, 95% CI, 0.78‑1.23). For demographic characteristics, the mean life loss per death was relatively higher for males (2.07, 95% CI, 1.44‑2.68) and younger populations (3.72, 95% CI, 2.06‑5.46) than for females (1.88, 95% CI, 1.21-2.57) and elderly people (1.69, 95% CI, 1.28-2.10), respectively. CONCLUSIONS We found that both cold and hot temperatures significantly aggravated premature death from CVDs. Our results indicated that the whole range of effects of ambient temperature on CVDs should be given attention.
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Affiliation(s)
- Ling-Shuang Lv
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Chun-Liang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China.
| | - Dong-Hui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Wen-Jun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Yi-Jun Xie
- Hunan Provincial Climate Center, Changsha, 410007, China
| | - Yi-Qing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Xing-E Zhang
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
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Kanagasabai T, Xie W, Yan L, Zhao L, Carter E, Guo D, Daskalopoulou SS, Chan Q, Elliott P, Ezzati M, Yang X, Xie G, Kelly F, Wu Y, Baumgartner J. Household Air Pollution and Blood Pressure, Vascular Damage, and Subclinical Indicators of Cardiovascular Disease in Older Chinese Adults. Am J Hypertens 2022; 35:121-131. [PMID: 34505873 PMCID: PMC8807175 DOI: 10.1093/ajh/hpab141] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/09/2021] [Accepted: 09/09/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Limited data suggest that household air pollution from cooking and heating with solid fuel (i.e., coal and biomass) stoves may contribute to the development of hypertension and vascular damage. METHODS Using mixed-effects regression models, we investigated the associations of household air pollution with blood pressure (BP) and vascular function in 753 adults (ages 40-79 years) from 3 diverse provinces in China. We conducted repeated measures of participants' household fuel use, personal exposure to fine particulate air pollution (PM2.5), BP, brachial-femoral pulse wave velocity (bfPWV), and augmentation index. Ultrasound images of the carotid arteries were obtained to assess intima-media thickness (CIMT) and plaques. Covariate information on sociodemographics, health behaviors, 24-h urinary sodium, and blood lipids was also obtained. RESULTS Average estimated yearly personal exposure to PM2.5 was 97.5 µg/m3 (SD: 79.2; range: 3.5-1241), and 65% of participants cooked with solid fuel. In multivariable models, current solid fuel use was associated with higher systolic (2.4 mm Hg, 95% CI: -0.4, 4.9) and diastolic BP (1.4 mm Hg, 95% CI: -0.1, 3.0) and greater total area of plaques (1.7 mm2, 95% CI: -6.5, 9.8) compared with exclusive use of electricity or gas stoves. A 1 - ln(µg/m3) increase in PM2.5 exposure was associated with higher systolic (1.5 mm Hg, 95% CI: 0.2, 2.7) and diastolic BP (1.0 mm Hg, 95% CI: 0.4, 1.7) and with greater CIMT (0.02 mm, 95% CI: 0.00, 0.04) and total area of plaques (4.7 mm2, 95% CI: -2.0, 11.5). We did not find associations with arterial stiffness, except for a lower bfPWV (-1.5 m/s, 95% CI: -3.0, -0.0) among users of solid fuel heaters. CONCLUSIONS These findings add to limited evidence that household air pollution is associated with higher BP and with greater CIMT and total plaque area.
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Affiliation(s)
- Thirumagal Kanagasabai
- Institute for Health and Social Policy, and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Li Yan
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Liancheng Zhao
- Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, China
| | - Ellison Carter
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Dongshuang Guo
- Department of Cardiology,Yuxian Hospital, Yuxian, Shanxi, China
| | - Stella S Daskalopoulou
- Department of Medicine, Division of Internal Medicine and Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Xudong Yang
- Department of Building Science, Tsinghua University, Beijing, China
| | - Gaoqiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Frank Kelly
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Jill Baumgartner
- Institute for Health and Social Policy, and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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Wei J, Wang P, Xia F, Miao J, Zhou X, Yang Z, Gong Z, Chen L, Wang T. Time trends in cardiovascular disease mortality attributable to non-optimal temperatures in China: An age-period-cohort analysis using the Global Burden of Disease Study 2019. Front Public Health 2022; 10:1075551. [PMID: 37089862 PMCID: PMC10113563 DOI: 10.3389/fpubh.2022.1075551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/28/2022] [Indexed: 04/25/2023] Open
Abstract
Background Associations between non-optimal temperatures and cardiovascular disease (CVD) mortality risk have been previously reported, yet the trends of CVD mortality attributable to non-optimal temperatures remain unclear in China. We analyzed trends in CVD mortality attributable to non-optimal temperatures and associations with age, period, and birth cohort. Methods Data were obtained from the Global Burden of Disease Study (GBD) 2019. Joinpoint regression analysis was used to calculate annual percent change (APC) and average annual percent change (AAPC) from 1990 to 2019. We used the age-period-cohort model to analyze age, period, and cohort effects in CVD mortality attributable to non-optimal temperatures between 1990 and 2019. Results The age-standardized mortality rate (ASMR) of CVD attributable to non-optimal temperature generally declined in China from 1990 to 2019, whereas ischemic heart disease (IHD) increased slightly. Low temperatures have a greater death burden than high temperatures, but the death burden from high temperatures showed steady increases. Joinpoint regression analysis showed that CVD mortality decreased in all age groups except for IHD, and the decreases were greater in females than in males. The mortality of CVD attributable to non-optimal temperatures of males was higher than females. The mortality rate showed an upwards trend with age across all CVD categories. Period risks were generally found in unfavorable trends. The cohort effects showed a progressive downward trend during the entire period. Conclusion Although there have been reductions in CVD mortality attributable to non-optimum temperatures, the mortality of IHD has increased and the burden from non-optimal temperatures remains high in China. In the context of global climate change, our results call for more attention and strategies to address climate change that protect human health from non-optimal temperatures.
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Zhou Y, Zhao L, Meng X, Cai QJ, Zhao XL, Zhou XL, Hu AH. Seasonal variation of ambulatory blood pressure in Chinese hypertensive adolescents. Front Pediatr 2022. [PMID: 36467472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Blood pressure (BP) exhibits seasonal variation with lower levels at higher temperatures and vice versa. This phenomenon affects both sexes and all age groups. So far, only a few research studies have investigated this condition in adolescents and none of them were based on hypertensive population or ever applied ambulatory blood pressure monitor (ABPM). Therefore, we carried out the first study that used ABPM to record seasonal variation of blood pressure in hypertensive adolescents. METHODS From March 2018 to February 2019, 649 ABPMs from hypertensive adolescents between 13 and 17 years who were referred to wear an ABPM device in Beijing and Baoding were extracted. Seasonal change in ambulatory BP value, dipping status, and prevalence of different BP phenotypes were analyzed and compared. RESULTS Mean age of participants was 14.9 ± 1.5 years and 65.8% of them were boys. Of the participants, 75.3% met the criteria of overweight or obesity. From summer to winter, average 24-hour, day-time, and night-time BP showed significant rise, which was 9.8/2.8, 9.8/3.0, and 10.9/3.4 mmHg, respectively. This seasonal effect on BP was not dependent on the obesity degree. In addition, higher prevalence of nondippers and risers existed in winter while white coat hypertension was more frequent in warmer seasons. CONCLUSION Hypertensive adolescents showed evident seasonal change in their ABPM results, which was featured by elevated BP level and more frequent abnormal dipping patterns in winter. On the contrary, higher prevalence of white coat hypertension was found in warmer seasons. Physicians should take seasonal variation into consideration when managing adolescent hypertension.
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Affiliation(s)
- Yi Zhou
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Lin Zhao
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Xu Meng
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Qiu-Jing Cai
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiao-Lei Zhao
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xian-Liang Zhou
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Ai-Hua Hu
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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40
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Affiliation(s)
- Shin Osawa
- Itabashi Chuo Medical Center, Tokyo, Japan
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41
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Zhang S, Lu W, Wei Z, Zhang H. Air Pollution and Cardiac Arrhythmias: From Epidemiological and Clinical Evidences to Cellular Electrophysiological Mechanisms. Front Cardiovasc Med 2021; 8:736151. [PMID: 34778399 PMCID: PMC8581215 DOI: 10.3389/fcvm.2021.736151] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/04/2021] [Indexed: 01/08/2023] Open
Abstract
Cardiovascular disease is the leading cause of death worldwide and kills over 17 million people per year. In the recent decade, growing epidemiological evidence links air pollution and cardiac arrhythmias, suggesting a detrimental influence of air pollution on cardiac electrophysiological functionality. However, the proarrhythmic mechanisms underlying the air pollution-induced cardiac arrhythmias are not fully understood. The purpose of this work is to provide recent advances in air pollution-induced arrhythmias with a comprehensive review of the literature on the common air pollutants and arrhythmias. Six common air pollutants of widespread concern are discussed, namely particulate matter, carbon monoxide, hydrogen sulfide, sulfur dioxide, nitrogen dioxide, and ozone. The epidemiological and clinical reports in recent years are reviewed by pollutant type, and the recently identified mechanisms including both the general pathways and the direct influences of air pollutants on the cellular electrophysiology are summarized. Particularly, this review focuses on the impaired ion channel functionality underlying the air pollution-induced arrhythmias. Alterations of ionic currents directly by the air pollutants, as well as the alterations mediated by intracellular signaling or other more general pathways are reviewed in this work. Finally, areas for future research are suggested to address several remaining scientific questions.
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Affiliation(s)
- Shugang Zhang
- Computational Cardiology Group, College of Computer Science and Technology, Ocean University of China, Qingdao, China.,Biological Physics Group, School of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - Weigang Lu
- Computational Cardiology Group, College of Computer Science and Technology, Ocean University of China, Qingdao, China.,Biological Physics Group, School of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - Zhiqiang Wei
- Computational Cardiology Group, College of Computer Science and Technology, Ocean University of China, Qingdao, China
| | - Henggui Zhang
- Biological Physics Group, School of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
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42
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Narita K, Hoshide S, Kario K. Seasonal variation in blood pressure: current evidence and recommendations for hypertension management. Hypertens Res 2021; 44:1363-1372. [PMID: 34489592 DOI: 10.1038/s41440-021-00732-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/25/2021] [Accepted: 05/28/2021] [Indexed: 02/07/2023]
Abstract
Blood pressure (BP) exhibits seasonal variation, with an elevation of daytime BP in winter and an elevation of nighttime BP in summer. The wintertime elevation of daytime BP is largely attributable to cold temperatures. The summertime elevation of nighttime BP is not due mainly to temperature; rather, it is considered to be related to physical discomfort and poor sleep quality due to the summer weather. The winter elevation of daytime BP is likely to be associated with the increased incidence of cardiovascular disease (CVD) events in winter compared to other seasons. The suppression of excess seasonal BP changes, especially the wintertime elevation of daytime BP and the summertime elevation of nighttime BP, would contribute to the prevention of CVD events. Herein, we review the literature on seasonal variations in BP, and we recommend the following measures for suppressing excess seasonal BP changes as part of a regimen to manage hypertension: (1) out-of-office BP monitoring, especially home BP measurements, throughout the year to evaluate seasonal variations in BP; (2) the early titration and tapering of antihypertensive medications before winter and summer; (3) the optimization of environmental factors such as room temperature and housing conditions; and (4) the use of information and communication technology-based medicine to evaluate seasonal variations in BP and provide early therapeutic intervention. Seasonal BP variations are an important treatment target for the prevention of CVD through the management of hypertension, and further research is necessary to clarify these variations.
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Affiliation(s)
- Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
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43
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Haghayegh S, Smolensky MH, Khoshnevis S, Hermida RC, Castriotta RJ, Diller KR. The Circadian Rhythm of Thermoregulation Modulates both the Sleep/Wake Cycle and 24 h Pattern of Arterial Blood Pressure. Compr Physiol 2021; 11:2645-2658. [PMID: 34636410 DOI: 10.1002/cphy.c210008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Borbély proposed an interacting two-component model of sleep regulation comprising a homeostatic Process S and a circadian Process C. The model has provided understanding of the association between core body temperature (CBT) as a key element of Process C that is deterministic of sleep onset and offset. However, it additionally provides a new perspective of the importance of the thermoregulatory mechanisms of Process C in modulating the circadian rhythm of arterial blood pressure (ABP). Herein, we examine the circadian physiology of thermoregulation, including at the end of the activity span the profound redistribution of cardiac output from the systemic circulation to the arteriovenous anastomoses of the glabrous skin that markedly enhances convective transfer of heat from the body to the environment to cause (i) decrease of the CBT as a pathway to sleep onset and (ii) attenuation of the asleep ABP mean and augmentation of the ABP decline (dipping) from the wake-time mean, in combination the strongest predictors of the risk for blood vessel and organ pathology and morbid and mortal cardiovascular disease events. We additionally review the means by which blood perfusion to the glabrous skin can be manipulated on demand by selective thermal stimulation, that is, mild warming, on the skin of the cervical spinal cord to intensify Process C as a way to facilitate sleep induction and promote healthy asleep ABP. © 2021 American Physiological Society. Compr Physiol 11:1-14, 2021.
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Affiliation(s)
- Shahab Haghayegh
- Department of Biostatics, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.,Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Michael H Smolensky
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA.,Department of Internal Medicine, Division of Pulmonary and Sleep Medicine, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sepideh Khoshnevis
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Ramon C Hermida
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA.,Bioengineering and Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies, University of Vigo, Vigo, Spain
| | - Richard J Castriotta
- Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kenneth R Diller
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA
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44
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Luo ZR, Lin ZQ, Chen LW, Qiu HF. Effects of seasonal and climate variations on in-hospital mortality and length of stay in patients with type A aortic dissection. J Cardiothorac Surg 2021; 16:252. [PMID: 34496919 PMCID: PMC8424972 DOI: 10.1186/s13019-021-01639-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Objective To investigate the effects of seasonal and climatic changes on postoperative in-hospital mortality and length of stay (LOS) in patients with type A acute aortic dissection (AAD). Methods Patients undergoing implantation of the modified triple-branched stent graft to replace the descending aorta in addition to aortic root reconstruction for type A AAD in our hospital from January 2016 to December 2019 were included. Relevant data were retrospectively collected and analyzed. Results A total of 404 patients were included in our analyses. The multivariate unconditional logistic regression analysis showed that patients admitted in autumn (OR 4.027, 95% CI 1.023–17.301, P = 0.039) or with coronary heart disease (OR 8.938, 95% CI 1.991–29.560, P = 0.049) were independently associated with an increased risk of postoperative in-hospital mortality. Furthermore, patients admitted in autumn (OR 5.956, 95% CI 2.719–7.921, P = 0.041) or with hypertension (OR 3.486, 95% CI 1.192–5.106, P = 0.035) were independently associated with an increased risk of longer LOS. Conclusion Patients admitted in autumn or with coronary heart disease are at higher risk of in-hospital mortality following surgery for type A AAD. Also, patients admitted in autumn or with hypertension have a longer hospital LOS. In the autumn of the temperature transition, we may need to strengthen the management of medical quality after surgery for type A AAD.
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Affiliation(s)
- Zeng-Rong Luo
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China
| | - Zhi-Qin Lin
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China
| | - Liang-Wan Chen
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China
| | - Han-Fan Qiu
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China. .,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China.
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45
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Zuo Y, Cai X, Wang Z, Hu Z, Wu Z, Zhang M, Yu A, Liu L, Xing Y. Prevalence, Clinical Features, and In-hospital Outcome of Fatty Liver Disease in Acute Aortic Dissection: A Single-Center Retrospective Study. Front Cardiovasc Med 2021; 8:698285. [PMID: 34485401 PMCID: PMC8414544 DOI: 10.3389/fcvm.2021.698285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Fatty liver disease (FLD) has emerged as a major public issue in China. We aim to investigate prevalence, clinical features, and in-hospital outcome of FLD in acute aortic dissection (AAD) patients. Methods: Data of 379 AAD patients from 2017 to 2019 at Renmin hospital of Wuhan University was retrospectively collected and divided according to age and FLD absence. Propensity score matching was used for minimal confounding. We compared their physical environmental parameter of onset, clinical features, and in-hospital outcome. Results: The mean age was 52.0 ± 11.5 years in type A and 55.1 ± 11.4 in type B. 25.0% of type A and 19.2% of type B AAD patients had FLD. Logistic regression indicated a negative association between FLD and age, both in type A [unadjusted odds ratio (OR) 0.958 (per 1 year), 95% confidence interval (CI) 0.930–0.988, p = 0.0064] and type B [unadjusted OR 0.943 (per 1 year), 95% CI 0.910–0.978, p = 0.0013]. After matching, type A with FLD had onset with a lower air quality index (AQI) of 68.5 [interquartile range (IQR) 46.0–90.0] and a lower Pm 2.5 concentration of 36.0 μg/m3 (IQR 23.0–56.0) compared with non-FLD group. In Kaplan-Meier estimation, FLD was associated with higher risk of in-hospital mortality in type B AAD (p = 0.0297). Conclusion: The prevalence of FLD in AAD decrease with age, both in type A and type B AAD. Type A AAD patients with FLD had onset with better air quality parameters compared with non-FLD group. FLD was associated with higher risk of in-hospital mortality in type B AAD.
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Affiliation(s)
- Yifan Zuo
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Cai
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhiwei Wang
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhipeng Hu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhiyong Wu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Min Zhang
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Anfeng Yu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liang Liu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yun Xing
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
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46
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Narita K, Hoshide S, Kario K. Relationship Between Home Blood Pressure and the Onset Season of Cardiovascular Events: The J-HOP Study (Japan Morning Surge-Home Blood Pressure). Am J Hypertens 2021; 34:729-736. [PMID: 33493266 DOI: 10.1093/ajh/hpab016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/26/2020] [Accepted: 01/22/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The incidence of cardiovascular disease (CVD) increases during winter. The risk that elevated home blood pressure (BP) poses for CVD events that occur in each of 4 seasons is unclear. We conducted a post hoc analysis using the dataset from a nationwide cohort, the Japan Morning Surge-Home Blood Pressure (J-HOP) study, to assess the association between home BP and winter-onset CVD events. METHODS J-HOP participants who had cardiovascular risks conducted morning and evening home BP measurements for a 14-day period and were followed-up for the occurrence of CVD events. RESULTS We analyzed 4,258 participants (mean age 64.9 years; 47% male; 92% hypertensives) who were followed-up for an average of 6.2 ± 3.8 years (26,295 person-years). We divided the total of 269 CVD events (10.2/1,000 person-years) by the season of onset as follows: 82 in the winter and 187 in the other seasons (spring, summer, and autumn). In the Cox models adjusted for covariates and the season when home BPs were measured at baseline, morning home systolic BP (SBP) was associated with both winter-onset and other season-onset CVD events: hazard ratio (HR) for winter 1.22, 95% confidence interval (CI) 1.06-1.42 per 10 mm Hg; HR for other seasons 1.11, 95% CI 1.00-1.23. Evening home SBP was associated with the other season-onset CVD events (HR 1.20, 95% CI 1.08-1.33 per 10 mm Hg), but not with the winter-onset CVD events. CONCLUSIONS Our findings indicate that compared with evening home BP, morning home BP might be a superior predictor of winter-onset CVD events.
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Affiliation(s)
- Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
- Department of Cardiology, Karatsu Red Cross Hospital, Saga, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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47
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Seasonal variation of blood pressure in children. Pediatr Nephrol 2021; 36:2257-2263. [PMID: 33211170 PMCID: PMC8260525 DOI: 10.1007/s00467-020-04823-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/20/2020] [Accepted: 10/13/2020] [Indexed: 01/18/2023]
Abstract
Seasonal blood pressure (BP) variation is mostly found between the summer and winter months. Guidelines for diagnosis and treatment of hypertension in children have not considered this variation until recently. This review aims to present an overview of seasonal BP variation in childhood along with potential underlying pathophysiological mechanisms and long-term implications as well as conclusions for future studies. In pediatric cohorts, seven studies investigated seasonal changes in BP. These changes amount to 3.4-5.9 mmHg (or 0.5-1.5 mmHg per - 1 °C difference in environmental temperature) in systolic BP with a peak in fall or winter. Potential mechanisms and mediators of seasonal BP variation include sympathetic activation of the nervous system with an increase of urinary and plasma norepinephrine levels in the winter season. Additionally, the physical activity among children and adolescents was inversely correlated with BP levels. Temperature sensitivity of BP and pediatric BP levels predict future systolic BP and target-organ damage. Therefore, cardiovascular events may even be long-term complications of seasonal BP variation in pediatric hypertensive patients. Overall, these data strongly suggest an important effect of ambient temperature on BP in children. Additional studies in pediatric cohorts are needed to define how best to incorporate such variation into clinical practice.
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48
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Zafeiratou S, Samoli E, Dimakopoulou K, Rodopoulou S, Analitis A, Gasparrini A, Stafoggia M, De' Donato F, Rao S, Monteiro A, Rai M, Zhang S, Breitner S, Aunan K, Schneider A, Katsouyanni K. A systematic review on the association between total and cardiopulmonary mortality/morbidity or cardiovascular risk factors with long-term exposure to increased or decreased ambient temperature. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:145383. [PMID: 33578152 DOI: 10.1016/j.scitotenv.2021.145383] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/11/2020] [Accepted: 01/19/2021] [Indexed: 05/07/2023]
Abstract
The health effects of acute exposure to temperature extremes are established; those of long-term exposure only recently received attention. We performed a systematic review to assess the associations of long-term (>3 months) exposure to higher or lower temperature on total and cardiopulmonary mortality and morbidity, screening 3455 studies and selecting 34. The studies were classified in those observing associations within a population over years with changing annual temperature indices and those comparing areas with a different climate. We also assessed the risk of bias, adapting appropriately an instrument developed by the World Health Organization for air pollution. Studies reported that annual temperature indices for extremes and variability were associated with annual increases in mortality, indicating that effects of temperature extremes cannot be attributed only to short-term mortality displacement. Studies on cardiovascular mortality indicated stronger associations with cold rather than hot temperature, whilst those on respiratory outcomes reported effects of both heat and cold but were few and used diverse health outcomes. Interactions with air pollution were not generally assessed. The few studies investigating effect modification showed stronger effects among the elderly and those socially deprived. Comparisons of health outcome prevalence between areas reported lower blood pressure and a tendency for higher obesity in populations living in warmer climates. Our review indicated interesting associations between long-term exposure to unusual temperature levels in specific areas and differences in health outcomes and cardiovascular risk factors between geographical locations with different climate, but the number of studies by design and health outcome was small. Risk of bias was identified because of the use of crude exposure assessment and inadequate adjustment for confounding. More and better designed studies, including the investigation of effect modifiers, are needed.
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Affiliation(s)
- Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | | | - Massimo Stafoggia
- Department of Epidemiology of the Lazio Region Health Service (ASL ROMA 1), Italy
| | - Francesca De' Donato
- Department of Epidemiology of the Lazio Region Health Service (ASL ROMA 1), Italy
| | - Shilpa Rao
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | | | - Masna Rai
- Helmholtz Zentrum München (HMGU), Germany
| | - Siqi Zhang
- Helmholtz Zentrum München (HMGU), Germany
| | | | - Kristin Aunan
- CICERO Center for International Climate Research, Norway
| | | | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece; Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, UK.
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Abstract
Significance: The vascular extracellular matrix (ECM) not only provides mechanical stability but also manipulates vascular cell behaviors, which are crucial for vascular function and homeostasis. ECM remodeling, which alters vascular wall mechanical properties and exposes vascular cells to bioactive molecules, is involved in the development and progression of hypertension. Recent Advances: This brief review summarized the dynamic changes in ECM components and their modification and degradation during hypertension and after antihypertensive treatment. We also discussed how alterations in the ECM amount, assembly, mechanical properties, and degradation fragment generation provide input into the pathological process of hypertension. Critical Issues: Although the relevance between ECM remodeling and hypertension has been recognized, the underlying mechanism by which ECM remodeling initiates the development of hypertension remains unclear. Therefore, the modulation of ECM remodeling on arterial stiffness and hypertension in genetically modified rodent models is summarized in this review. The circulating biomarkers based on ECM metabolism and therapeutic strategies targeting ECM disorders in hypertension are also introduced. Future Directions: Further research will provide more comprehensive understanding of ECM remodeling in hypertension by the application of matridomic and degradomic approaches. The better understanding of mechanisms underlying vascular ECM remodeling may provide novel potential therapeutic strategies for preventing and treating hypertension. Antioxid. Redox Signal. 34, 765-783.
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Affiliation(s)
- Zeyu Cai
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Ze Gong
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Zhiqing Li
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Li Li
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Wei Kong
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
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Low sun exposure habits is associated with a dose-dependent increased risk of hypertension: a report from the large MISS cohort. Photochem Photobiol Sci 2021; 20:285-292. [PMID: 33721253 DOI: 10.1007/s43630-021-00017-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/27/2021] [Indexed: 12/16/2022]
Abstract
In prospective observational cohort studies, increasing sun exposure habits have been associated with reduced risk of cardiovascular mortality. Our aim was to assess possible observational mechanisms for this phenomenon. A written questionnaire was answered by 23,593 women in the year 2000 regarding risk factors for melanoma, including factors of possible interest for hypertension, such as detailed sun exposure habits, hypertension, marital status, education, smoking, alcohol consumption, BMI, exercise, and chronic high stress. Hypertension was measured by the proxy "use of hypertension medication" 2005-2007, and high stress by "need of anti-depressive medication". Sun exposure habits was assessed by the number of `yes' to the following questions; Do you sunbath during summer?, During winter vacation?, Do you travel south to sunbath?, Or do you use sun bed? Women answering 'yes' on one or two questions had moderate and those answering 'yes' on three or four as having greatest sun exposure. The main outcome was the risk of hypertension by sun exposure habits adjusted for confounding. As compared to those women with the greatest sun exposure, women with low and moderate sun exposure were at 41% and 15% higher odds of hypertension (OR 1.41, 95% CI 1.3‒1.6, p < 0.001 and OR 1.15, 95% CI 1.1‒1.2, p < 0.001), respectively. There was a strong age-related increased risk of hypertension. Other risk factors for hypertension were lack of exercise (OR 1.36), a non-fair phenotype (OR 1.08), chronic high stress level (OR 1.8), and lack of university education (OR 1.3). We conclude that in our observational design sun exposure was associated with a dose-dependent reduced risk of hypertension, which might partly explain the fewer deaths of cardiovascular disease with increasing sun exposure.
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