1
|
Hummel B, Yerkes MA, Harskamp RE, Galenkamp H, Kunst AE, Lok A, van Valkengoed IGM. The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study. SSM Popul Health 2023; 23:101432. [PMID: 37234865 PMCID: PMC10195766 DOI: 10.1016/j.ssmph.2023.101432] [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: 02/24/2023] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011-2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (-0.65 mmol/mol, -0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.
Collapse
Affiliation(s)
- Bryn Hummel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Mara A Yerkes
- Department of Interdisciplinary Social Sciences, Utrecht University, Heidelberglaan 8, 3584, CS, Utrecht, the Netherlands
| | - Ralf E Harskamp
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam University Medical Centre, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Irene G M van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| |
Collapse
|
2
|
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.
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Chronobiological Patterns of Aneurysmal Subarachnoid Hemorrhage in Central China. Glob Heart 2022; 17:29. [PMID: 35586745 PMCID: PMC9053527 DOI: 10.5334/gh.1117] [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] [Received: 07/08/2021] [Accepted: 04/05/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is an acute and sometimes fatal cerebrovascular disease. The chronobiological patterns of aSAH are still unclear worldwide. This 15-year time-series study aims to clarify the chronobiological patterns including seasonal, monthly, weekly, and circadian distributions of aSAH. Methods: We retrospectively analyzed the medical records of aSAH patients in central China. To investigate seasonal and weekly distributions, we used the χ2 goodness-of-fit test to analyze the uniformity of the onset time. To explore monthly and circadian distributions, we established Fourier models to show the rhythmicity in chronobiological patterns. Subgroup analyses were conducted to assess the impact of age, gender, hypertension statuses, and aneurysmal characteristics (number, size, and location) on the chronobiological patterns of aSAH. Results: A total of 1469 patients with aSAH were recruited in the study. The seasonal and monthly distribution exhibited significantly higher incidence in winter and January/December and lower incidence in summer and July. The weekly distribution of aSAH onset showed no significant uneven variation. The circadian distribution of aSAH exhibited a significant pattern (p = 0.0145), with a morning peak around 8:00, and a late afternoon peak at 16:00–20.00. The circadian rhythmicity varied in subgroups of different ages, genders, and aneurysmal locations. Conclusion: The occurrence of aSAH exhibits significant circannual and circadian patterns among the Chinese population. Patients with aSAH of different ages, genders, and aneurysmal locations would present different chronobiological patterns.
Collapse
|
5
|
Bauer F, Lindtke J, Seibert F, Rohn B, Doevelaar A, Babel N, Schlattmann P, Bertram S, Zgoura P, Westhoff TH. Impact of weather changes on hospital admissions for hypertension. Sci Rep 2022; 12:5716. [PMID: 35383236 PMCID: PMC8983729 DOI: 10.1038/s41598-022-09644-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/17/2022] [Indexed: 11/09/2022] Open
Abstract
Blood pressure (BP) shows a seasonal variation with higher levels at lower temperatures. Many hypertensives, however, report on BP disturbances rather in association with acutely changing weather conditions than with absolute temperatures. To date, the impact of changing meteorological parameters on hypertensive episodes remains elusive. We performed a retrospective time series regression analysis on 203,703 patients in three hospitals in Germany between 2010 and 2018, of whom 7362 patients were admitted for hypertensive disease. Numbers of daily admissions for hypertension were associated with metereological data obtained from three nearby weather stations. Data comprised temperature (mean, maximal, minimal and range within 24 h), athmospheric pressure, and precipitation. Changes of these parameters were calculated over a two and three day period. There was an inverse correlation between maximal daily temperature and the number of admissions for hypertensive disease, which remained significant both after adjustment for seasonality and week day in a spline model and in a constrained distributed lag model. A decrease of maximal temperature by 5 °C was associated with a 3% increase of risk for admission for hypertension and vice versa. There were no significant effects of precipitation and athmospheric pressure on the number of admissions. With regard to all observed metereological parameters, neither the change within two, nor within three days was consistently associated with the number of daily admissions. High temperatures are associated with lower numbers of hypertensive episodes requiring hospital admission. In contrast to the subjective perception of many hypertensive patients, however, acutely changing weather conditions are not associated with a higher risk of hypertensive emergency.
Collapse
Affiliation(s)
- Frederic Bauer
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Janine Lindtke
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Felix Seibert
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Benjamin Rohn
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Adrian Doevelaar
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Nina Babel
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Peter Schlattmann
- Department of Medical Statistics, Informatics and Data Science, Jena University Hospital, Jena, Germany
| | - Sebastian Bertram
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Panagiota Zgoura
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Timm H Westhoff
- Department of Internal Medicine I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Yamamoto S, Koh M, Matsumura K, Hamazaki K, Inadera H, Kuroda S. Impact of Low Ambient Temperature on the Occurrence of Spontaneous Intracerebral Hemorrhage-Analysis of Population-Based Stroke Registry in Toyama, Japan. J Stroke Cerebrovasc Dis 2021; 31:106156. [PMID: 34735898 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 09/25/2021] [Accepted: 10/01/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Although several studies have reported that some meteorological factors such as ambient temperature and atmospheric pressure, affect the incidence of spontaneous intracerebral hemorrhage (ICH), the correlation remains unclear. This retrospective time-series analysis was aimed to clarify the effects of meteorological parameters on the incidence of ICH. MATERIALS AND METHODS Data of patients with ICH were obtained from a population-based survey of acute stroke patients between April 2016 and March 2019. All days during the study period were categorized into "no ICH day" when no ICHs occurred, "single ICH day" when only one ICH occurred, and "cluster day" when two or more ICHs occurred. Meteorological data were compared for among the three categories. RESULTS 1,691 ICH patients from 19 hospitals were registered. In a total of 1,095 days, 250 were categorized as no ICH days, 361 as single ICH days, and 484 as cluster days. Daily ambient temperature declined in parallel with the daily number of ICHs, and it was a significant predictor for single ICH days and cluster days. Furthermore, the incidence of ICH in patients aged 65 years or above, men, those who emerged at home, those with modified Rankin Scale 3-5; and those with hypertension; and ICHs in the basal ganglia, brain stem, and cerebellum were more likely to be affected by low ambient temperature. CONCLUSION Daily ambient temperature was significantly associated with ICH incidence. Patients' activity, history of hypertension, and location of hemorrhage were also related to the impact of low ambient temperature on the incidence of ICH.
Collapse
Affiliation(s)
- Shusuke Yamamoto
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.
| | - Masaki Koh
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.
| | - Kenta Matsumura
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama, Toyama, Japan.
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Satoshi Kuroda
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.
| |
Collapse
|
8
|
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.
Collapse
|
9
|
Gorbunov VM, Smirnova MI, Koshelyaevskaya YN, Panueva NN, Furman NV, Dolotovskaya PV. The “Inverse” Seasonal Blood Pressure Variability Phenotype. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-06-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The seasonal blood pressure variability (BPV) is known to demonstrate a typical winter peak. Recently, more attention is paid to the opposite situation: the summer BP levels being higher than those in winter. This phenomenon is called inverse BPV. The present article summarizes recent data on this topic. The data of the HOMED-BP project, as well as the results of the original prospective study in 770 hypertensive patients from two Russian Federation regions (mean follow-up duration 6.4 years), were used. According to the preliminary knowledge, the prevalence of inverse BPV in hypertensive patients is relatively high (15-25%). This phenomenon is more typical for treated patients, particularly for those on combination therapy, and is associated with beta-blocker intake. Higher duration of hypertension and higher levels of some risk factors (smoking) characterize the patients with inverse BPV. According to the HOMED-BP data, patients with inverse BPV had the highest overall cardiovascular risk (hazard ratio in comparison with the reference group of “minimal” “normal” BPV was 3.07; p=0.004). In summary, inverse BPV is a potentially unfavorable BP phenotype. However, its reproducibility and prospective value deserve further investigation. The absolute magnitude of seasonal BPV in these patients, calculated using different BP measurement methods, warrants special attention.
Collapse
Affiliation(s)
- V. M. Gorbunov
- National Medical Research Center for Therapy and Preventive Medicine
| | - M. I. Smirnova
- National Medical Research Center for Therapy and Preventive Medicine
| | | | | | - N. V. Furman
- Saratov State Medical University named after V.I. Razumovsky
| | | |
Collapse
|
10
|
Hartwig SV, Hacon SDS, Oliveira BFAD, Jacobson LDSV, Sousa RFV, Ignotti E. The effect of ambient temperature on blood pressure of patients undergoing hemodialysis in the Pantanal-Brazil. Heliyon 2021; 7:e07348. [PMID: 34235283 PMCID: PMC8246300 DOI: 10.1016/j.heliyon.2021.e07348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 11/15/2022] Open
Abstract
The objective was to analyze the association of changes in pre-dialysis systolic and diastolic blood pressure with air temperature in a municipality in the Brazilian Pantanal, a tropical climate area. Longitudinal panel study, with analysis of mixed effects models of 133 hemodialysis patients in the city of Cáceres-Mato Grosso in 2014. Air temperature showed an inverse association with pre-dialysis systolic and diastolic blood pressure. With each increase of 1 °C in the mean air temperature, the pre-dialysis systolic blood pressure decreases -0.730mmHg (p ≤ 0.000) and the pre-dialysis diastolic blood pressure decreases -0.280mmHg (p ≤ 0.000). The estimated effect was greater for systolic blood pressure, but both pre-dialysis blood pressure measures are reduced with an increase in lag (up to two days), even when adjusted for relative air humidity. Air temperature is determinant for changes in pre-dialysis systolic and diastolic blood pressure in hemodialysis patients. The temperature effect was greater for systolic blood pressure than for diastolic blood pressure.
Collapse
|
11
|
Ciardullo S, Muraca E, Cannistraci R, Manzoni G, Perra S, Bianconi E, Oltolini A, Zerbini F, Grassi G, Mancia G, Lattuada G, Perseghin G. Seasonal variation in estimated cardiovascular risk in patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2021; 31:1494-1500. [PMID: 33810954 DOI: 10.1016/j.numecd.2021.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Seasonal variations in several risk factors for cardiovascular events (CVD) were described. Here, we evaluate the impact of seasonal variations in blood pressure (BP), lipid profile and glycemic control on estimated CVD risk in patients with type 2 diabetes (T2D). METHODS AND RESULTS Retrospective monocentric study of patients with T2D who were visited at least once in the winter period and once in the summer period, less than 8 months apart, for which data related to systolic (S) BP, diastolic (D) BP, body mass index, glycosylated hemoglobin (HbA1c), total cholesterol, HDL cholesterol and smoking habit were available on both occasions. The 10-year CVD risk was calculated using the UKPDS risk engine and the ASCVD risk estimator. As many as 411 patients were included in the study. Significant within-patient differences between summer and winter were found for the absolute risk of events assessed with both calculators (Δs-w UKPDS-CHD: -1.33%, Δs-w UKPDS-Stroke: -0.84%, Δs-w ASCVD: -2.21%). The seasonal change in SBP was the main responsible for the change in risk estimated with both the UKPDS-Stroke (r2 = 0.43) and the ASCVD (r2 = 0.50) scores, while the change in total cholesterol was the main determinant of the change in risk for the UKPDS-CHD (r2 = 0.34). A significant correlation was identified between changes in temperature and changes in SBP (ρ = 0.130, p = 0.008), but not in other risk factors. CONCLUSIONS Seasonal variations in the classic CVD risk factors influence the risk estimated using validated calculators.
Collapse
Affiliation(s)
- Stefano Ciardullo
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Emanuele Muraca
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy
| | - Rosa Cannistraci
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Giuseppina Manzoni
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy
| | - Silvia Perra
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy
| | - Eleonora Bianconi
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy
| | - Alice Oltolini
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy
| | - Francesca Zerbini
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy
| | - Guido Grassi
- Clinica Medica, University of Milano Bicocca, Milan, Italy
| | - Giuseppe Mancia
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Guido Lattuada
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy
| | - Gianluca Perseghin
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
| |
Collapse
|
12
|
Ma Y, Tully PJ, Hofman A, Tzourio C. Blood Pressure Variability and Dementia: A State-of-the-Art Review. Am J Hypertens 2020; 33:1059-1066. [PMID: 32710605 DOI: 10.1093/ajh/hpaa119] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/30/2022] Open
Abstract
Accumulating evidence demonstrates that blood pressure variability (BPV) may contribute to target organ damage, causing coronary heart disease, stroke, and renal disease independent of the level of blood pressure (BP). Several lines of evidence have also linked increased BPV to a higher risk of cognitive decline and incident dementia. The estimated number of dementia cases worldwide is nearly 50 million, and this number continues to grow with increasing life expectancy. Because there is no effective treatment to modify the course of dementia, targeting modifiable vascular factors continues as a top priority for dementia prevention. A clear understanding of the role of BPV in dementia may shed light on the etiology, early prevention, and novel therapeutic targets of dementia, and has therefore gained substantial attention from researchers and clinicians. This review summarizes state-of-art evidence on the relationship between BPV and dementia, with a specific focus on the epidemiological evidence, the underlying mechanisms, and potential intervention strategies. We also discuss challenges and opportunities for future research to facilitate optimal BP management and the clinical translation of BPV for the risk assessment and prevention of dementia.
Collapse
Affiliation(s)
- Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Phillip J Tully
- School of Medicine, The University of Adelaide, Adelaide, Australia
| | - Albert Hofman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Christophe Tzourio
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, Bordeaux, France
| |
Collapse
|
13
|
Asadi MH, Changizi-Ashtiyani S. The Relationship between Stroke and Seasonal Variations in Persian Medicine. Int J Prev Med 2020; 11:79. [PMID: 33033588 PMCID: PMC7513774 DOI: 10.4103/ijpvm.ijpvm_224_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 01/10/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mohammad-Hossein Asadi
- Traditional and Complementary Medicine Research Center, Arak University of Medical University, Arak, Iran
| | - Saeed Changizi-Ashtiyani
- Traditional and Complementary Medicine Research Center, Arak University of Medical University, Arak, Iran
| |
Collapse
|
14
|
Naser AM, He FJ, Rahman M, Narayan KMV, Campbell NRC. Urinary Sodium Excretion and Blood Pressure Relationship across Methods of Evaluating the Completeness of 24-h Urine Collections. Nutrients 2020; 12:E2772. [PMID: 32932868 PMCID: PMC7551660 DOI: 10.3390/nu12092772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 01/06/2023] Open
Abstract
We compared the sodium intake and systolic blood pressure (SBP) relationship from complete 24-h urine samples determined by several methods: self-reported no-missed urine, creatinine index ≥0.7, measured 24-h urine creatinine (mCER) within 25% and 15% of Kawasaki predicted urine creatinine, and sex-specific mCER ranges (mCER 15-25 mg/kg/24-h for men; 10-20 mg/kg/24-h for women). We pooled 10,031 BP and 24-h urine sodium data from 2143 participants. We implemented multilevel linear models to illustrate the shape of the sodium-BP relationship using the restricted cubic spline (RCS) plots, and to assess the difference in mean SBP for a 100 mmol increase in 24-h urine sodium. The RCS plot illustrated an initial steep positive sodium-SBP relationship for all methods, followed by a less steep positive relationship for self-reported no-missed urine, creatinine index ≥0.7, and sex-specific mCER ranges; and a plateaued relationship for the two Kawasaki methods. Each 100 mmol/24-h increase in urinary sodium was associated with 0.64 (95% CI: 0.34, 0.94) mmHg higher SBP for self-reported no-missed urine, 0.68 (95% CI: 0.27, 1.08) mmHg higher SBP for creatinine index ≥0.7, 0.87 (95% CI: 0.07, 1.67) mmHg higher SBP for mCER within 25% Kawasaki predicted urine creatinine, 0.98 (95% CI: -0.07, 2.02) mmHg change in SBP for mCER within 15% Kawasaki predicted urine creatinine, and 1.96 (95% CI: 0.93, 2.99) mmHg higher SBP for sex-specific mCER ranges. Studies examining 24-h urine sodium in relation to health outcomes will have different results based on how urine collections are deemed as complete.
Collapse
Affiliation(s)
- Abu Mohd Naser
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Feng J. He
- Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK;
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh;
| | - K. M. Venkat Narayan
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Norm R. C. Campbell
- Department of Medicine, O’Brien Institute of Public Health, Libin Cardiovascular Institute of Alberta at the University of Calgary, Calgary, AB T2N 4Z6, Canada;
| |
Collapse
|
15
|
Naser AM, Rahman M, Unicomb L, Doza S, Selim S, Chaity M, Luby SP, Anand S, Staimez L, Clasen TF, Gujral UP, Gribble MO, Narayan KMV. Past Sodium Intake, Contemporary Sodium Intake, and Cardiometabolic Health in Southwest Coastal Bangladesh. J Am Heart Assoc 2020; 9:e014978. [PMID: 32875927 PMCID: PMC7727005 DOI: 10.1161/jaha.119.014978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background We compared the relationship of past and contemporary sodium (Na) intake with cardiometabolic biomarkers. Methods and Results A total of 1191 participants' data from a randomized controlled trial in coastal Bangladesh were analyzed. Participants provided 24-hour urine Na (24UNa) data for 5 monthly visits. Their fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein, blood pressure, and 24-hour urine protein were measured at the fifth visit. Participants' mean 24UNa over the first 4 visits was the past Na, and 24UNa of the fifth visit was the contemporary Na intake. We estimated the prevalence ratios of elevated cardiometabolic biomarkers and metabolic syndrome across 24UNa tertiles by multilevel logistic regression using participant-, household-, and community-level random intercepts. Models were adjusted for age, sex, body mass index, smoking, physical activity, alcohol consumption, sleep hours, religion, and household wealth. Compared with participants in tertile 1 of past urine Na, those in tertile 3 had 1.46 (95% CI, 1.08-1.99) times higher prevalence of prediabetes or diabetes mellitus, 5.49 (95% CI, 2.73-11.01) times higher prevalence of large waist circumference, and 1.60 (95% CI, 1.04-2.46) times higher prevalence of metabolic syndrome. Compared with participants in tertile 1 of contemporary urine Na, those in tertile 3 had 1.93 (95% CI, 1.24-3.00) times higher prevalence of prediabetes or diabetes mellitus, 3.14 (95% CI, 1.45-6.83) times higher prevalence of proteinuria, and 2.23 (95% CI, 1.34-3.71) times higher prevalence of large waist circumference. Conclusions Both past and contemporary Na intakes were associated with higher cardiometabolic disease risk.
Collapse
Affiliation(s)
- Abu Mohd Naser
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Solaiman Doza
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Shahjada Selim
- Department of Endocrinology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh
| | | | - Stephen P Luby
- Division of Infectious Diseases and Geographic MedicineStanford University Stanford CA
| | - Shuchi Anand
- Division of Nephrology School of Medicine Stanford University Stanford CA
| | - Lisa Staimez
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Thomas F Clasen
- Gangarosa Department of Environmental Health Sciences Rollins School of Public HealthEmory University Atlanta GA
| | - Unjali P Gujral
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Matthew O Gribble
- Gangarosa Department of Environmental Health Sciences Rollins School of Public HealthEmory University Atlanta GA.,Department of Epidemiology Rollins School of Public HealthEmory University Atlanta GA
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| |
Collapse
|
16
|
Moscote-Salazar LR, Agrawal A. Re: Meteorological Factors and Seasonal Stroke Rates. J Stroke Cerebrovasc Dis 2020; 29:104766. [PMID: 32171624 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh (India)
| |
Collapse
|
17
|
Park S, Kario K, Chia Y, Turana Y, Chen C, Buranakitjaroen P, Nailes J, Hoshide S, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Teo BW, Zhang Y, Shin J, Van Minh H, Tomitani N, Kabutoya T, Sukonthasarn A, Verma N, Wang T, Wang J. The influence of the ambient temperature on blood pressure and how it will affect the epidemiology of hypertension in Asia. J Clin Hypertens (Greenwich) 2020; 22:438-444. [PMID: 31851429 PMCID: PMC8029770 DOI: 10.1111/jch.13762] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/21/2019] [Indexed: 12/14/2022]
Abstract
Epidemiologic studies have consistently demonstrated an increased risk of cardiovascular disease during colder temperatures. Hemodynamic changes associated with cold temperature and an increase in thrombogenicity may both account for the increase in cardiovascular risk and mortality. Studies using both in-office and out-of-office BP measurements have consistently shown an elevation in BP during the colder seasons. The large difference in BP between cold and warm months may increase the incidence of hypertension and reduce the hypertension control rate, potentially resulting in increased cardiovascular risk, especially among those at risk of cardiovascular disease. The current trends in global warming and climate change may have a profound impact on the epidemiology of hypertension and cardiovascular disease, as changes in the climate may significantly affect both BP variability and cardiovascular disease, especially in those with high cardiovascular risk and the elderly. Furthermore, climate change could have a significant influence on hypertension in Asia, considering the unique characteristics of hypertensive patients in Asia. As an increase in ambient temperature decreases the mean daytime average and morning surge in BP, but increases the nocturnal BP, it is difficult to predict how environmental changes will affect the epidemiology and prognosis of hypertension in the Asian-Pacific region. However, these seasonal variations in BP could be minimized by adjusting the housing conditions and using anticipation medicine. In this review, we discuss the impact of seasonal variation in the ambient temperature on hypertension and cardiovascular disease and discuss how this may impact the epidemiology of hypertension and cardiovascular disease.
Collapse
Affiliation(s)
- Sungha Park
- Division of CardiologyYonsei Cardiovascular HospitalYonsei University Health SystemSeoulKorea
- Integrative Research Center for Cerebrovascular and Cardiovascular DiseasesYonsei University College of MedicineSeoulKorea
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Yuda Turana
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Chen‐Huan Chen
- Department of MedicineSchool of Medicine National Yang‐Ming UniversityTaipeiTaiwan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | | | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular CenterJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | - Boon Wee Teo
- Division of Nephrology Department of MedicineYong Loo Lin School of MedicineSingapore CitySingapore
| | - Yu‐Qing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHue CityVietnam
| | - Naoko Tomitani
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Apichard Sukonthasarn
- Cardiology DivisionDepartment of Internal MedicineFaculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Narsingh Verma
- Department of PhysiologyKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Department of Internal MedicineNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsShanghai Key Laboratory of HypertensionThe Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | | |
Collapse
|
18
|
Seasonal variation in blood pressure: Evidence, consensus and recommendations for clinical practice. Consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens 2020; 38:1235-1243. [DOI: 10.1097/hjh.0000000000002341] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
19
|
Seasonal variation in 24 h blood pressure profile in healthy adults- A prospective observational study. J Hum Hypertens 2019; 33:626-633. [PMID: 30755660 DOI: 10.1038/s41371-019-0173-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/19/2018] [Accepted: 01/18/2019] [Indexed: 01/06/2023]
Abstract
The clinical and experimental data on seasonal variation in blood pressure is mainly from office and home blood pressure (BP) monitoring studies. There are few studies from temperate climates on seasonal changes with ambulatory blood pressure (ABP) monitoring and none from India. This is a prospective, observational study among healthy adults. ABP was measured in four different seasons in 28 subjects. Mean arterial pressure (MAP), ambulatory systolic blood pressure (SBP), and ambulatory diastolic blood pressure (DBP) were significantly higher in winter compared to summer season. 24-hour MAP was lowest in summer while highest MAP was recorded in winter (97.04 ± 8.30 and 103.89 ± 8.54, respectively). The mean difference was -6.86 mm Hg (95% CI: -10.74 to -2.97, p = 0.001). This difference was mainly due to increase in day time MAP. There was no difference in 24 h systolic and diastolic blood pressure between summer and winter. There was significant difference between summer and winter in the SBP (day time) [125.61 ± 11.44 and 131.93 ± 9.46, mean difference -6.32 (95% CI: -10.69 to -1.95, p = 0.005)] and DBP (day time) [79.57 ± 9.95 and 87.07 ± 9.9, mean difference -7.50 (95% CI: -12.49 to -2.51, p = 0.003)]. The night time systolic and diastolic BP was similar during winter and summer. Thus, BP increases significantly during winter compared to summer season. This change is primarily in the day time systolic, diastolic and mean blood pressures. Larger studies are required to further validate our findings.
Collapse
|
20
|
Angelini V, Daly M, Moro M, Navarro Paniagua M, Sidman E, Walker I, Weldon M. The effect of the Winter Fuel Payment on household temperature and health: a regression discontinuity design study. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundThe Winter Fuel Payment (WFP) is a non-NHS population-level policy intervention that aims to reduce cold exposure and enhance the health and well-being of older adults. Labelling this cash transfer as ‘winter fuel’ has been shown to lead to increased household energy expenditure, but it is not known if this expenditure produces warmer homes or health benefits.ObjectivesFirst, the association between indoor temperature and health was established to identify the outcome measures most likely to be affected by the WFP. Then, whether or not receiving the WFP is associated with raised household temperature levels and/or improved health was assessed.DesignRandom and fixed effects regression models were used to estimate the link between ambient indoor temperature and health. A regression discontinuity (RD) design analysis exploiting the sharp eligibility criteria for the WFP was employed to estimate the potential impact of the payment.SettingThe sample was drawn from the English Longitudinal Study of Ageing (ELSA), an observational study of community-dwelling individuals aged ≥ 50 years in England.ParticipantsAnalyses examining the association between household temperature and health had a maximum sample of 12,210 adults aged 50–90 years. The RD analyses drew on a maximum of 5902 observations.InterventionThe WFP provides households with a member who is aged > 60 years (up to 2010, from which point the minimum age increased) in the qualifying week with a lump sum annual payment, typically in November or December.Main outcome measuresDifferences in indoor temperature were examined, and, following an extensive literature review of relevant participant-reported health indicators and objectively recorded biomarkers likely to be affected by indoor temperature, a series of key measures were selected: blood pressure, inflammation, lung function, the presence of chest infections, subjective health and depressive symptom ratings.Data sourcesThe first six waves of the ELSA were drawn from, accessible through the UK Data Service (SN:5050 English Longitudinal Study of Ageing: Waves 0–7, 1998–2015).ResultsResults from both random and fixed-effects multilevel regression models showed that low levels of indoor temperature were associated with raised systolic and diastolic blood pressure levels and raised fibrinogen levels. However, across the RD models, no evidence was found that the WFP was consistently associated with differences in either household temperature or the health of qualifying (vs. non-qualifying) households.LimitationsThe presence of small effects cannot be ruled out, not detectable because of the sample size in the current study.ConclusionsThis study capitalised on the sharp assignment rules regarding WFP eligibility to estimate the potential effect of the WFP on household temperature and health in a national sample of English adults. The RD design employed did not identify evidence linking the WFP to warmer homes or potential health and well-being effects.Future workFurther research should utilise larger samples of participants close to the WFP eligibility cut-off point examined during particularly cold weather in order to identify whether or not the WFP is linked to health benefits not detected in the current study, which may have implications for population health and the evaluation of the effectiveness of the WFP.FundingThe National Institute for Health Research Public Health Research programme.
Collapse
Affiliation(s)
- Viola Angelini
- Faculty of Economics and Business Economics, University of Groningen, Groningen, the Netherlands
| | - Michael Daly
- Management Work and Organisation, Stirling Management School, University of Stirling, Stirling, UK
| | - Mirko Moro
- Economics Division, Stirling Management School, University of Stirling, Stirling, UK
| | - Maria Navarro Paniagua
- Department of Economics, Lancaster University Management School, Lancaster University, Lancaster, UK
| | - Elanor Sidman
- Management Work and Organisation, Stirling Management School, University of Stirling, Stirling, UK
| | - Ian Walker
- Department of Economics, Lancaster University Management School, Lancaster University, Lancaster, UK
| | - Matthew Weldon
- Department of Economics, Lancaster University Management School, Lancaster University, Lancaster, UK
| |
Collapse
|
21
|
Abstract
This study aims to evaluate the relationship between mean outdoor temperature and mean daily blood pressure (BP) and heart rate (HR) among six, large, geographically and climatically diverse US cities. We collected BP and HR data from Higi stations, located in a wide range of neighborhood grocery stores and retail pharmacies, from six US cities (Houston, Los Angeles, Miami, Boise, Chicago, and New York City). Outdoor daily temperature data were collected from the National Centers for Environmental Information's database. Pearson's correlation was used to assess the linear relationship between mean daily outdoor temperature and mean daily BP and HR for each city from May 2016 through April 2017. A total of 2 140 626 BP and HR readings were recorded in the six study cities. Mean outdoor temperature was inversely correlated with both mean daily average systolic (r=-0.69, P<0.0001) and diastolic (r=-0.71; P<0.0001) BPs, but not HR (r<0.0001, P=0.48). We also found that temperature change had a larger impact on BP in equatorial climates such as Miami compared with colder and more temperature variable cities like Chicago and Boise. Previous studies have found that BP varies seasonally, but few have looked at the impact of daily temperature on both BP and HR changes. Our study is one of the largest and most climatically diverse populations ever looking at this relationship. Our results suggest that temperature, and perhaps geography, should play a role in tailoring individualized evaluation and treatment for hypertensive diseases.
Collapse
|
22
|
Delles C, Carrick E, Graham D, Nicklin SA. Utilizing proteomics to understand and define hypertension: where are we and where do we go? Expert Rev Proteomics 2018; 15:581-592. [PMID: 29999442 PMCID: PMC6092739 DOI: 10.1080/14789450.2018.1493927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/25/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Hypertension is a complex and multifactorial cardiovascular disorder. With different mechanisms contributing to a different extent to an individual's blood pressure, the discovery of novel pathogenetic principles of hypertension is challenging. However, there is an urgent and unmet clinical need to improve prevention, detection, and therapy of hypertension in order to reduce the global burden associated with hypertension-related cardiovascular diseases. Areas covered: Proteomic techniques have been applied in reductionist experimental models including angiotensin II infusion models in rodents and the spontaneously hypertensive rat in order to unravel mechanisms involved in blood pressure control and end organ damage. In humans proteomic studies mainly focus on prediction and detection of organ damage, particularly of heart failure and renal disease. While there are only few proteomic studies specifically addressing human primary hypertension, there are more data available in hypertensive disorders in pregnancy, such as preeclampsia. We will review these studies and discuss implications of proteomics on precision medicine approaches. Expert commentary: Despite the potential of proteomic studies in hypertension there has been moderate progress in this area of research. Standardized large-scale studies are required in order to make best use of the potential that proteomics offers in hypertension and other cardiovascular diseases.
Collapse
Affiliation(s)
- Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Emma Carrick
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Delyth Graham
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stuart A. Nicklin
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
23
|
Low CT, Lai PC, Yeung PSS, Siu AYC, Leung KTY, Wong PPY. Temperature and age–gender effects on out-of-hospital cardiac arrest cases. HONG KONG J EMERG ME 2018. [DOI: 10.1177/1024907917751301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Temperature is a key factor influencing the occurrence of out-of-hospital cardiac arrest, yet there is no equivalent study in Hong Kong. This study reports results involving a large-scale territory-wide investigation on the impacts of ambient temperature and age–gender differences on out-of-hospital cardiac arrest outcome in Hong Kong. Methods: This study included 25,467 out-of-hospital cardiac arrest cases treated by the Hong Kong Fire Services Department between December 2011 and November 2016 inclusive. Simple correlation and regression analyses were used to examine the relationships between out-of-hospital cardiac arrest cases and temperature, age and gender. Calendar charts were used to visualise temporal patterns of pre-hospital emergency medical services related to out-of-hospital cardiac arrest cases. Results: A strong negative curvilinear relationship was found between out-of-hospital cardiac arrest and daily temperature (r2 > 0.9) with prominent effects on elderly people aged ≥85 years. For each unit decrease in mean temperature in °C, there was a maximum of 5.6% increase in out-of-hospital cardiac arrest cases among all age groups and 7.3% increase in the ≥85 years elderly age group. Men were slightly more at risk of out-of-hospital cardiac arrest compared with women. The demand for out-of-hospital cardiac arrest–related emergency medical services was highest between 06:00 and 11:00 in the wintertime. Conclusion: This study provides the first local evidence linking weather and demographic effects with out-of-hospital cardiac arrest in Hong Kong. It offers empirical evidence to policymakers in support of strengthening existing emergency medical services to deal with the expected increase in out-of-hospital cardiac arrest in the wintertime and in regions with a large number of elderly population.
Collapse
Affiliation(s)
- Chien Tat Low
- Department of Geography, The University of Hong Kong, Hong Kong
| | - Poh Chin Lai
- Department of Geography, The University of Hong Kong, Hong Kong
| | | | | | | | - Paulina Pui Yun Wong
- Department of Geography, The University of Hong Kong, Hong Kong
- Science Unit, Lingnan University, Hong Kong
| |
Collapse
|
24
|
Arku RE, Ezzati M, Baumgartner J, Fink G, Zhou B, Hystad P, Brauer M. Elevated blood pressure and household solid fuel use in premenopausal women: Analysis of 12 Demographic and Health Surveys (DHS) from 10 countries. ENVIRONMENTAL RESEARCH 2018; 160:499-505. [PMID: 29107891 DOI: 10.1016/j.envres.2017.10.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Approximately three billion people are exposed to household air pollution (HAP) from solid fuel cookstoves. Studies from single settings have linked HAP with elevated blood pressure (BP), but no evidence exists from multi-country analyses. OBJECTIVES Using nationally representative and internationally comparable data, we examined the association between solid fuel use and BP in 77,605 largely premenopausal women (aged 15-49) from ten resource-poor countries. METHODS We obtained data on systolic and diastolic BP, self-reported primary cooking fuel, health and socio-demographic characteristics from 12 Demographic and Health Surveys conducted in Albania, Armenia, Azerbaijan, Bangladesh, Benin, Ghana, Kyrgyzstan, Lesotho, Namibia, and Peru. We estimated associations between history of fuel use [solid fuel (coal or biomass) versus clean fuel (electricity or gas)] with systolic and diastolic BP and hypertension using a meta-analytical approach. RESULTS Overall, the country-level mean systolic and diastolic BP were 117 (range: 111-127) and 74 (71-83) mmHg, respectively. The country-level mean age of the women was 30.8 years (range: 28.4-32.9). The prevalence of solid fuel use was 46.0% (range: 4.1-95.8). In adjusted, pooled analyses, primary use of solid fuel was associated with 0.58mmHg higher systolic BP (95% CI: 0.23, 0.93) as compared to primary use of clean fuel. The pooled estimates for diastolic BP and pulse pressure were also positive, but the confidence intervals contained zero. The pooled odds of hypertension was [OR = 1.07 (95% CI: 0.99, 1.16)], an effect that was driven by rural participants for whom solid fuel use was associated with a 16% greater odds of hypertension [OR = 1.16 (95% CI: 1.01, 1.35)]. CONCLUSIONS Cooking with solid fuels was associated with small increases in BP and odds of hypertension. Use of cleaner fuels like gas or electricity may reduce cardiovascular risk in developing countries, particularly among rural residents.
Collapse
Affiliation(s)
- Raphael E Arku
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada; Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA.
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health and WHO Collaborating Centre on NCD Surveillance and Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Jill Baumgartner
- Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Günther Fink
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Bin Zhou
- MRC-PHE Centre for Environment and Health and WHO Collaborating Centre on NCD Surveillance and Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Perry Hystad
- The School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
25
|
Thosar SS, Niederhausen M, Lapidus J, Fino NF, Cigarroa J, Minnier J, Colner S, Nayak A, Burchill LJ. Self-regulated use of a wearable activity sensor is not associated with improvements in physical activity, cardiometabolic risk or subjective health status. Br J Sports Med 2017; 52:1217-1218. [PMID: 29222201 DOI: 10.1136/bjsports-2017-098512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Saurabh S Thosar
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon, USA
| | - Meike Niederhausen
- Biostatistics and Design Program, Oregon Health and Science University, Portland, Oregon, USA
| | - Jodi Lapidus
- Biostatistics and Design Program, Oregon Health and Science University, Portland, Oregon, USA
| | - Nora F Fino
- Biostatistics and Design Program, Oregon Health and Science University, Portland, Oregon, USA
| | - Joaquin Cigarroa
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Jessica Minnier
- Biostatistics and Design Program, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Asha Nayak
- Intel Corporation, Santa Clara, California, USA
| | - Luke J Burchill
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| |
Collapse
|
26
|
Goyal A, Aslam N, Kaur S, Soni RK, Midha V, Chaudhary A, Dhaliwal LK, Singh B, Chhabra ST, Mohan B, Anand IS, Wander GS. Factors affecting seasonal changes in blood pressure in North India: A population based four-seasons study. Indian Heart J 2017; 70:360-367. [PMID: 29961451 PMCID: PMC6034019 DOI: 10.1016/j.ihj.2017.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/12/2017] [Accepted: 09/16/2017] [Indexed: 11/18/2022] Open
Abstract
Objective There are no community based, longitudinal, intra individual epidemiological studies on effect of weather and season on blood pressure (BP). We evaluated the effect of season and temperature on prevalence and epidemiology of BP in tropical climate. Methods and results It was a longitudinal cross sectional survey of rural and urban subjects in their native surroundings. BP was measured in four different seasons in same subjects. A total of 978 subjects (452 rural and 521 urban) were included in the current analysis. Demographic characteristics such as age, gender, education, occupational based physical activity and body mass index (BMI) were recorded. Mean BP, both systolic and diastolic were significantly higher in winter season as compared to summer season. Mean difference between winter and summer was 9.01 (95% CI: 7.74–10.28, p < 0.001) in systolic BP and 5.61 (95% CI: 4.75–6.47, p < 0.001) in diastolic BP. This increase in BP was more marked in rural areas and elderly subjects. Prevalence of hypertension was significantly higher during winter (23.72%) than in summer (10.12%). Conclusion BP increases significantly during winter season as compared to summer season. Increase is more marked in rural areas and elderly subjects. Seasonal variation in BP should be taken into account while looking at prevalence of hypertension in epidemiological studies.
Collapse
Affiliation(s)
- Abhishek Goyal
- Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Naved Aslam
- Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | | | - R K Soni
- Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Vandana Midha
- Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | | | | | - Bhupinder Singh
- Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Shibba T Chhabra
- Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Bishav Mohan
- Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Inder S Anand
- University of Minnesota Medical School, VA Medical Center Minneapolis MN, USA
| | - Gurpreet S Wander
- Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
| |
Collapse
|
27
|
Lim YH, Han C, Bae S, Hong YC. Modulation of blood pressure in response to low ambient temperature: The role of DNA methylation of zinc finger genes. ENVIRONMENTAL RESEARCH 2017; 153:106-111. [PMID: 27918981 DOI: 10.1016/j.envres.2016.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 11/24/2016] [Accepted: 11/26/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Blood pressure rises with a drop in external temperature, but the role of DNA methylation in such blood pressure modulation has not been studied in detail. We evaluated blood pressure and DNA methylation of vascular disease-related genes in association with low temperature. METHODS To examine changes in blood pressure and DNA methylation associated with low temperature, we conducted repeated measures analysis among 50 participants over 3 repeated visits, and validated the association among another 52 participants. In addition, the mean of methylation changes in the identified CpG sites was evaluated with changes in blood pressure. Mediation analyses were also conducted to model the indirect association between low ambient temperature and blood pressure through changes in DNA methylation. RESULTS With a 1°C decrease in temperature, increases of 0.6mmHg (standard error (SE), 0.2) in SBP and 0.3mmHg (SE, 0.1) in DBP occurred (P<0.05). Of 24,490 CpG sites in vascular genes, 2 CpG sites of zinc finger (ZNF) genes were significantly associated with temperature after Bonferroni's correction in discovery and replication data. A 10% increase in methylation expression in 2 CpG sites in ZNF genes was associated with a 4-mmHg elevation in DBP (SE, 1.8; P=0.0236). The hypermethylation was attributable to the association of ambient temperature with DBP (proportion of mediation=11.8-20.4%). CONCLUSIONS Methylation changes in ZNF genes might be involved in the elevation of blood pressure when the body is exposed to cold temperature.
Collapse
Affiliation(s)
- Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Changwoo Han
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sanghyuk Bae
- Department of Preventive Medicine, Dankook University, Cheonan, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
28
|
Herbowski L. The major influence of the atmosphere on intracranial pressure: an observational study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:181-188. [PMID: 27333899 DOI: 10.1007/s00484-016-1202-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 06/01/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
The impact of the atmosphere on human physiology has been studied widely within the last years. In practice, intracranial pressure is a pressure difference between intracranial compartments and the surrounding atmosphere. This means that gauge intracranial pressure uses atmospheric pressure as its zero point, and therefore, this method of pressure measurement excludes the effects of barometric pressure's fluctuation. The comparison of these two physical quantities can only take place through their absolute value relationship. The aim of this study is to investigate the direct effect of barometric pressure on the absolute intracranial pressure homeostasis. A prospective observational cross-sectional open study was conducted in Szczecin, Poland. In 28 neurosurgical patients with suspected normal-pressure hydrocephalus, intracranial intraventricular pressure was monitored in a sitting position. A total of 168 intracranial pressure and atmospheric pressure measurements were performed. Absolute atmospheric pressure was recorded directly. All values of intracranial gauge pressure were converted to absolute pressure (the sum of gauge intracranial pressure and local absolute atmospheric pressure). The average absolute mean intracranial pressure in the patients is 1006.6 hPa (95 % CI 1004.5 to 1008.8 hPa, SEM 1.1), and the mean absolute atmospheric pressure is 1007.9 hPa (95 % CI 1006.3 to 1009.6 hPa, SEM 0.8). The observed association between atmospheric and intracranial pressure is strongly significant (Spearman correlation r = 0.87, p < 0.05) and all the measurements are perfectly reliable (Bland-Altman coefficient is 4.8 %). It appears from this study that changes in absolute intracranial pressure are related to seasonal variation. Absolute intracranial pressure is shown to be impacted positively by atmospheric pressure.
Collapse
Affiliation(s)
- Leszek Herbowski
- Neurosurgery and Neurotraumatology Department, District Hospital, Arkonska 4, 71-455, Szczecin, Poland.
| |
Collapse
|
29
|
Gillespie J, Beverland IJ, Hamilton S, Padmanabhan S. Development, Evaluation, and Comparison of Land Use Regression Modeling Methods to Estimate Residential Exposure to Nitrogen Dioxide in a Cohort Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2016; 50:11085-11093. [PMID: 27618146 DOI: 10.1021/acs.est.6b02089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We used a network of 135 NO2 passive diffusion tube sites to develop land use regression (LUR) models in a UK conurbation. Network sites were divided into four groups (32-35 sites per group) and models developed using combinations of 1-3 groups of "training" sites to evaluate how the number of training sites influenced model performance and residential NO2 exposure estimates for a cohort of 13 679 participants. All models explained moderate to high variance in training and independent "hold-out" data (Training adj. R2: 62-89%; Hold-out R2: 44-85%). Average hold-out R2 increased by 9.5%, while average training adj. R2 decreased by 7.2% when the number of training groups was increased from 1 to 3. Exposure estimate precision improved with increasing number of training sites (median intralocation relative standard deviations of 19.2, 10.3, and 7.7% for 1-group, 2-group and 3-group models respectively). Independent 1-group models gave highly variable exposure estimates suggesting that variations in LUR sampling networks with relatively low numbers of sites (≤35) may substantially alter exposure estimates. Collectively, our analyses suggest that use of more than 60 training sites has quantifiable benefits in epidemiological application of LUR models.
Collapse
Affiliation(s)
- Jonathan Gillespie
- Department of Civil and Environmental Engineering, University of Strathclyde , James Weir Building, 75 Montrose Street, Glasgow, G1 1XJ, U.K
| | - Iain J Beverland
- Department of Civil and Environmental Engineering, University of Strathclyde , James Weir Building, 75 Montrose Street, Glasgow, G1 1XJ, U.K
| | - Scott Hamilton
- Ricardo Energy and Environment, 18 Blythswood Square, Glasgow G2 4BG, U.K
| | - Sandosh Padmanabhan
- University of Glasgow , Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow G12 8TA
| |
Collapse
|
30
|
Okeahialam BN. The Cold Dusty Harmattan: A Season of Anguish for Cardiologists and Patients. ENVIRONMENTAL HEALTH INSIGHTS 2016; 10:143-146. [PMID: 27594787 PMCID: PMC5004994 DOI: 10.4137/ehi.s38350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 05/30/2023]
Abstract
Human health and disease often demonstrate seasonal patterns. Knowledge of these aspects aids anticipation and planning. Numerous studies have shown that hypertension and cardiovascular diseases demonstrate a seasonal pattern. The Harmattan, the cold dusty season in Sub-Saharan Africa, is the season of greatest concern in this regard. In this commentary, the author draws on his and other researchers' studies to explain the grounds for onset and worsening of existing cardiovascular diseases. As implied in the title, it is a season that puts great strain on the cardiologist and the health system, as well as greater disease burden on the patient. This should be taken into consideration in planning and pooling of resources for effective patient management and mitigation of impact of disease.
Collapse
|
31
|
Kazlauskas HA, Raskauskiene N, Radziuviene R, Janusonis V. Twenty years trends in mortality rates from stroke in Klaipeda. Brain Behav 2016; 6:e00499. [PMID: 27547501 PMCID: PMC4893389 DOI: 10.1002/brb3.499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 04/02/2016] [Accepted: 04/27/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND During the past decades, mortality from stroke decreased in many western European countries; however, changes concerning long-term stroke mortality in eastern European countries are less evident. OBJECTIVE To assess age- and gender-specific trends in stroke mortality in Klaipeda (Lithuania) from 1994 to 2013. DESIGN Descriptive epidemiological study. SETTING/SUBJECTS Permanent population of Klaipeda. METHODS Data on 2509 permanent residents of Klaipeda aged 35-79 years who died from stroke between 1994 and 2013 were gathered. Directly, age-standardized (European population) stroke mortality rates were analyzed using joinpoint regression separately for specific age groups (35-64, 65-79, and 35-79 years) and by gender. Annual percentage change (APC) and 95% CIs were presented. RESULTS Stroke mortality in the 35- to 79-year-old age group peaked in 1994-1997, it then decreased by -9.9% (95% CI: -18.7, -0.2) yearly up until 2001 and leveled off by -0.2% (-5.1, 4.9) between 2001 and 2013. Among men aged 35-64 years, mortality decreased substantially by 12.8% (-21.5, -3.3) per year from 1994 to 2001 and turned positive by 6.3% (0.8, 12.1) between 2000 and 2013. Among women aged 35-64 years, mortality decreased significantly by 15.5% (-28.1, -0.7) from 1994 to 2000. There was evidence of recent plateauing of trends for 35- to 64-year-old women between 2000 and 2013. In the 65- to 79-year-old age group, mortality decreased from 1994 onward yearly by -5.5% (-7.9, -3.0) in women and by -3.3% (-5.6, -0.9) in men. CONCLUSIONS Joinpoint regression revealed steadily decreasing trend in stroke mortality between 1994 and 2001. The decline in death rates flattened out in the recent decade. Mortality rates varied among age groups and were more pronounced in adults aged 35-64 years. It is essential to monitor and manage stroke risk factors, especially among middle-aged population.
Collapse
Affiliation(s)
- Henrikas A. Kazlauskas
- Department of Neurology and RehabilitationKlaipeda University HospitalKlaipedaLithuania
- Behavioral Medicine Institute Lithuanian University of Health SciencesPalangaLithuania
| | - Nijole Raskauskiene
- Behavioral Medicine Institute Lithuanian University of Health SciencesPalangaLithuania
| | - Rima Radziuviene
- Behavioral Medicine Institute Lithuanian University of Health SciencesPalangaLithuania
| | - Vinsas Janusonis
- Klaipeda University HospitalKlaipeda UniversityKlaipedaLithuania
| |
Collapse
|
32
|
Kühlmann AYR, Etnel JRG, Roos-Hesselink JW, Jeekel J, Bogers AJJC, Takkenberg JJM. Systematic review and meta-analysis of music interventions in hypertension treatment: a quest for answers. BMC Cardiovasc Disord 2016; 16:69. [PMID: 27095510 PMCID: PMC4837643 DOI: 10.1186/s12872-016-0244-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/13/2016] [Indexed: 01/01/2023] Open
Abstract
Background Adverse effects, treatment resistance and high costs associated with pharmacological treatment of hypertension have led to growing interest in non-pharmacological complementary therapies such as music interventions. This meta-analysis aims to provide an overview of reported evidence on the efficacy of music interventions in the treatment of hypertension. Methods A systematic literature search was conducted for publications on the effect of music interventions on blood pressure in adult hypertensive subjects published between January 1990-June 2014. Randomized controlled trials with a follow-up duration ≥28 days were included. Blood pressure measures were pooled using inverse variance weighting. Results Of the 1689 abstracts reviewed, 10 randomized controlled trials were included. Random-effects pooling of the music intervention groups showed a trend toward a decrease in mean systolic blood pressure (SBP) from 144 mmHg(95 % CI:137–152) to 134 mmHg(95 % CI:124–144), and in mean diastolic blood pressure (DBP) from 84 mmHg(95 % CI:78–89) to 78 mmHg(95 % CI:73–84). Fixed-effect analysis of a subgroup of 3 trials with valid control groups showed a significant decrease in pooled mean SBP and DBP in both intervention and control groups. A comparison between music intervention groups and control groups was not possible due to unavailable measures of dispersion. Conclusions This systematic review and meta-analysis revealed a trend towards a decrease in blood pressure in hypertensive patients who received music interventions, but failed to establish a cause-effect relationship between music interventions and blood pressure reduction. Considering the potential value of this safe, low-cost intervention, well-designed, high quality and sufficiently powered randomized studies assessing the efficacy of music interventions in the treatment of hypertension are warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12872-016-0244-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Anne Y R Kühlmann
- Department of Pediatric Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jonathan R G Etnel
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
| | | | - Johannes Jeekel
- Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
| | - Johanna J M Takkenberg
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands.
| |
Collapse
|
33
|
Zheng D, Arima H, Sato S, Gasparrini A, Heeley E, Delcourt C, Lo S, Huang Y, Wang J, Stapf C, Robinson T, Lavados P, Chalmers J, Anderson CS. Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study. PLoS One 2016; 11:e0149040. [PMID: 26859491 PMCID: PMC4747478 DOI: 10.1371/journal.pone.0149040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/26/2016] [Indexed: 11/25/2022] Open
Abstract
Background Rates of acute intracerebral hemorrhage (ICH) increase in winter months but the magnitude of risk is unknown. We aimed to quantify the association of ambient temperature with the risk of ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2) participants on an hourly timescale. Methods INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of patients with spontaneous ICH (<6h of onset) and elevated systolic blood pressure (SBP, 150–220 mmHg) assigned to intensive (target SBP <140 mmHg) or guideline-recommended (SBP <180 mmHg) BP treatment. We linked individual level hourly temperature to baseline data of 1997 participants, and performed case-crossover analyses using a distributed lag non-linear model with 24h lag period to assess the association of ambient temperature and risk of ICH. Results were presented as overall cumulative odds ratios (ORs) and 95% CI. Results Low ambient temperature (≤10°C) was associated with increased risks of ICH: overall cumulative OR was 1.37 (0.99–1.91) for 10°C, 1.92 (1.31–2.81) for 0°C, 3.13 (1.89–5.19) for -10°C, and 5.76 (2.30–14.42) for -20°C, as compared with a reference temperature of 20°C.There was no clear relation of low temperature beyond three hours after exposure. Results were consistent in sensitivity analyses. Conclusions Exposure to low ambient temperature within several hours increases the risk of ICH. Trial Registration ClinicalTrials.gov NCT00716079
Collapse
Affiliation(s)
- Danni Zheng
- Division of Neurology and Mental health, The George Institute for Global Health, Sydney, New South Wales, Australia
- Sydney Medical School, the University of Sydney, Sydney, New South Wales, Australia
| | - Hisatomi Arima
- Division of Neurology and Mental health, The George Institute for Global Health, Sydney, New South Wales, Australia
- Sydney Medical School, the University of Sydney, Sydney, New South Wales, Australia
- Centre for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga University, Shiga, Japan
| | - Shoichiro Sato
- Division of Neurology and Mental health, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Emma Heeley
- Sydney Medical School, the University of Sydney, Sydney, New South Wales, Australia
| | - Candice Delcourt
- Division of Neurology and Mental health, The George Institute for Global Health, Sydney, New South Wales, Australia
- Sydney Medical School, the University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Serigne Lo
- Sydney Medical School, the University of Sydney, Sydney, New South Wales, Australia
| | - Yining Huang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Jiguang Wang
- Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Christian Stapf
- Department of Neurology, APHP–Hôpital Lariboisière, DHU NeuroVasc Paris–Sorbonne, Université Paris Diderot–Sorbonne Paris Cité, Paris, France
- Department of Neuroscience, CRCHUM, University of Montreal, Montreal, Quebec, Canada
| | - Thompson Robinson
- Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Leicester, United Kingdom
| | - Pablo Lavados
- Vascular Neurology Program, Neurology Services, Department of Internal Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - John Chalmers
- Division of Neurology and Mental health, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Craig S. Anderson
- Division of Neurology and Mental health, The George Institute for Global Health, Sydney, New South Wales, Australia
- Sydney Medical School, the University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- * E-mail:
| | | |
Collapse
|
34
|
Summertime dosage-dependent hypersensitivity to an angiotensin II receptor blocker. BMC Res Notes 2015; 8:227. [PMID: 26055103 PMCID: PMC4467666 DOI: 10.1186/s13104-015-1215-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 05/29/2015] [Indexed: 01/08/2023] Open
Abstract
Background Summertime dips in blood pressure (BP), both in normotensive and hypertensive subjects, are well known. However, the dips are small and are not related to particular forms or doses of antihypertensive medication. Nevertheless it is the practice in some quarters to decrease antihypertensive medication in summer, and/or to increase in winter. Large scale studies being inconclusive, there are calls for long-term examination of the relationship between environmental temperature and blood pressure in single individuals under medication. Case presentation While analyzing data from a subject whose BP had been controlled for a decade with the angiotensin-II receptor blocker losartan, an extreme, dosage-dependent, summertime dip came to light. Downward dosage adjustment appeared essential and may have prevented hypotension-related pathology. Conclusion The benefits of aggressive medication (the “J curve” phenomenon) being debated, the possibility of seasonal hypersensitivity, perhaps explicable in terms of differential signaling by countervailing receptors, should be taken into account when considering dosage adjustments in hypertensive subjects.
Collapse
|
35
|
Tuo B, Li C, Peng L, Ye M, Liu W, Zhong X, Li H. Analysis of differentially expressed genes in cold-exposed mice to investigate the potential causes of cold-induced hypertension. Exp Ther Med 2014; 8:110-114. [PMID: 24944607 PMCID: PMC4061198 DOI: 10.3892/etm.2014.1703] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 04/15/2014] [Indexed: 11/08/2022] Open
Abstract
Cold exposure is considered to be an important contributing factor to the high morbidity of hypertension. In order to elucidate the cause and mechanism of cold-induced hypertension (CIH), gene expression analysis was performed on microarray data for two groups of cold-exposed mice (4°C for 1 week and 4°C for 5 weeks, three replicates per group) and their respective control groups maintained at 30°C. Analysis results indicated that the differentially expressed genes with the most significance were associated with adaptive thermogenesis, fatty acid metabolism and energy metabolism. The expected marked increase in metabolism during cold exposure caused tissue hypoxia. Genes involved in the hypoxia-inducible factor signaling pathway were activated. In addition, genes associated with oxidative stress were significantly upregulated, including superoxide dismutase 2 (SOD2) and epoxide hydrolase 2 (EPHX2). The majority of genes involved in inflammation-associated pathways were shown to be downregulated in the 4°C 5-week group. Therefore, the results of the present study indicate that tissue hypoxia and increased oxidative stress may play important roles in the process of CIH.
Collapse
Affiliation(s)
- Buxiong Tuo
- Department of Cardiology, 451 Hospital of PLA, Xi'an, Shaanxi 710054, P.R. China
| | - Chaomin Li
- Department of Cardiology, 451 Hospital of PLA, Xi'an, Shaanxi 710054, P.R. China
| | - Lijing Peng
- Department of Cardiology, 451 Hospital of PLA, Xi'an, Shaanxi 710054, P.R. China
| | - Mingxia Ye
- Department of Cardiology, 451 Hospital of PLA, Xi'an, Shaanxi 710054, P.R. China
| | - Wei Liu
- Department of Cardiology, 451 Hospital of PLA, Xi'an, Shaanxi 710054, P.R. China
| | - Xiaolan Zhong
- Department of Cardiology, 451 Hospital of PLA, Xi'an, Shaanxi 710054, P.R. China
| | - Hui Li
- Department of Cardiology, 451 Hospital of PLA, Xi'an, Shaanxi 710054, P.R. China
| |
Collapse
|
36
|
Chen Q, Wang J, Tian J, Tang X, Yu C, Marshall RJ, Chen D, Cao W, Zhan S, Lv J, Lee L, Hu Y. Association between ambient temperature and blood pressure and blood pressure regulators: 1831 hypertensive patients followed up for three years. PLoS One 2013; 8:e84522. [PMID: 24391962 PMCID: PMC3877276 DOI: 10.1371/journal.pone.0084522] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 11/14/2013] [Indexed: 12/27/2022] Open
Abstract
Several studies have suggested an association between ambient air temperature and blood pressure. However, this has not been reliably confirmed by longitudinal studies. Also, whether the reaction to temperature stimulation is modified by other factors such as antihypertensive medication is rarely investigated. The present study explores the relationship between ambient temperature and blood pressure, without and with antihypertensive medication, in a study of 1,831 hypertensive patients followed up for three years, in two or four weekly check ups, accumulating 62,452 follow-up records. Both baseline and follow-up blood pressure showed an inverse association with ambient temperature, which explained 32.4% and 65.6% of variation of systolic blood pressure and diastolic blood pressure (P<0.05) respectively. The amplitude of individual blood pressure fluctuation with temperature throughout a year (a 29 degrees centigrade range) was 9.4/7.3 mmHg. Medication with angiotensin converting enzyme inhibitor benazepril attenuated the blood pressure fluctuation by 2.4/1.3 mmHg each year, though the inverse association of temperature and blood pressure remained. Gender, drinking behavior and body mass index were also found to modify the association between temperature and diastolic blood pressure. The results indicate that ambient temperature may negatively regulate blood pressure. Hypertensive patients should monitor and treat blood pressure more carefully in cold days, and it could be especially important for the males, thinner people and drinkers.
Collapse
Affiliation(s)
- Qing Chen
- Department of Hygienic Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, P. R. China
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Jinwei Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Jun Tian
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Xun Tang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Roger J. Marshall
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Dafang Chen
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Weihua Cao
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Siyan Zhan
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Jun Lv
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Liming Lee
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Yonghua Hu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
- * E-mail:
| |
Collapse
|
37
|
[Weather sensitivity can be measured]. MMW Fortschr Med 2013; 155:28. [PMID: 24006585 DOI: 10.1007/s15006-013-2027-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|