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Li A, Zhang Q, Yao Y, Zhu X, Liu C, Guo Y, Kan H, Chen R. Higher ambient temperatures may worsen obstructive sleep apnea: A nationwide smartwatch-based analysis of 6.2 million person-days. Sci Bull (Beijing) 2024; 69:2114-2121. [PMID: 38821748 DOI: 10.1016/j.scib.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 06/02/2024]
Abstract
Obstructive sleep apnea (OSA) is a serious type of sleep disorder that can lead to cardiometabolic and neurocognitive diseases. We utilized smart device-based photoplethysmography technology to collect sleep data from the Chinese population from 2019 to 2022. Distributed lag nonlinear models combined with a generalized nonlinear model or a linear mixed effects model were used to investigate the short-term associations between daily temperature and indicators of OSA severity. We included a total of 6,232,056 d of sleep monitoring data from 51,842 participants with moderate to severe risk of OSA from 313 Chinese cities. The relationships between ambient temperature and OSA exacerbation, apnea-hypopnea index (AHI), and minimum oxygen saturation (MinSpO2) were almost linear and present only on the same day. Higher temperatures were associated with a greater risk of OSA exacerbation, with an 8.4% (95% confidence interval (CI): 7.6%-9.3%) increase per 10 °C increase in temperature. A 10 °C increase in daily temperature corresponded to an AHI increase of 0.70 events/h (95% CI: 0.65-0.76) and a MinSpO2 decrease of 0.18% (95% CI: 0.16%-0.19%). Exposure to elevated temperatures during the night can also lead to adverse effects. The effects of higher temperatures on OSA severity were stronger among men, participants with a body mass index ≥ 24 kg/m2, those aged 45 years and older, individuals with a history of hypertension and diabetes, and during the cold season. This large-scale, nationwide, longitudinal study provides robust evidence suggesting that higher ambient temperatures may immediately worsen OSA.
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Affiliation(s)
- Anni Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Qingli Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Yuan Yao
- Department of Pulmonary Vessel and Thrombotic Disease, Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China; Institute for Hospital Management Research, Chinese PLA General Hospital, Beijing 100048, China
| | - Xinlei Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Yutao Guo
- Department of Pulmonary Vessel and Thrombotic Disease, Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China.
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Song M, Zheng L, Chen L, Zhang C, Chen X, Zhao C. Epidemiological characteristics of chronic non-communicable diseases in Dongfang, China, 2021: a cross-sectional survey. BMJ Open 2024; 14:e081710. [PMID: 38803260 PMCID: PMC11129020 DOI: 10.1136/bmjopen-2023-081710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The study aimed to understand the composition, epidemiological characteristics and disease burden of chronic non-communicable diseases and to evaluate the association between sociodemographic factors and chronic non-communicable diseases. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS Medical records of 196 761 residents were collected from Dongfang disease surveillance system from January to December 2021. PRIMARY OUTCOME Prevalence and disability burden were recorded. Logistic regression was used to investigate the relationship between sociodemography factors and diseases. RESULTS Cardiovascular diseases, chronic lower respiratory diseases and other upper respiratory tract diseases were the main chronic non-communicable diseases. In multivariable analysis, men were associated with increased risk of cardiovascular diseases (OR=1.210, 95% CI 1.162 to 1.261) and chronic lower respiratory diseases (OR=1.128, 95% CI 1.079 to 1.180). Older age was associated with increased risk of cardiovascular diseases (OR=83.952, 95% CI 58.954 to 119.550), whereas was associated with decreased risk of chronic lower respiratory diseases (OR=0.442, 95% CI 0.415 to 0.471) and other upper respiratory tract diseases (OR=0.450, 95% CI 0.411 to 0.493). The unemployed and poor household were associated with decreased risk of cardiovascular diseases (OR=0.463, 95% CI 0.412 to 0.521 and OR=0.390, 95% CI 0.342 to 0.444, respectively), whereas were associated with increased risk of chronic lower respiratory diseases (OR=12.219, 95% CI 6.343 to 23.539 and OR=10.954, 95% CI 5.666 to 21.177, respectively) and other upper respiratory tract diseases (OR=2.246, 95% CI 1.719 to 2.936 and OR=3.035, 95% CI 2.308 to 3.991, respectively). Gender and age moderated the association between personnel category and major diseases. CONCLUSIONS The spectrum and epidemiological characteristics of chronic diseases observed in Dongfang is good evidence for developing prevention guides and health policies for region.
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Affiliation(s)
- Meixuan Song
- Department of Nursing, Tongji University School of Medicine, Shanghai, China
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Liang Zheng
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Lan Chen
- Department of Internal Medicine, Dongfang People's Hospital, Dongfang, Hainan, China
| | - Chunmei Zhang
- Dongfang Municipal Health Commission, Dongfang, Hainan, China
| | - Xingyi Chen
- Department of Medical, Tongji University Affilliated East Hospital, Shanghai, China
| | - Chunyan Zhao
- Department of Nursing, Tongji University Affilliated East Hospital, Shanghai, China
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3
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Umishio W. Importance of measuring indoor temperature to understand blood pressure levels and variability at home. Hypertens Res 2024; 47:826-828. [PMID: 38216733 DOI: 10.1038/s41440-023-01576-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 01/14/2024]
Affiliation(s)
- Wataru Umishio
- Department of Architecture and Building Engineering, School of Environment and Society, Tokyo Institute of Technology, Meguro-ku, Tokyo, Japan.
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Kanagawa, Japan.
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4
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Kario K, Tomitani N, Wang TD, Park S, Li Y, Shin J, Tsoi K, Chen CH, Cheng HM, Siddique S, Turana Y, Buranakitjaroen P, Van Huynh M, Nailes J, Sison J, Soenarta AA, Sogunuru GP, Sukonthasarn A, Tay JC, Teo BW, Verma N, Zhang Y, Schlaich M, Nagai M, Fujiwara T, Hoshide S, Chia YC, Wang JG. Home blood pressure-centered approach - from digital health to medical practice: HOPE Asia Network consensus statement 2023. Hypertens Res 2023; 46:2561-2574. [PMID: 37605071 DOI: 10.1038/s41440-023-01397-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/20/2023] [Accepted: 07/12/2023] [Indexed: 08/23/2023]
Abstract
Recent innovations in digital technology have enabled the simultaneous accumulation, and the linking and analysis of time-series big data relating to several factors that influence blood pressure (BP), including biological indicators, physical activity, and environmental information. Various approaches can be used to monitor BP: in the office/clinic; at home; 24-h ambulatory recording; or with wearable and cuffless devices. Of these, home BP monitoring is a reliable and convenient method, and is recommended for hypertension management by current national and international guidelines. This recommendation is based on evidence showing that home BP is an important predictor of cardiovascular, cerebrovascular and kidney disease in patients with hypertension. In addition, lifetime personalized health record (PHR)-based home BP with telemonitoring combined with co-interventions has been shown to lower BP more effectively than the traditional approach based on office BP. Thus, home BP represents a key metric for personalized anticipation medicine, from digital healthcare to digital medicine. This paper summarizes the latest evidence on home BP monitoring and proposes a Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network consensus on a home BP-centered approach to the management of hypertension.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
| | - Naoko Tomitani
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Tzung-Dau Wang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
- Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, South Korea
| | - Yan Li
- Centre for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jinho Shin
- Faculty of Cardiology Service, Hanyang University Medical Center, Seoul, South Korea
| | - Kelvin Tsoi
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chen-Huan Chen
- Department of Internal Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Hao-Min Cheng
- Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Division of Faculty Development, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Yuda Turana
- Department of Neurology. School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Peera Buranakitjaroen
- Division of Hypertension, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Minh Van Huynh
- Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Jennifer Nailes
- Department of Preventive and Community Medicine and Research Institute for Health Sciences, University of the East Ramon Magsaysay Memorial Medical Center Inc., Quezon City, Philippines
| | - Jorge Sison
- Section of Cardiology, Department of Medicine, Medical Center Manila, Manila, Philippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia-National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
| | - Guru Prasad Sogunuru
- Fortis Hospitals, Chennai, Tamil Nadu, India
- College of Medical Sciences, Kathmandu University, Bharatpur, Nepal
| | - Apichard Sukonthasarn
- Cardiology Division, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Boon Wee Teo
- Division of Nephrology Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Narsingh Verma
- Department of Physiology, King George's Medical University, Lucknow, India
| | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Markus Schlaich
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and Royal Perth Hospital Research Foundation, The University of Western Australia, Perth, WA, Australia
| | - Michiaki Nagai
- Department of Internal Medicine, General Medicine and Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Takeshi Fujiwara
- 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
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ji-Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, the Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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5
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Kario K. Evidence for the surge blood pressure resonance hypothesis as a trigger for cardiovascular disease events. Hypertens Res 2023; 46:2065-2069. [PMID: 37322131 DOI: 10.1038/s41440-023-01346-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
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6
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Narita K, Kario K. Seasonal variation in blood pressure and its impact on target organ damage and cardiovascular disease incidence. Hypertens Res 2023; 46:1710-1711. [PMID: 37106045 DOI: 10.1038/s41440-023-01289-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023]
Affiliation(s)
- Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
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7
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Kario K, Hoshide S, Mogi M. Topics 2023 in Hypertension Research leading to guidelines in Asia. Hypertens Res 2023; 46:1357-1362. [PMID: 37271784 DOI: 10.1038/s41440-023-01285-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 06/06/2023]
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
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8
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Nakagami H, Otsuka H, Akiyama H. Monitoring with wearable devices will clarify the association between indoor temperature and blood pressure. Hypertens Res 2023:10.1038/s41440-023-01261-7. [PMID: 36977899 DOI: 10.1038/s41440-023-01261-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023]
Abstract
The association of blood pressure and temperature is well known in seasonal observation, and low temperature in the winter season is often considered a cause of high blood pressure. The current evidence for short-term studies of temperature and blood pressure is based on the daily observation, however continuous monitoring with wearable devices will allow us to evaluate the rapid effect of cold temperature exposure on blood pressure. In a Japanese, prospective intervention study from 2014 to 2019 (the Smart Wellness Housing survey), approximately 90% of Japanese lived in cold houses (indoor temperature less than 18 °C). Importantly, the indoor temperature was associated with the increase of morning systolic blood pressure. We recently addressed the sympathetic nervous activation of individuals in both their houses and a highly insulated and airtight model house in the winter season using portable electrocardiography equipment. A few subjects showed a morning surge in sympathetic activity, which was more intense at their cold houses, which suggests the importance of the indoor environment in the management of early morning hypertension. In near future, real-time monitoring with wearable devices will provide important information for a better life-environment, leading to risk reduction of morning surge and cardiovascular events.
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Affiliation(s)
- Hironori Nakagami
- Department of Health Development and Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka, Japan.
| | - Hiroki Otsuka
- Asahi Kasei Construction Materials Corporation, 1-105 Kanda Jimbocho, Chiyoda Ward, Tokyo, Japan
| | - Hitoshi Akiyama
- Asahi Kasei Construction Materials Corporation, 1-105 Kanda Jimbocho, Chiyoda Ward, Tokyo, Japan
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9
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Management of seasonal variation in blood pressure through the optimal adjustment of antihypertensive medications and indoor temperature. Hypertens Res 2023; 46:806-808. [PMID: 36577848 DOI: 10.1038/s41440-022-01151-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022]
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10
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Shibata S, Hoshide S. Current situation of telemedicine research for cardiovascular risk in Japan. Hypertens Res 2023; 46:1171-1180. [PMID: 36849580 PMCID: PMC9969376 DOI: 10.1038/s41440-023-01224-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
Hypertension continues to be a principal risk factor for the occurrence of cardiovascular disorders, stroke, and kidney diseases. Although more than 40 million subjects suffer from hypertension in Japan, its optimal control is achieved only a subpopulation of patients, highlighting the need for novel approaches to manage this disorder. Toward the better control of blood pressure, the Japanese Society of Hypertension has developed the Future Plan, in which the application of the state-of-art information and communication technology, including web-based resources, artificial intelligence, and big data analysis, is considered as one of the promising solutions. In fact, the rapid advance of digital health technologies, as well as ongoing coronavirus disease 2019 pandemic, has triggered the structural changes in the healthcare system globally, increasing demand for the remote delivery of the medical services. Nonetheless, it is not entirely clear what evidence exists that support the widespread use of telemedicine in Japan. Here, we summarize the current status of telemedicine research, particularly in the field of hypertension and other cardiovascular risk factors. We note that there have been very few interventional studies in Japan that clearly showed the superiority or noninferiority of telemedicine over standard care, and that the methods of online consultation considerably varied among studies. Clearly, more evidence is necessary for wide implementation of telemedicine in hypertensive patients in Japan, and also those with other cardiovascular risk factors.
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Affiliation(s)
- Shigeru Shibata
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
| | - Satoshi Hoshide
- grid.410804.90000000123090000Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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11
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Short- to long-term blood pressure variability: Current evidence and new evaluations. Hypertens Res 2023; 46:950-958. [PMID: 36759660 DOI: 10.1038/s41440-023-01199-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/05/2023] [Accepted: 01/19/2023] [Indexed: 02/11/2023]
Abstract
Increased blood pressure (BP) variability and the BP surge have been reported to be associated with increased cardiovascular risk independently of BP levels and can also be a trigger of cardiovascular events. There are multiple types of BP variation: beat-to-beat variations related to breathing and the autonomic nervous system, diurnal BP variation and nocturnal dipping related to sleep and physical activity over a 24-hr period, day-to-day BP variability with anomalous readings within a several-day period, visit-to-visit BP variability between outpatient visits, and seasonal variations. BP variability is also associated with the progression to hypertension from prehypertension and the progression of chronic kidney disease and cognitive impairments. Our research group proposed the "resonance hypothesis of blood pressure surge" as a new etiological hypothesis of BP variability and surges; i.e., the concept that when the time phases of surges and hypertension-inducing environmental influences coincide, resonance occurs and is amplified into a larger "dynamic surge" that triggers the onset of cardiovascular disease. New devices to assess BP variability as well as new therapeutic interventions to reduce BP variability are being developed. Although there are still issues to be addressed (including measurement accuracy), cuffless devices and information and communication technology (ICT)-based BP monitoring devices have been developed and validated. These new devices will be useful for the individualized optimal management of BP. However, evidence regarding the usefulness of therapeutic interventions to control BP variability is still lacking.
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12
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Morning surge in sympathetic nervous activity in the indoor environment during the cold winter season. Hypertens Res 2023; 46:231-235. [PMID: 36224284 DOI: 10.1038/s41440-022-01020-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 02/03/2023]
Abstract
We addressed to the sympathetic nervous activation of the same people in both their houses and a highly insulated and airtight model house (model house) during the cold winter season. Eight subjects (4 males and 4 females) stayed two nights at each house and were continuously monitored for sympathetic nerve system by calculating LF (low frequency)/HF (high frequency) in the analysis of heart rate variability using a wearable electrocardiography equipment. The room temperatures were kept constant at 20 °C or more in model house, but much lower in their houses. In all subjects, the sleeping duration is longer in model house compared with that in the participants' houses. Four subjects showed a morning surge in sympathetic activity that were more intense at their houses. This morning surge in sympathetic activity in a residential setting suggests the importance of the indoor environment in the management of early morning hypertension.
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Umishio W, Ikaga T, Kario K, Fujino Y, Suzuki M, Ando S, Hoshi T, Yoshimura T, Yoshino H, Murakami S. Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan. Hypertens Res 2023; 46:9-18. [PMID: 36224288 PMCID: PMC9747607 DOI: 10.1038/s41440-022-01060-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/22/2022] [Indexed: 02/03/2023]
Abstract
Current countermeasures for preventing hypertension emphasize only improvements to lifestyle. Recently, improving life environment has attracted attention, in parallel with publication of the WHO Housing and health guidelines. We quantitatively evaluated the relationship between housing thermal environment and blood pressure (BP) in a real-world setting. We conducted a nationwide, prospective intervention study-the Smart Wellness Housing survey-in Japan, as a non-randomized controlled trial. The intervention was the retrofitting of thermal insulation in houses. Participant recruitment was done by construction companies in all 47 prefectures of Japan. Measurements of home BP and indoor temperature at 1.0 m above the floor in the living room, changing room, and bedroom were taken for 2 weeks before and after the intervention each winter (November-March) of FY 2014-2019. As of July 2022, over 2500 households and 5000 participants were registered in the database. We found that (1) about 90% of Japanese lived in cold homes (minimum indoor temperature <18 °C), (2) indoor temperature was non-linearly associated with home BP, (3) morning systolic BP (SBP) was more sensitive than evening SBP to changes in indoor temperature, (4) SBP was influenced by indoor temperature change particularly in older participants and women, (5) unstable indoor temperature was associated with large BP variability, and (6) insulation retrofitting intervention significantly reduced home BP, especially in hypertensive patients. We proposed that the BP reduction effect of the life-environment is comparable to that achievable by lifestyle.
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Affiliation(s)
- Wataru Umishio
- Department of Architecture and Building Engineering, School of Environment and Society, Tokyo Institute of Technology, Ookayama, Meguro-ku, Tokyo, Japan.
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Kanagawa, Japan.
| | - Toshiharu Ikaga
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Kanagawa, Japan
| | - Kazuomi Kario
- Department of Cardiology, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Masaru Suzuki
- Department of Emergency Medicine, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Chiba, Japan
| | - Shintaro Ando
- Department of Architecture, Faculty of Environmental Engineering, The University of Kitakyushu, Kitakyushu, Fukuoka, Japan
| | - Tanji Hoshi
- Tokyo Metropolitan University, Hachioji, Tokyo, Japan
| | - Takesumi Yoshimura
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | | | - Shuzo Murakami
- Institute for Built Environment and Carbon Neutral for SDGs, Hirakawacho, Chiyoda-ku, Tokyo, Japan
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14
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Dasinger JH, Walton SD, Burns EC, Cherian-Shaw M, Abais-Battad JM, Mattson DL. Impact of bedding on Dahl salt-sensitive hypertension and renal damage. Am J Physiol Renal Physiol 2022; 323:F666-F672. [PMID: 36108053 PMCID: PMC9705021 DOI: 10.1152/ajprenal.00201.2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022] Open
Abstract
Salt-sensitive hypertension, increases in blood pressure in response to increased salt intake, is associated with an increased risk of morbidity, mortality, and end-organ damage compared with salt-resistant hypertension. The Dahl salt-sensitive (SS) rat mimics the phenotypic characteristics observed in human hypertension when rats are challenged with a high-salt diet. Our previous work demonstrated that environmental factors, such as dietary protein, alter the severity of salt sensitivity in Dahl SS rats and should be an important consideration in experimental design. The present study investigated how the bedding on which animals were maintained (wood vs. corncob) could impact the SS phenotype in the Dahl SS rat. Animals that were maintained on corncob bedding exhibited a significant attenuation in blood pressure and renal end-organ damage in response to a high-salt diet compared with animals maintained on wood bedding. This attenuation was associated with an improvement in renal function and reduction in immune cell infiltration into the kidneys of Dahl SS rats maintained on corncob bedding. These results indicate that the type of bedding impacts the SS phenotype in the Dahl SS rat and that the bedding used in experiments can be a confounding factor to consider during data interpretation and experimental design.NEW & NOTEWORTHY Results from our present study demonstrate the profound effect of animal bedding on the severity of salt-sensitive hypertension, renal damage, and inflammation in Dahl salt-sensitive rats. This study highlights the important consideration that should be given to environmental factors, namely, the type of bedding in animal facilities, in experimental design and data interpretation.
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Affiliation(s)
- John Henry Dasinger
- Department of Physiology, Medical College of Georgia, grid.410427.4Augusta University, Augusta, Georgia
| | - Samuel D Walton
- Department of Physiology, Medical College of Georgia, grid.410427.4Augusta University, Augusta, Georgia
| | - Emily C Burns
- Department of Physiology, Medical College of Georgia, grid.410427.4Augusta University, Augusta, Georgia
| | - Mary Cherian-Shaw
- Department of Physiology, Medical College of Georgia, grid.410427.4Augusta University, Augusta, Georgia
| | - Justine M Abais-Battad
- Department of Physiology, Medical College of Georgia, grid.410427.4Augusta University, Augusta, Georgia
| | - David L Mattson
- Department of Physiology, Medical College of Georgia, grid.410427.4Augusta University, Augusta, Georgia
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Narita K, Hoshide S, Kario K. The role of blood pressure management in stroke prevention: current status and future prospects. Expert Rev Cardiovasc Ther 2022; 20:829-838. [PMID: 36245101 DOI: 10.1080/14779072.2022.2137490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/14/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Stroke is the second-leading cause of death worldwide and the second-leading cause of disability-adjusted life-years. It is well known that hypertension is a significant risk factor for cardiovascular events, including stroke. AREAS COVERED Recent interventional trials have demonstrated the superiority of intensive blood pressure (BP) control for prevention of cardiovascular events compared to standard BP control. Notably, in the Strategy of Blood Pressure Intervention in Elderly Hypertensive Patients (STEP) trial, intensive BP control showed superiority in the prevention of stroke events in elderly hypertensive patients. Novel medications such as angiotensin receptor-neprilysin inhibitors and sodium glucose cotransporter 2 inhibitors have the potential to suppress various CVD events including stroke. Non-pharmacological antihypertensive therapies such as renal denervation have demonstrated BP-lowering effects and may be useful for stroke prevention. Additionally, new methods and systems of BP monitoring including various kinds of nighttime BP measurement devices, wearable devices, and methods using information and communication technology can be used to assess the pathophysiology of BP variability as a risk factor and an event trigger of stroke incidence. EXPERT OPINION Novel therapies and new technologies for BP evaluation strongly support the development of individualized anticipatory medicine, which should be useful for the prevention of stroke.
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Affiliation(s)
- Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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