Blood pressure fluctuations and the indoor environment in a highly insulated and airtight model house during the cold winter season

Nakagami, Hironori; Akiyama, Hiroshi; Otsuka, Hiroki; Iwamae, Atsushi; Yamada, Hidekazu

doi:10.1038/s41440-022-00928-x

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…By contrast, instability in outdoor temperature showed an association with neither diurnal nor day-by-day HBP variability. Of interest, Nakagami et al [ 39 ] evaluated the effect of houses on BP level and variability by comparing 24-h BP at home and at a highly insulated model house. They found that residents who usually lived in a cold house had lower BP and smaller BP variability when in the model house, where indoor temperature was high and stable.…”

Section: Introductionmentioning

confidence: 99%

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Umishio

Ikaga²,

Kario³

et al. 2022

Hypertens Res

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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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Section: Introductionmentioning

confidence: 99%

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Umishio

Ikaga²,

Kario³

et al. 2022

Hypertens Res

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“… 31 , 38 , 39 The underlying explanation for this phenomenon is that lower temperature cause temporary constriction of blood vessels, resulting in increased resistance to blood flow and consequently higher blood pressure. 40 It has been hypothesized by several studies that high systolic blood pressure affects aqueous humor by ultrafiltration, which increases IOP. 41 – 43 Our effect mediation results show that IOP is partially altered because of a change in systolic blood pressure caused by outdoor temperature.…”

Section: Discussionmentioning

confidence: 99%

Intraocular Pressure and Its Relation to Climate Parameters—Results From the Gutenberg Health Study

Hartmann

Grabitz

Wild

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose To investigate the association between intraocular pressure (IOP) and climate parameters. Methods The Gutenberg Health Study (GHS) is a population-based cohort study in Mainz, Germany. Participants underwent two comprehensive ophthalmologic examinations (baseline visit and five-year follow up) including non-contact tonometry, objective refraction, pachymetry, perimetry, and fundus imaging in the time frame of 2007 to 2017. The respective climate parameters were assessed at the University Mainz including temperature, air humidity, and air pressure. Associations of IOP and climatic parameters were computed using component models and cross-correlation plots. Multivariable regression analysis was performed to adjust for age, sex, body mass index, diabetes, central corneal thickness, and systolic blood pressure. To further explore the link between systolic blood pressure, temperature, and IOP, an effect mediation analysis was conducted. Results A total of 14,632 participants (age 55 ± 11 years at baseline, 49.1% female) were included in this analysis. Mean IOP was 14.24 ± 2.8 mm Hg at baseline. There was a similar periodic change in IOP and in temperature, as shown in the component models. IOP was not associated with air humidity. In univariable and multivariable regression analyses we found a significant association between lower IOP during the summer months with higher air temperature (B = −0.011, P < 0.001). This could be partially explained in mediation analysis by lower systolic blood pressure at higher air temperature. Furthermore, IOP was associated with air pressure in univariable (B = 0.005, P = 0.04.) and multivariable models (B = 0.006, P = 0.03). Conclusions There is a periodic annual change of IOP with higher values in winter and lower values in summer supporting the hypothesis of an impact of environmental temperature on IOP, which is partly mediated by lower systolic blood pressure in summer.

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“…Morning BP surge are augmented in cold seasons, and cold temperature has an impact on the BP surge. We and others have reported that indoor temperature showed increased blood pressure with fluctuation, which might lead to high cardiovascular mortality in the winter season [1][2][3][4]. Activation of the sympathetic nervous system in response to cold temperature increases vascular tone in resistance arteries, and bedtime administration of an α-adrenergic blocker suppresses morning BP surge by reducing resistance [5].…”

Section: Introductionmentioning

confidence: 99%

Morning surge in sympathetic nervous activity in the indoor environment during the cold winter season

et al. 2022

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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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Blood pressure fluctuations and the indoor environment in a highly insulated and airtight model house during the cold winter season

Cited by 5 publications

References 6 publications

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Intraocular Pressure and Its Relation to Climate Parameters—Results From the Gutenberg Health Study

Morning surge in sympathetic nervous activity in the indoor environment during the cold winter season

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