Influence of seasonal variation on blood pressure measurements in children, adolescents and young adults

Miersch, André; Vogel, Mandy; Gausche, Ruth; Siekmeyer, Werner; Pfäffle, Roland; Dittrich, Katalin; Kieß, Wieland

doi:10.1007/s00467-013-2562-0

Cited by 29 publications

(30 citation statements)

References 20 publications

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“…Estimated overall SBP/DBP changes from summer to winter were 2.28/1.24 mm Hg in T1DM patients and 2.48/0.64 mm Hg in T2DM patients, at differences in a mean outdoor temperature of approximately 18°C. These changes were lower than those reported in Japanese (approximately 25°C yearly temperature differences), Taiwanese (subtropical monsoon climate, Chinese (various temperate zones), and Iraqi (hot summer season) adult study cohorts, but comparable to results observed in studies with similar climatic conditions . A German study in both healthy and sick children and adolescents aged 3 to 21 years reported an SBP decrease of 0.12 mm Hg with each 1°C increase in outdoor temperature, which corresponds to our estimation.…”

Section: Discussionsupporting

confidence: 77%

“…These changes were lower than those reported in Japanese (approximately 25°C yearly temperature differences), Taiwanese (subtropical monsoon climate, Chinese (various temperate zones), and Iraqi (hot summer season) adult study cohorts, but comparable to results observed in studies with similar climatic conditions . A German study in both healthy and sick children and adolescents aged 3 to 21 years reported an SBP decrease of 0.12 mm Hg with each 1°C increase in outdoor temperature, which corresponds to our estimation. It was previously proposed that, paradoxically, seasonal BP differences are lower in countries with cold winters than in countries with mild winters, possibly attributable to better thermal efficiency standards leading to more constant indoor temperature .…”

Section: Discussionsupporting

confidence: 77%

“…Various epidemiologic studies observed that BP levels vary by season . Higher BP during cold seasons has been described in both normotensive and hypertensive patients as well as in children and adolescents and in adults . However, only few studies focused on seasonal changes of BP in diabetic patients .…”

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confidence: 99%

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Seasonal Variation in Blood Pressure in 162,135 Patients With Type 1 or Type 2 Diabetes Mellitus

Hermann

Rosenbauer

Dost

et al. 2015

J of Clinical Hypertension

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Seasonal variation in blood pressure (BP) has been observed in different populations. However, only few studies have focused on BP seasonality in diabetic patients. This study examined the seasonal patterns in BP in 62,589 patients with type 1 diabetes mellitus (T1DM) and in 99,546 patients with type 2 diabetes mellitus (T2DM) from the German/Austrian Diabetes Follow-up Registry. Adjusted mean BP values revealed seasonal cycles of 12 months, with higher BP in colder months. Using harmonic regression models, the estimated systolic BP difference throughout the year was 2.28/2.48 mm Hg in T1DM/T2DM (both P<.001). Interestingly, seasonal variation in diastolic BP was larger in T1DM than in T2DM (1.24/0.64 mm Hg, P<.001). A sex difference was observed in T1DM only, while age differences occurred in both types of diabetes. Correlations between BP and potentially related factors such as outdoor temperature indicated that reasons underlying BP seasonality are likely to be complex and vary by subgroup. J Clin Hypertens (Greenwich). 2016;18:270-278. ª 2015 Wiley Periodicals, Inc.Hypertension is a common comorbidity in both type 2 (T2DM) and type 1 (T1DM) diabetes mellitus. Patients with T2DM may have hypertension at diabetes onset, whereas patients with T1DM usually develop hypertension as a result of nephropathy, but also weight gain and arterial stiffness over the years. Depending on age, 20% to 60% of T2DM patients and up to 30% of T1DM patients are affected by hypertension. patients as well as in children and adolescents 9,10 and in adults. [11][12][13] However, only few studies focused on seasonal changes of BP in diabetic patients.14,15 Thus, it remains unclear whether this cyclic behavior observed in various populations also applies to diabetic patients.The objective of the present analysis was to investigate whether and to what extent seasonal variation in BP exists in T1DM and T2DM patients. In addition, we examined whether seasonal patterns differ between age strata, sex, and type of diabetes. Knowledge of the extent of seasonality in BP in diabetic patients could optimize patient care and patient-self management in order to achieve BP targets, since seasonality may affect the classification of patients as normotensive or hypertensive. Furthermore, seasonal patterns in BP should be taken into consideration when setting up clinical trials. PATIENTS AND METHODSThe DPV Registry The Diabetes Follow-up Registry (DPV) is a German/ Austrian standardized computer-based prospective observational multicenter survey for all types of diabetes. Data are collected longitudinally at 377 diabetes centers (352 in Germany and 25 in Austria, March 2013) during routine patient care and documented in an electronic health record. Anonymized data are transmitted semiannually to the University of Ulm for central validation. Data are reported back to the diabetes centers for correction of implausible and missing data. 16The database comprises demographic and anthropometric characteristics as well as diabetes-related variables covering t...

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Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

Seasonal Variation in Blood Pressure in 162,135 Patients With Type 1 or Type 2 Diabetes Mellitus

Hermann

Rosenbauer

Dost

et al. 2015

J of Clinical Hypertension

Self Cite

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“…Our study showed that BP decreased from baseline to post-intervention in both the CG and IG, which aligned with two previous intervention trials conducted by Almas et al [28] and Seo et al [29]. A previous study suggested that BP measurement underwent a seasonal variation or influenced by outdoor temperature [30]. The BP of our study was assessed in October and June, respectively.…”

Section: Discussionsupporting

confidence: 91%

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China

et al. 2020

Nutrients

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This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.

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“…Even repeated BP measures on several occasions (clinic visits) may not provide an accurate assessment of a patient's BP, as the BP changes with daytime/nighttime period, level of stress and anxiety, surrounding temperature, seasons [13] and other factors. Home BP monitoring offers a more reliable BP assessment than the office BP measurement, and this strategy has also been proven to be feasible in children and adolescents, resulting in the development of appropriate reference values [14].…”

Section: Bp Levels In Adults and Childrenmentioning

confidence: 98%

Blood pressure (BP) assessment—from BP level to BP variability

Feber

Litwin

2015

Pediatr Nephrol

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The assessment of blood pressure (BP) can be challenging in children, especially in very young individuals, due to their variable body size and lack of cooperation. In the absence of data relating BP with cardiovascular outcomes in children, there is a need to convert absolute BP values (in mmHg) into age-, gender- and height appropriate BP percentiles or Z-scores in order to compare a patient's BP with the BP of healthy children of the same age, but also of children of different ages. Traditionally, the interpretation of BP has been based mainly on the assessment of the BP level obtained by office, home or 24-h BP monitoring. Recent studies suggest that it is not only BP level (i.e. average BP) but also BP variability that is clinically important for the development of target organ damage, including the progression of chronic kidney disease. In this review we describe current methods to evaluate of BP level, outline available methods for BP variability assessment and discuss the clinical consequences of BP variability, including its potential role in the management of hypertension.

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Influence of seasonal variation on blood pressure measurements in children, adolescents and young adults

Abstract: Blood pressure measurements in children and adolescents, even in a temperate climate, are influenced by temperature and subject to seasonal variation. Considering seasonal variations in blood pressure could be of clinical interest.

Cited by 29 publications

References 20 publications

Seasonal Variation in Blood Pressure in 162,135 Patients With Type 1 or Type 2 Diabetes Mellitus

Seasonal Variation in Blood Pressure in 162,135 Patients With Type 1 or Type 2 Diabetes Mellitus

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China

Blood pressure (BP) assessment—from BP level to BP variability

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