Seasonal variations in office, home and 24 h ambulatory blood pressure in patients with essential hypertension

Minami, Junichi; Kawano, Yuhei; Ishimitsu, Toshihiko; Yoshimi, Hiroki; Takishita, Shuichi

doi:10.1097/00004872-199612000-00006

Cited by 130 publications

(97 citation statements)

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“…5,6 The highest BPs occur during the day time and the lowest at night, during sleep (known as the nocturnal dip). 2,3,[5][6][7] BP also appears to vary by season 6,8,9 with the highest measurements occurring during winter months. Although temporal factors have been individually studied in research settings, relatively little is known about the composite influence of these factors in clinical practice, on designating a patient as hypertensive, and about the possible interactions with patient features.…”

Section: Introductionmentioning

confidence: 99%

Elevated blood pressure in primary care varies in relation to circadian and seasonal changes

et al. 2008

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Blood pressure (BP) is known to vary by time of day and day of year. Studies differ substantially on the magnitude of the effect and there is doubt whether variation is clinically meaningful. We used more than 2 million BP measurements obtained between 1996 and 2004 from Geisinger Clinic primary care patients. General estimating equations were used to determine the effect of time of day and month of year on the probability of identifying BP values above four diagnostic cutoff points (SBPX120 mm Hg, SBPX140 mm Hg, DBPX80 mm Hg, DBPX90 mm Hg). Time of day and month of year were significantly associated with the odds of measuring elevated BP, regardless of definition. The odds ratio (OR) for SBPX120 mm Hg in the evening (1900 hours) versus midday (1200 hours) was 1.32 (Po0.001). The OR for SBPX120 mm Hg in winter to summer months was 1.24 (Po0.001). Similar results were found for each age/gender group. These data indicate that in clinical practice, measurement of an elevated BP may vary by 40% depending on the time of day and month of year. The magnitude of the variability in BP measurement attributable to the combined effect of these temporal factors is clinically significant. Anticipation of changes in BP attributable to temporal factors may improve accuracy of diagnosis and precision of therapy.

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Section: Introductionmentioning

confidence: 99%

Elevated blood pressure in primary care varies in relation to circadian and seasonal changes

et al. 2008

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“…[10][11][12][13][14][15][16] Of the four seasons, cold winter has the highest mortality and morbidity of cardiovascular diseases in a year. [15][16][17][18] Cold temperatures make hypertension more severe in hypertensive patients.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17][18] Cold temperatures make hypertension more severe in hypertensive patients. 10,14,15,[19][20][21] Chronic cold exposure induces hypertension and cardiac hypertrophy in rats within 1-3 weeks, 22,27,31,32 namely CIH. Cold-induced hypertension is a natural form of experimentally induced hypertension that does not require surgery, administration of large doses of hormones or drugs, or genetic manipulation.…”

Section: Introductionmentioning

confidence: 99%

AAV delivery of mineralocorticoid receptor shRNA prevents progression of cold-induced hypertension and attenuates renal damage

et al. 2006

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The aim of this study was to determine the effect of RNA interference inhibition of mineralocorticoid receptor (MR) on cold-induced hypertension (CIH) and renal damage. Recombinant adeno-associated virus (AAV) carrying short hairpin small interference (si)RNA for MR (AAV.MR-shRNA) was constructed and tested for the ability to inhibit renal MR and to control CIH. Three groups of rats with CIH received AAV.MR-shRNA (1.25 Â 10 9 particles/rat, intravenous), AAV carrying scrambled shRNA (AAV.Control-shRNA) (1.25 Â 10 9 particles/rat, intravenous) and phosphate buffer solution (PBS), respectively. All rats were kept in a cold chamber (6.71C) throughout the experiment. Adeno-associated virus delivery of MR-shRNA prevented progression of CIH. Blood pressure (BP) of the AAV.MR-shRNA-treated group did not increase and remained at 14573 mm Hg, whereas BP of the AAV.Control-shRNA-treated and PBStreated group increased to 16774 and 16173 mm Hg, respectively, at 3 weeks after gene delivery. Thus, the antihypertensive effect of a single injection of AAV.MRshRNA lasted for at least 3 weeks (length of the study). Adeno-associated virus carrying short hairpin siRNA for MR significantly increased urinary sodium excretion and decreased proteinuria. It also decreased serum creatinine and blood urea nitrogen, suggesting enhanced renal function. Both Western blot and immunohistochemical analysis showed that MR expression was decreased significantly in the kidney in the AAV.MR-shRNA-treated rats, confirming that renal MR is effectively inhibited by AAV.MR-shRNA. Adeno-associated virus carrying short hairpin siRNA for MR also significantly attenuated renal hypertrophy. In addition, AAV delivery of MR-shRNA prevented atrophy and dilation of renal tubules and abolished tubular deposition of proteinaceous material seen in CIH rats. Conclusions: (1) AAV delivery of MR-shRNA effectively silenced MR in vivo. (2) RNA interference inhibition of MR may open a new avenue for the long-term control of hypertension and renal damage.

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“…1,12,13 Several studies have demonstrated that BP is subject to seasonal influences and is lower in hot than in cold months. [13][14][15] This influence is not limited to office measurements but affects daily values (that is, home BP and ambulatory BP) as well. 15 Moreover, Modesti et al 16 recently examined the association between air temperature and ambulatory BP profile: they showed that cold temperature was significantly associated with excessive sleep-through MS in elderly persons, even when they were treated with a higher number of antihypertensive drugs in cold weather.…”

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confidence: 99%

The risk of cold temperature: an important aspect of the determination of morning blood pressure surge

Yano

Kario

2010

Hypertens Res

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Seasonal variations in office, home and 24 h ambulatory blood pressure in patients with essential hypertension

Cited by 130 publications

References 0 publications

Elevated blood pressure in primary care varies in relation to circadian and seasonal changes

Elevated blood pressure in primary care varies in relation to circadian and seasonal changes

AAV delivery of mineralocorticoid receptor shRNA prevents progression of cold-induced hypertension and attenuates renal damage

The risk of cold temperature: an important aspect of the determination of morning blood pressure surge

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