Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA.
Occup Environ Med. 2011 Apr;68(4):296-301. doi: 10.1136/oem.2010.056507. Epub 2010 Sep 23.
Cardiovascular mortality has been linked to changes in outdoor temperature. However, the mechanisms behind these effects are not well established. We aimed to study the effect of outdoor temperature on blood pressure, as increased blood pressure is a risk factor for cardiovascular death.
The study population consisted of men aged 53-100 years living in the Boston area. We used a mixed effects model to estimate the effect of three temperature variables: ambient, apparent and dew point temperature (DPT), on repeated measures (every 3-5 years) of diastolic (DBP) and systolic blood pressure (SBP). Random intercepts for subjects and several possible confounders were used in the models, including black carbon and barometric pressure.
We found modest associations between DBP and ambient and apparent temperature. In the basic models, DBP in association with a 5 °C decrease in 7-day moving averages of temperatures increased by 1.01% (95% CI -0.06% to 2.09%) and 1.55% (95% CI 0.61% to 2.49%) for ambient and apparent temperature, respectively. Excluding extreme temperatures strengthened these associations (2.13%, 95% CI 0.66% to 3.63%, and 1.65%, 95% CI 0.41% to 2.90%, for ambient and apparent temperature, respectively). Effect estimates for DPT were close to null. The effect of apparent temperature on SBP was similar (1.30% increase (95% CI 0.32% to 2.29%) for a 5 °C decrease in 7-day moving average).
Cumulative exposure to decreasing ambient and apparent temperature may increase blood pressure. These findings suggest that an increase in blood pressure could be a mechanism behind cold-related, but not heat-related, cardiovascular mortality.
心血管死亡率与室外温度变化有关。然而,这些影响的机制尚未得到很好的确定。我们旨在研究室外温度对血压的影响,因为血压升高是心血管死亡的一个危险因素。
研究人群包括居住在波士顿地区的 53-100 岁男性。我们使用混合效应模型来估计三个温度变量(环境温度、表观温度和露点温度)对舒张压(DBP)和收缩压(SBP)重复测量(每 3-5 年一次)的影响。模型中使用了受试者和几个可能的混杂因素的随机截距,包括黑碳和气压。
我们发现 DBP 与环境温度和表观温度之间存在适度的关联。在基本模型中,与 7 天移动平均温度降低 5°C 相关的 DBP 分别增加了 1.01%(95%CI-0.06%至 2.09%)和 1.55%(95%CI0.61%至 2.49%)。排除极端温度后,这些关联得到了加强(环境温度和表观温度分别为 2.13%(95%CI0.66%至 3.63%)和 1.65%(95%CI0.41%至 2.90%)。DPT 的效应估计接近零。表观温度对 SBP 的影响相似(7 天移动平均温度降低 5°C 时,SBP 增加 1.30%(95%CI0.32%至 2.29%))。
累积暴露于下降的环境温度和表观温度可能会升高血压。这些发现表明,血压升高可能是与寒冷相关而非与热相关的心血管死亡率的一个机制。