Ikäheimo Tiina M, Lehtinen Taru, Antikainen Riitta, Jokelainen Jari, Näyhä Simo, Hassi Juhani, Keinänen-Kiukaanniemi Sirkka, Laatikainen Tiina, Jousilahti Pekka, Jaakkola Jouni J K
1 Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland.
Eur J Public Health. 2014 Apr;24(2):237-43. doi: 10.1093/eurpub/ckt078. Epub 2013 Jun 22.
Exposure to cold weather increases blood pressure (BP) and may aggravate the symptoms and influence the prognosis of subjects with a diagnosis of hypertension. We tested the hypothesis that subjects with hypertension alone or in combination with another cardiovascular disease (CVD) experience cold-related cardiorespiratory symptoms more commonly than persons without hypertension. This information is relevant for proper treatment and could serve as an indicator for predicting wintertime morbidity and mortality.
A self-administered questionnaire inquiring of cold-related symptoms was obtained from 6591 men and women aged 25-74 yrs of the FINRISK Study 2002 population. BP was measured in association with clinical examinations. Symptom prevalence was compared between subjects with diagnosed hypertensive disease with (n = 395) or without (n = 764) another CVD, untreated diagnosed hypertension (n = 1308), measured high BP (n = 1070) and a reference group (n = 2728) with normal BP.
Hypertension in combination with another CVD was associated with increased cold-related dyspnoea (men: adjusted odds ratio 3.94, 95% confidence interval 2.57-6.02)/women: 4.41, 2.84-6.86), cough (2.64, 1.62-4.32/4.26, 2.60-6.99), wheezing (2.51, 1.42-4.43/;3.73, 2.08-6.69), mucus excretion (1.90, 1.24-2.91/2.53, 1.54-4.16), chest pain (22.5, 9.81-51.7/17.7, 8.37-37.5) and arrhythmias (43.4, 8.91-211/8.99, 3.99-20.2), compared with the reference group. Both diagnosed treated hypertension and untreated hypertension and measured high BP resulted in increased cardiorespiratory symptoms during the cold season.
Hypertension alone and together with another CVD is strongly associated with cold-related cardiorespiratory symptoms. As these symptoms may predict adverse health events, hypertensive patients need customized care and advice on how to cope with cold weather.
暴露于寒冷天气会使血压升高，可能会加重已确诊高血压患者的症状并影响其预后。我们检验了以下假设：单纯患有高血压或合并其他心血管疾病（CVD）的患者比无高血压的人更常出现与寒冷相关的心肺症状。这些信息对于恰当治疗具有相关性，并且可作为预测冬季发病率和死亡率的一项指标。
从2002年芬兰全国 FINRISK 研究中年龄在25 - 74岁的6591名男性和女性中获取一份询问与寒冷相关症状的自填式问卷。在临床检查时测量血压。比较已确诊高血压疾病且合并（n = 395）或未合并（n = 764）其他CVD的患者、未经治疗的已确诊高血压患者（n = 1308）、测量血压高的患者（n = 1070）以及血压正常的参照组（n = 2728）的症状患病率。
与参照组相比，高血压合并其他CVD与以下情况相关：与寒冷相关的呼吸困难增加（男性：校正比值比3.94，95%置信区间2.57 - 6.02；女性：4.41，2.84 - 6.86）、咳嗽（2.64，1.62 - 4.32；4.26，2.60 - 6.99）、喘息（2.51，1.42 - 4.43；3.73，2.08 - 6.69）、黏液分泌（1.90，1.24 - 2.91；2.53，1.54 - 4.16）、胸痛（22.5，9.81 - 51.7；17.7，8.37 - 37.5）和心律失常（43.4，8.91 - 211；8.99，3.99 - 20.2）。已确诊并接受治疗的高血压以及未经治疗的高血压和测量血压高均导致寒冷季节心肺症状增加。
单独的高血压以及与其他CVD合并存在均与寒冷相关的心肺症状密切相关。由于这些症状可能预示不良健康事件，高血压患者需要针对如何应对寒冷天气获得定制化的护理和建议。
