Su Danting, Du Huaidong, Zhang Xinwei, Qian Yijian, Chen Lingli, Chen Yaping, Guo Yu, Bian Zheng, Chen Zhengming, Li Liming, Yu Min
Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK, Tongxiang Centre for Disease Control and Prevention, Zhejiang Province, China, Chinese Academy of Medical Sciences, Beijing, China and School of Public Health, Peking University Health Sciences Center, Beijing, China.
Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK, Tongxiang Centre for Disease Control and Prevention, Zhejiang Province, China, Chinese Academy of Medical Sciences, Beijing, China and School of Public Health, Peking University Health Sciences Center, Beijing, China
Int J Epidemiol. 2014 Dec;43(6):1835-45. doi: 10.1093/ije/dyu158. Epub 2014 Aug 18.
In many Western populations, blood pressure varies moderately with season and outdoor temperature. Relatively little is known about effects of seasonal changes in blood pressure on the detection and control of hypertension in general populations, especially in low- and middle-income countries.
We analysed cross-sectional data of 57 375 (42% men) participants aged 30-79 (mean 52.3) years who were enrolled during 2004-08, as part of the China Kadoorie Biobank, from a rural county in the south-east costal Zhejiang Province. Analyses related daily mean outdoor temperature, obtained from local Meteorological Bureau, to mean systolic (SBP) and diastolic blood pressure (DBP), rate of newly detected hypertension and, among those with self-reported physician-diagnosed hypertension, rate of adequate blood pressure control, using multiple linear and logistic regression models.
The overall mean blood pressure was 135.9 mmHg for SBP and 80.5 mmHg for DBP. Daily outdoor temperature ranged between -2.9 and 33.7°C, with July being the hottest month (mean 29.4°C) and January the coldest (mean 4.0°C). Comparing January (the coldest month) with July (the warmest), the differences in the adjusted SBP/DBP were 19.2/7.7 mmHg. Each 10°C lower ambient temperature was associated with 6.9/2.9 mmHg higher SBP/DBP,14.1% higher prevalence of newly detected hypertension and, among those with pre-diagnosed hypertension, 13.0% lower hypertension control rate.
In rural China, lower outdoor temperature is strongly associated with higher mean blood pressure and hypertension prevalence as well as poorer hypertension control, and should be considered when conducting population-based hypertension surveys and providing treatment for hypertensive patients.
在许多西方人群中，血压随季节和室外温度有一定程度的变化。关于血压的季节性变化对普通人群中高血压的检测和控制的影响，人们了解相对较少，尤其是在低收入和中等收入国家。
作为中国嘉道理生物银行的一部分，我们分析了2004年至2008年期间从浙江省东南部沿海一个农村县招募的57375名年龄在30 - 79岁（平均52.3岁）参与者的横断面数据（男性占42%）。利用多元线性和逻辑回归模型，分析了从当地气象局获取的每日平均室外温度与平均收缩压（SBP）和舒张压（DBP）、新检测出高血压的比率，以及在自我报告有医生诊断高血压的人群中血压得到充分控制的比率之间的关系。
收缩压的总体平均血压为135.9 mmHg，舒张压为80.5 mmHg。每日室外温度在 - 2.9℃至33.7℃之间，7月是最热的月份（平均29.4℃），1月是最冷的月份（平均4.0℃）。将1月（最冷的月份）与7月（最热的月份）进行比较，调整后的收缩压/舒张压差异为19.2/7.7 mmHg。环境温度每降低10℃，收缩压/舒张压分别升高6.9/2.9 mmHg，新检测出高血压的患病率升高14.1%，在预先诊断为高血压的人群中，高血压控制率降低13.0%。
在中国农村，较低的室外温度与较高的平均血压、高血压患病率以及较差的高血压控制密切相关，在开展基于人群的高血压调查和为高血压患者提供治疗时应予以考虑。
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