Stergiou George S, Myrsilidi Aikaterini, Kollias Anastasios, Destounis Antonios, Roussias Leonidas, Kalogeropoulos Petros
Third University Department of Medicine, Hypertension Center STRIDE-7, Sotiria Hospital, Athens, Greece.
Cardiology Department, Hypertension Clinic, 7th Social Insurance Institution Hospital, Athens, Greece.
Hypertens Res. 2015 Dec;38(12):869-75. doi: 10.1038/hr.2015.96. Epub 2015 Sep 3.
This study investigated the relationship between seasonal variations in blood pressure (BP) and the corresponding changes in meteorological parameters and weather-induced patients' discomfort. Hypertensives on stable treatment were assessed in winter-1, summer and winter-2 with clinic (CBP), home (HBP) and 24-hour ambulatory BP (ABP). Discomfort indices derived from temperature, humidity and atmospheric pressure that reflected subjects' discomfort were evaluated. Symptomatic orthostatic hypotension was assessed with a questionnaire. Sixty subjects (mean age 65.1±8.8 [s.d.], 39 men) were analyzed. CBP, HBP and daytime ABP were lower in summer than in winter (P<0.01). Nighttime ABP was unchanged, which resulted in a 55% higher proportion of non-dippers (P<0.001). All the discomfort indices that reflected weather-induced subjects' discomfort were higher in summer (P<0.05) and systolic daytime ABP was <110 mm Hg in 15 subjects (25%). Seasonal changes in temperature and the discomfort indices were correlated with BP changes (P<0.05). Multivariate analyses revealed that winter BP levels, seasonal differences in temperature, female gender and the use of diuretics predicted the summer BP decline. In conclusion, all aspects of the BP profile, except nighttime ABP, are reduced in summer, resulting in an increased prevalence of non-dippers in summer with unknown consequences. Seasonal BP changes are influenced by changes in meteorological parameters, anthropometric and treatment characteristics. Trials are urgently needed to evaluate the clinical relevance of excessive BP decline in summer and management guidelines for practicing physicians should be developed.
本研究调查了血压（BP）的季节性变化与气象参数的相应变化以及天气引起的患者不适之间的关系。对接受稳定治疗的高血压患者在冬季1、夏季和冬季2进行了诊所血压（CBP）、家庭血压（HBP）和24小时动态血压（ABP）评估。评估了从温度、湿度和大气压得出的反映受试者不适的不适指数。通过问卷调查评估症状性体位性低血压。对60名受试者（平均年龄65.1±8.8[标准差]，39名男性）进行了分析。夏季的CBP、HBP和日间ABP均低于冬季（P<0.01）。夜间ABP无变化，这导致非勺型血压者的比例增加了55%（P<0.001）。所有反映天气引起的受试者不适的不适指数在夏季均较高（P<0.05），15名受试者（25%）的日间收缩压ABP<110 mmHg。温度的季节性变化和不适指数与血压变化相关（P<0.05）。多变量分析显示，冬季血压水平、温度的季节性差异、女性性别和利尿剂的使用可预测夏季血压下降。总之，除夜间ABP外，血压谱的所有方面在夏季均降低，导致夏季非勺型血压者的患病率增加，后果不明。季节性血压变化受气象参数、人体测量和治疗特征变化的影响。迫切需要进行试验以评估夏季血压过度下降的临床相关性，并应制定针对执业医师的管理指南。
