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家庭供暖指导对老年人室内温度和血压的短期影响:一项随机对照试验

Short-term effects of instruction in home heating on indoor temperature and blood pressure in elderly people: a randomized controlled trial.

作者信息

Saeki Keigo, Obayashi Kenji, Kurumatani Norio

机构信息

Department of Community Health and Epidemiology, Nara Medical University, School of Medicine, Nara, Japan.

出版信息

J Hypertens. 2015 Nov;33(11):2338-43. doi: 10.1097/HJH.0000000000000729.

Abstract

BACKGROUND

Increased mortality from cardiovascular disease in winter is partly explained by increased blood pressure (BP) caused by cold exposure. For physicians, instruction in home heating is feasible option to reduce cold exposure, but the effectiveness remains unknown.

OBJECTIVES

To determine whether instruction in home heating increases indoor temperatures and decreases ambulatory BP among elderly people, we conducted an open-label, simply randomized, controlled trial in the winters.

METHODS

As an intervention, the participants were asked to set the heating device in the living room to start 1 h before estimated rising time with target temperature at 24°C, and to stay in the living room until 2 h after rising as long as possible. Repeatedly measured ambulatory BP, physical activity, and indoor temperatures until 4 h after rising were assessed using multilevel linear regression model with random intercept among individual.

RESULTS

A total of 359 eligible participants (mean age ± standard deviation: 71.6 ± 6.6) were randomly allocated to the control group (n = 173) and intervention group (n = 186). Intervention significantly increased living room temperature by 2.09°C (95% confidence interval 1.28-2.90), and significantly decreased SBP and DBP by 4.43/2.33 mmHg (95% confidence interval 0.97-7.88/0.08-4.58 mmHg) after adjusting for confounders including age, sex, antihypertensive medication, household income, and physical activity.

DISCUSSION

Short-term effect of instruction in home heating showed larger increase of indoor temperature than that of insulation intervention. Significant reduction of BPsuggests the effectiveness on preventing cardiovascular incidence in winter.

CONCLUSION

To summarize, instruction in heating significantly decreased BP.

摘要

背景

冬季心血管疾病死亡率增加部分原因是寒冷暴露导致血压升高。对于医生而言,指导家庭供暖是减少寒冷暴露的可行选择,但其有效性尚不清楚。

目的

为了确定家庭供暖指导是否能提高老年人室内温度并降低动态血压,我们在冬季进行了一项开放标签、简单随机对照试验。

方法

作为干预措施,要求参与者将客厅的供暖设备设置为在预计起床时间前1小时启动,目标温度为24°C,并尽可能长时间待在客厅直到起床后2小时。使用个体间随机截距的多水平线性回归模型评估起床后4小时内反复测量的动态血压、身体活动和室内温度。

结果

共有359名符合条件的参与者(平均年龄±标准差:71.6±6.6)被随机分配到对照组(n = 173)和干预组(n = 186)。在调整年龄、性别、抗高血压药物、家庭收入和身体活动等混杂因素后,干预显著提高了客厅温度2.09°C(95%置信区间1.28 - 2.90),并显著降低收缩压和舒张压4.43/2.33 mmHg(95%置信区间0.97 - 7.88/0.08 - 4.58 mmHg)。

讨论

家庭供暖指导的短期效果显示室内温度升高幅度大于保温干预。血压显著降低表明其对预防冬季心血管疾病发病有效。

结论

总之,供暖指导显著降低了血压。

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