Obayashi Kenji, Saeki Keigo
Department of Epidemiology, Nara Medical University School of Medicine.
Nihon Eiseigaku Zasshi. 2018;73(2):138-142. doi: 10.1265/jjh.73.138.
The purpose of this short review is to describe the influence of housing environment temperature and lighting on circadian blood pressure (BP) variability using data from the HEIJO-KYO cohort, a community-based cohort study launched in 2010. Increased excess mortality from cardiovascular disease in winter is a worldwide problem. Previous studies showed higher conventional BP and higher daytime ambulatory BP in winter; however, the relationship between indoor cold exposure and circadian BP variability remained unknown. In our cohort, we found a significant inverse relationship between indoor temperature and morning BP surge, independent of potential confounding factors. In addition, we found the tertile group with the lowest daytime indoor temperatures showed significantly higher urinary sodium excretion than the tertile group with the highest daytime indoor temperatures. Higher sodium intake caused by indoor cold exposure may partly explain the higher BP in winter. Physiologically, light exposure is the most important environmental cue for the circadian timing system and melatonin secretion. In our cohort, we observed that an increase in nighttime short-wave length light exposure and a decrease in daytime light exposure were significantly associated with lower melatonin secretion. Furthermore, lower melatonin levels were significantly related to higher nighttime BPs and parameters of atherosclerosis, which are predictors of cardiovascular disease incidence. Further longitudinal studies of the influence of housing environment temperature and lighting on cardiovascular disease incidence are required.
本简短综述的目的是利用平成京队列(一项于2010年启动的基于社区的队列研究)的数据,描述居住环境温度和光照对昼夜血压(BP)变异性的影响。冬季心血管疾病导致的额外死亡率增加是一个全球性问题。先前的研究表明,冬季传统血压和日间动态血压较高;然而,室内寒冷暴露与昼夜血压变异性之间的关系仍不清楚。在我们的队列中,我们发现室内温度与早晨血压激增之间存在显著的负相关关系,且不受潜在混杂因素的影响。此外,我们发现白天室内温度最低的三分位数组的尿钠排泄量显著高于白天室内温度最高的三分位数组。室内寒冷暴露导致的钠摄入量增加可能部分解释了冬季血压升高的原因。从生理上讲,光照是昼夜节律系统和褪黑素分泌最重要的环境线索。在我们的队列中,我们观察到夜间短波长度光照增加和白天光照减少与较低的褪黑素分泌显著相关。此外,较低的褪黑素水平与较高的夜间血压和动脉粥样硬化参数显著相关,而这些参数是心血管疾病发病率的预测指标。需要进一步进行纵向研究,以探讨居住环境温度和光照对心血管疾病发病率的影响。