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基于网络同步远程医疗保健项目的患者环境温度与家庭血压关系评估:回顾性研究

Assessment of the Relationship Between Ambient Temperature and Home Blood Pressure in Patients From a Web-Based Synchronous Telehealth Care Program: Retrospective Study.

作者信息

Huang Ching-Chang, Chen Ying-Hsien, Hung Chi-Sheng, Lee Jen-Kuang, Hsu Tse-Pin, Wu Hui-Wen, Chuang Pao-Yu, Chen Ming-Fong, Ho Yi-Lwun

机构信息

Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

J Med Internet Res. 2019 Mar 4;21(3):e12369. doi: 10.2196/12369.

Abstract

BACKGROUND

Decreased ambient temperature significantly increases office blood pressure, but few studies have evaluated the effect of ambient temperature on home blood pressure.

OBJECTIVE

We aimed to investigate the relationship between short-term ambient temperature exposure and home blood pressure.

METHODS

We recruited patients with chronic cardiovascular diseases from a telehealth care program at a university-affiliated hospital. Blood pressure was measured at home by patients or their caregivers. We obtained hourly meteorological data for Taipei (temperature, relative humidity, and wind speed) for the same time period from the Central Weather Bureau, Taiwan.

RESULTS

From 2009 to 2013, we enrolled a total of 253 patients. Mean patient age was 70.28 (SD 13.79) years, and 66.0% (167/253) of patients were male. We collected a total of 110,715 home blood pressure measurements. Ambient temperature had a negative linear effect on all 3 home blood pressure parameters after adjusting for demographic and clinical factors and antihypertensive agents. A 1°C decrease was associated with a 0.5492-mm Hg increase in mean blood pressure, a 0.6841-mm Hg increase in systolic blood pressure, and a 0.2709-mm Hg increase in diastolic blood pressure. This temperature effect on home blood pressure was less prominent in patients with diabetes or hypertension. Antihypertensive agents modified this negative effect of temperature on home blood pressure to some extent, and angiotensin receptor blockers had the most favorable results.

CONCLUSIONS

Short-term exposure to low ambient temperature significantly increased home blood pressure in patients with chronic cardiovascular diseases. Antihypertensive agents may modify this effect.

摘要

背景

环境温度降低会显著升高诊室血压,但很少有研究评估环境温度对家庭血压的影响。

目的

我们旨在研究短期环境温度暴露与家庭血压之间的关系。

方法

我们从一所大学附属医院的远程医疗保健项目中招募慢性心血管疾病患者。患者或其护理人员在家中测量血压。我们从台湾中央气象局获取了同一时期台北的每小时气象数据(温度、相对湿度和风速)。

结果

2009年至2013年,我们共纳入253例患者。患者平均年龄为70.28(标准差13.79)岁,66.0%(167/253)的患者为男性。我们总共收集了110715次家庭血压测量数据。在调整了人口统计学和临床因素以及抗高血压药物后,环境温度对所有3个家庭血压参数均有负线性影响。温度每降低1°C,平均血压升高0.5492 mmHg,收缩压升高0.6841 mmHg,舒张压升高0.2709 mmHg。这种温度对家庭血压的影响在糖尿病或高血压患者中不太明显。抗高血压药物在一定程度上改变了温度对家庭血压的这种负面影响,其中血管紧张素受体阻滞剂的效果最为理想。

结论

短期暴露于低环境温度会显著升高慢性心血管疾病患者的家庭血压。抗高血压药物可能会改变这种影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcf2/6421515/171afd4f52c9/jmir_v21i3e12369_fig1.jpg

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