Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
Studium Patavinum, Department of Medicine, University of Padova, Padua.
J Hypertens. 2020 Jul;38(7):1235-1243. doi: 10.1097/HJH.0000000000002341.
: Blood pressure (BP) exhibits seasonal variation with lower levels at higher environmental temperatures and higher at lower temperatures. This is a global phenomenon affecting both sexes, all age groups, normotensive individuals, and hypertensive patients. In treated hypertensive patients it may result in excessive BP decline in summer, or rise in winter, possibly deserving treatment modification. This Consensus Statement by the European Society of Hypertension Working Group on BP Monitoring and Cardiovascular Variability provides a review of the evidence on the seasonal BP variation regarding its epidemiology, pathophysiology, relevance, magnitude, and the findings using different measurement methods. Consensus recommendations are provided for health professionals on how to evaluate the seasonal BP changes in treated hypertensive patients and when treatment modification might be justified. (i) In treated hypertensive patients symptoms appearing with temperature rise and suggesting overtreatment must be investigated for possible excessive BP drop due to seasonal variation. On the other hand, a BP rise during cold weather, might be due to seasonal variation. (ii) The seasonal BP changes should be confirmed by repeated office measurements; preferably with home or ambulatory BP monitoring. Other reasons for BP change must be excluded. (iii) Similar issues might appear in people traveling from cold to hot places, or the reverse. (iv) BP levels below the recommended treatment goal should be considered for possible down-titration, particularly if there are symptoms suggesting overtreatment. SBP less than 110 mmHg requires consideration for treatment down-titration, even in asymptomatic patients. Further research is needed on the optimal management of the seasonal BP changes.
血压（BP）表现出季节性变化，环境温度较高时血压较低，温度较低时血压较高。这是一种全球性现象，影响所有性别、所有年龄组、正常血压个体和高血压患者。在接受治疗的高血压患者中，夏季血压可能会过度下降，冬季血压可能会上升，这可能需要调整治疗方案。欧洲高血压学会血压监测和心血管变异性工作组发表的这份共识声明，回顾了有关季节性血压变化的流行病学、病理生理学、相关性、幅度以及使用不同测量方法的研究结果。该声明为临床医生提供了关于如何评估治疗中高血压患者的季节性血压变化以及何时需要调整治疗的建议。（i）在接受治疗的高血压患者中，如果出现与体温升高相关的症状且提示过度治疗，应调查可能因季节性变化导致的血压过度下降。另一方面，寒冷天气时血压升高可能是季节性变化引起的。（ii）应通过重复的诊室测量来确认季节性血压变化；最好使用家庭或动态血压监测。应排除其他导致血压变化的原因。（iii）从寒冷地区到炎热地区或相反方向旅行的人可能会出现类似的血压问题。（iv）如果有过度治疗的症状提示，应考虑将血压降至低于推荐的治疗目标值。特别是 SBP 低于 110mmHg 的患者，即使无症状也需要考虑降压治疗。需要进一步研究季节性血压变化的最佳管理方法。
