室外温度与血压的关系及其对寒冷地区未来心脑血管疾病风险的影响。
The association of outdoor temperature with blood pressure, and its influence on future cardio-cerebrovascular disease risk in cold areas.
机构信息
Department of Chronic Disease, Harbin Nangang District CDC.
Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin.
出版信息
J Hypertens. 2020 Jun;38(6):1080-1089. doi: 10.1097/HJH.0000000000002387.
OBJECTIVES
To explore whether lower outdoor temperature increases cardio-cerebrovascular disease risk through regulating blood pressure and whether indoor heating in winter is beneficial to prevent cardio-cerebrovascular disease in cold areas.
METHODS
We analyzed the data of 38 589 participants in Harbin from the China Kadoorie Biobank (CKB) during 2004-2008, with an average of 7.14-year follow-up. Linear regression analysis was performed to estimate the relationship between outdoor temperature and blood pressure. Cox regression analysis and logistic regression analysis were used to analyze the association of blood pressure with cardio-cerebrovascular event risk. Mediation analysis was performed to explore the role of blood pressure in the association between outdoor temperature and cardio-cerebrovascular events risk.
RESULTS
There was an increase of 6.7 mmHg in SBP and 2.1 mmHg in DBP for each 10 °C decrease in outdoor temperature when outdoor temperature was higher than 5 °C. There was an inverse association between outdoor temperature and cardio-cerebrovascular event morbidity. The increases in blood pressure and cardio-cerebrovascular event morbidity were attenuated in months when central heating was fully provided. Participants with hypertension have higher risks of cardio-cerebrovascular disease (hazard ratio 1.347; 95% CI 1.281--1.415), CVD (hazard ratio 1.347; 95% CI 1.282--1.416), MACE (hazard ratio 1.670; 95% CI 1.560--1.788) and stroke (hazard ratio 1.683; 95% CI 1.571--1.803). Mediation analysis demonstrated that the association between outdoor temperature and cardio-cerebrovascular events risk was potentially mediated by blood pressure.
CONCLUSION
Temperature-driven blood pressure potentially mediates the association between outdoor temperature and cardio-cerebrovascular events risk. Indoor heating in winter is probably beneficial to cardio-cerebrovascular disease prevention by inhibition of blood pressure increase.
目的
探讨低温是否通过调节血压增加心脑血管疾病风险，以及冬季室内供暖是否有利于寒冷地区预防心脑血管疾病。
方法
我们分析了 2004-2008 年中国慢性病前瞻性研究（CKB）哈尔滨地区 38589 名参与者的数据，平均随访 7.14 年。采用线性回归分析估计室外温度与血压之间的关系。采用 Cox 回归分析和 logistic 回归分析分析血压与心脑血管事件风险的关系。采用中介分析探讨血压在心脑血管事件风险与室外温度之间的关联中的作用。
结果
当室外温度高于 5°C 时，室外温度每降低 10°C，SBP 升高 6.7mmHg，DBP 升高 2.1mmHg。室外温度与心脑血管事件发病率呈负相关。在中央供暖充分提供的月份，血压和心脑血管事件发病率的增加减弱。高血压患者发生心脑血管疾病的风险较高（风险比 1.347；95%可信区间 1.281--1.415）、CVD（风险比 1.347；95%可信区间 1.282--1.416）、MACE（风险比 1.670；95%可信区间 1.560--1.788）和中风（风险比 1.683；95%可信区间 1.571--1.803）。中介分析表明，室外温度与心脑血管事件风险之间的关联可能是由血压介导的。
结论
温度驱动的血压可能介导了室外温度与心脑血管事件风险之间的关联。冬季室内供暖可能通过抑制血压升高而有利于预防心脑血管疾病。
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