Department of Cardiovascular Medicine, National Research Centre for Translational Medicine, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Hypertens Res. 2023 Jun;46(6):1433-1441. doi: 10.1038/s41440-023-01201-5. Epub 2023 Feb 14.
There is some evidence that nighttime blood pressure varies between seasons. In the present analysis, we investigated the seasonal variation in ambulatory nighttime blood pressure and its associations with target organ damage. In 1054 untreated patients referred for ambulatory blood pressure monitoring, we performed measurements of urinary albumin-to-creatinine ratio (ACR, n = 1044), carotid-femoral pulse wave velocity (cfPWV, n = 1020) and left ventricular mass index (LVMI, n = 622). Patients referred in spring (n = 337, 32.0%), summer (n = 210, 19.9%), autumn (n = 196, 18.6%) and winter (n = 311, 29.5%) had similar 24-h ambulatory systolic/diastolic blood pressure (P ≥ 0.25). However, both before and after adjustment for confounding factors, nighttime systolic/diastolic blood pressure differed significantly between seasons (P < 0.001), being highest in summer and lowest in winter (adjusted mean values 117.0/75.3 mm Hg vs. 111.4/71.1 mm Hg). After adjustment for confounding factors, nighttime systolic/diastolic blood pressure were significantly and positively associated with ACR, cfPWV and LVMI (P < 0.006). In season-specific analyses, statistical significance was reached for all the associations of nighttime blood pressure with target organ damage in summer (P ≤ 0.02), and for some of the associations in spring, autumn and winter. The association between nighttime systolic blood pressure and ACR was significantly stronger in patients examined in summer than those in winter (standardized β, 0.31 vs 0.11 mg/mmol, P for interaction = 0.03). In conclusion, there is indeed seasonality in nighttime blood pressure level, as well as in its association with renal injury in terms of urinary albumin excretion. Our study shows that there is indeed seasonal variability in nighttime blood pressure, highest in summer and lowest in winter, and its association with renal injury in terms of urinary albumin excretion varies between summer and winter as well.
有一些证据表明，夜间血压在不同季节之间存在差异。在本分析中，我们研究了动态夜间血压的季节性变化及其与靶器官损伤的关系。在 1054 名未经治疗的接受动态血压监测的患者中，我们测量了尿白蛋白与肌酐的比值（ACR，n=1044）、颈动脉-股动脉脉搏波速度（cfPWV，n=1020）和左心室质量指数（LVMI，n=622）。在春季（n=337，32.0%）、夏季（n=210，19.9%）、秋季（n=196，18.6%）和冬季（n=311，29.5%）就诊的患者之间，24 小时动态收缩压/舒张压（P≥0.25）相似。然而，在调整混杂因素后，夜间收缩压/舒张压在不同季节之间仍有显著差异（P<0.001），夏季最高，冬季最低（校正平均数值分别为 117.0/75.3mmHg 与 111.4/71.1mmHg）。在调整混杂因素后，夜间收缩压/舒张压与 ACR、cfPWV 和 LVMI 呈显著正相关（P<0.006）。在季节特异性分析中，在夏季，夜间血压与靶器官损伤的所有关联均达到统计学意义（P≤0.02），而在春季、秋季和冬季的一些关联中也达到统计学意义。在夏季接受检查的患者中，夜间收缩压与 ACR 的相关性明显强于冬季接受检查的患者（标准化β值分别为 0.31 与 0.11mg/mmol，P 交互作用值=0.03）。总之，夜间血压水平存在季节性变化，其与尿白蛋白排泄相关的肾损伤之间也存在季节性变化。我们的研究表明，夜间血压确实存在季节性变化，夏季最高，冬季最低，其与尿白蛋白排泄相关的肾损伤之间的关联也存在季节性变化，夏季与冬季之间存在差异。
