de Castro M C, Mion Júnior D, Marcondes M, Sabbaga E
Nephrology Division, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Brazil.
Sao Paulo Med J. 1998 Jul-Aug;116(4):1774-7. doi: 10.1590/s1516-31801998000400006.
Seasonal variation in arterial blood pressure has been reported in studies with hypertensive and normotensive subjects. However, the influence of seasonal change on blood pressure of hemodialysis patients has not been reported.
To investigate the seasonal variation of blood pressure in Brazil, a tropical country, in patients on hemodialysis.
Prospective, cohort study.
Dialysis unit of a tertiary medical center (a teaching hospital of the University of São Paulo School of Medicine, São Paulo).
Sixteen patients with chronic renal failure undergoing hemodialysis.
Blood pressure, body weight, and ambient temperature were evaluated during 6 hemodialysis sessions carried out on 13 days during the four seasons.
The diastolic blood pressure was lower in summer than in fall and winter (95 +/- 8 vs 107 +/- 10 and 101 +/- 10 mmHg, respectively; p < 0.05). The same was observed with mean blood pressure (116 +/- 8 vs 130 +/- 11 and 124 +/- 9 mmHg, respectively; p < 0.01). On the other hand, the ambient temperature was higher in summer than in fall and winter (23.0 +/- 1.6 vs 19.5 +/- 3.0 and 15.8 +/- 1.9 degrees C, respectively; p < 0.01).
We concluded that for patients with chronic renal failure the blood pressure has a seasonal variation with higher pressures in fall and winter than in summer. Thus, further studies are needed to elucidate the impact of this observation on the adjustment of antihypertensive treatment and on morbidity and mortality in maintenance dialysis patients.
在高血压和血压正常的受试者研究中已报道动脉血压存在季节性变化。然而，季节变化对血液透析患者血压的影响尚未见报道。
调查在巴西这个热带国家血液透析患者的血压季节性变化。
前瞻性队列研究。
一家三级医疗中心（圣保罗大学医学院的教学医院）的透析单元。
16例接受血液透析的慢性肾衰竭患者。
在四季中13天内进行的6次血液透析过程中评估血压、体重和环境温度。
夏季舒张压低于秋季和冬季（分别为95±8 mmHg与107±10 mmHg和101±10 mmHg；p<0.05）。平均血压也有同样情况（分别为116±8 mmHg与130±11 mmHg和124±9 mmHg；p<0.01）。另一方面，夏季环境温度高于秋季和冬季（分别为23.0±1.6℃与19.5±3.0℃和15.8±1.9℃；p<0.01）。
我们得出结论，对于慢性肾衰竭患者，血压存在季节性变化，秋季和冬季的血压高于夏季。因此，需要进一步研究以阐明这一观察结果对维持性透析患者降压治疗调整以及发病率和死亡率的影响。
