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The relationship between indoor, outdoor and ambient temperatures and morning BP surges from inter-seasonally repeated measurements

Journal of Human Hypertension volume 28, pages 482–488 (2014)Cite this article

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Abstract

Higher morning blood pressure (BP) surge is a risk factor for cardiovascular disease independent of 24-h mean BP. Although low outdoor temperatures are associated with higher morning BP surges (MBPSs), the influence of indoor temperature and ambient temperatures (temperature while indoors or temperature while outdoors) on MBPS remains unclear. Such information may help prevent excess winter mortality. We simultaneously measured indoor temperatures (living room and bedroom), ambulatory BP and physical activity using wrist actigraphy for 768 person-days during winter and spring/fall in 192 participants (mean age, 69.9 years). Although the indoor and outdoor temperatures showed a strong correlation during periods of moderate temperature (range: 9.8 to 27.7 °C, rp=0.84), the correlation decreased during periods of lower outdoor temperatures (range: −3.37 to 9.73 °C, rp=0.28). In univariate and multivariate analyses, models with ambient temperatures showed the best goodness of fit (lowest Akaike’s information criterion (AIC)) followed by models with indoor temperatures and those with outdoor temperatures (AIC: ambient<indoor<outdoor temperature). A multivariate linear mixed-effect regression model showed that a 1 °C decrease in the ambient temperature was significantly associated with a 0.44 mm Hg increase in the sleep-trough MBPS and a 0.52 mm Hg increase in the prewaking BP surge. This was independent of potential confounders, including physical activity.

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Acknowledgements

We are indebted to all the participants of this study. We thank Sachiko Uemura, Naomi Takenaka and Shoichi Takamiya for their valuable support during data collection and analysis. This work was supported by grants for the Department of Indoor Environmental Medicine, Nara Medical University; Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology; Mitsui Sumitomo Insurance Welfare Foundation; Meiji Yasuda Life Foundation of Health and Welfare; Osaka Gas Group Welfare Foundation; Japan Diabetes Foundation; and Japan Science and Technology Agency.

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Authors and Affiliations

  1. Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan

    K Saeki, K Obayashi, N Okamoto, K Tomioka & N Kurumatani

  2. Department of Nursing, Tenri Health Care University, Nara, Japan

    J Iwamoto

  3. Center for Academic Industrial and Governmental Relations, Nara Medical University School of Medicine, Nara, Japan

    N Tone

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  1. K Saeki
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Correspondence to K Saeki.

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Saeki, K., Obayashi, K., Iwamoto, J. et al. The relationship between indoor, outdoor and ambient temperatures and morning BP surges from inter-seasonally repeated measurements. J Hum Hypertens 28, 482–488 (2014). https://doi.org/10.1038/jhh.2014.4

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