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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Seasonality in nighttime blood pressure and its associations with target organ damage

Hypertension Research volume 46, pages 1433–1441 (2023)Cite this article

A Comment to this article was published on 28 April 2023

Abstract

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.

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Acknowledgements

We acknowledge all patients for their commitment to the study. We also appreciate the technical assistance of Bei-Wen Lv, Jun-Wei Li and Yi Zhou.

Funding

This work was supported by the Chinese National Natural Science Foundation (82270452, 82070432, 82070435, 82270469), the Shanghai Municipal Health Commission (Grant for Leading Academics 2022LJ022) and the Shanghai Talent Development Fund (2021087).

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Authors and Affiliations

  1. 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

    Yi Cheng, Chang-Sheng Sheng, Jian-Feng Huang, Dong-Yan Zhang, Ming-Xuan Li, Yi-Bang Cheng, De-Wei An, Qian-Hui Guo, Ying Wang, Qi-Fang Huang, Ting-Yan Xu, Yan Li & Ji-Guang Wang

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Correspondence to Chang-Sheng Sheng.

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Cheng, Y., Sheng, CS., Huang, JF. et al. Seasonality in nighttime blood pressure and its associations with target organ damage. Hypertens Res 46, 1433–1441 (2023). https://doi.org/10.1038/s41440-023-01201-5

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