Impact of indoor temperature instability on diurnal and day-by-day variability of home blood pressure in winter: a nationwide Smart Wellness Housing survey in Japan

Umishio, Wataru; Ikaga, Toshiharu; Kario, Kazuomi; Fujino, Yoshihisa; Suzuki, Mitsuaki; Ando, Shintaro; Hoshi, Tanji; Yoshimura, Takesumi; Yokota, Hiroshi; Murakami, Shuzo

doi:10.1038/s41440-021-00699-x

Cited by 25 publications

(11 citation statements)

References 36 publications

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“…In addition to BP level, BP variability requires due consideration when evaluating the risk of cardiovascular events. We hypothesized that a stable home thermal environment helps to reduce BP variability, and evaluated the indoor temperature–BP relationship from another perspective [ 38 ]. Over a 2-week period we used the morning-evening (ME) difference as an index of diurnal variability, and the standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM) as well as average real variability (ARV) as indices of day-by-day variability.…”

Section: Introductionmentioning

confidence: 99%

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Umishio

Ikaga²,

Kario³

et al. 2022

Hypertens Res

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Current countermeasures for preventing hypertension emphasize only improvements to lifestyle. Recently, improving life environment has attracted attention, in parallel with publication of the WHO Housing and health guidelines. We quantitatively evaluated the relationship between housing thermal environment and blood pressure (BP) in a real-world setting. We conducted a nationwide, prospective intervention study—the Smart Wellness Housing survey—in Japan, as a non-randomized controlled trial. The intervention was the retrofitting of thermal insulation in houses. Participant recruitment was done by construction companies in all 47 prefectures of Japan. Measurements of home BP and indoor temperature at 1.0 m above the floor in the living room, changing room, and bedroom were taken for 2 weeks before and after the intervention each winter (November–March) of FY 2014–2019. As of July 2022, over 2500 households and 5000 participants were registered in the database. We found that (1) about 90% of Japanese lived in cold homes (minimum indoor temperature <18 °C), (2) indoor temperature was non-linearly associated with home BP, (3) morning systolic BP (SBP) was more sensitive than evening SBP to changes in indoor temperature, (4) SBP was influenced by indoor temperature change particularly in older participants and women, (5) unstable indoor temperature was associated with large BP variability, and (6) insulation retrofitting intervention significantly reduced home BP, especially in hypertensive patients. We proposed that the BP reduction effect of the life-environment is comparable to that achievable by lifestyle.

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Section: Introductionmentioning

confidence: 99%

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Umishio

Ikaga²,

Kario³

et al. 2022

Hypertens Res

Self Cite

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“…These findings suggest associations between better housing quality and lower winter excess mortality. A few recent reports showed the relationship between indoor temperatures and BP in Japan [11][12][13]. Saeki et al reported that the indoor temperature showed strong associations with daytime SBP, nocturnal BP and morning BP surge [11].…”

Section: Resultsmentioning

confidence: 99%

“…Saeki et al reported that the indoor temperature showed strong associations with daytime SBP, nocturnal BP and morning BP surge [11]. Umishio et al also showed that systolic blood pressure in the morning had a significantly higher sensitivity to changes in the indoor temperature (8.2 mm Hg increase/10 °C decrease) than that in the evening (6.5 mm Hg increase/10 °C decrease) [12]. They also suggest that the low indoor temperature in Japan might be a risk of morning surge of BP.…”

Section: Resultsmentioning

confidence: 99%

Morning surge in sympathetic nervous activity in the indoor environment during the cold winter season

et al. 2022

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We addressed to the sympathetic nervous activation of the same people in both their houses and a highly insulated and airtight model house (model house) during the cold winter season. Eight subjects (4 males and 4 females) stayed two nights at each house and were continuously monitored for sympathetic nerve system by calculating LF (low frequency)/HF (high frequency) in the analysis of heart rate variability using a wearable electrocardiography equipment. The room temperatures were kept constant at 20 °C or more in model house, but much lower in their houses. In all subjects, the sleeping duration is longer in model house compared with that in the participants' houses. Four subjects showed a morning surge in sympathetic activity that were more intense at their houses. This morning surge in sympathetic activity in a residential setting suggests the importance of the indoor environment in the management of early morning hypertension.

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“…More highquality epidemiologic investigations and primary prevention studies are needed to explore the role of TyG index in the progression of hypertension. Besides, the BP variability and the different environments, times of measurement (seasonal variations or diurnal variations) may lead to inaccuracy of BP values (54)(55)(56)(57). Finally, even though the model we used was adjusted for multiple covariates, certain possible confounding factors, such as exercise habits and family history of hypertension, were not included.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Associations of the Triglyceride and Glucose Index With Hypertension Stages, Phenotypes, and Their Progressions Among Middle-Aged and Older Chinese

Shan

et al. 2023

Int J Public Health

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Objectives: To assess the associations of the triglyceride and glucose (TyG) index with hypertension stages, phenotypes, and their progressions.Methods: The data originated from the China Health and Retirement Longitudinal Study. Multinomial logistic regression investigated the associations of the TyG index with hypertension stages (stage 1, stage 2), phenotypes (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], systolic diastolic hypertension [SDH]), their progressions.Results: Compared with the lowest quartile of TyG index, the highest quartile was associated with increased risks of stage 1 hypertension (OR 1.71, 95% CI 1.38–2.13), stage 2 (1.74, 1.27–2.38), ISH (1.66, 1.31–2.11), IDH (2.52, 1.26–5.05), and SDH (1.65, 1.23–2.23). Similar results were found when TyG index was a continuous variable. From 2011 to 2015, a higher baseline TyG index was associated with normotension to stage 1 (per-unit: 1.39, 1.16–1.65), normotension to ISH (per-unit: 1.28, 1.04–1.56), and normotension to IDH (per-unit: 1.94, 1.27–2.97).Conclusion: The TyG index was associated with different hypertension stages, phenotypes, their progressions, and could be served as a surrogate indicator for early hypertension management.

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Impact of indoor temperature instability on diurnal and day-by-day variability of home blood pressure in winter: a nationwide Smart Wellness Housing survey in Japan

Cited by 25 publications

References 36 publications

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Morning surge in sympathetic nervous activity in the indoor environment during the cold winter season

Associations of the Triglyceride and Glucose Index With Hypertension Stages, Phenotypes, and Their Progressions Among Middle-Aged and Older Chinese

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