Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis

Qiong Wang; Changchang Li; Yanfang Guo; Adrian G Barnett; Shilu Tong; Dung Phung; Cordia Chu; Keith Dear; Xuemei Wang; Cunrui Huang

doi:10.1016/j.scitotenv.2016.10.019

Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis

Sci Total Environ. 2017 Jan 1:575:276-286. doi: 10.1016/j.scitotenv.2016.10.019. Epub 2016 Oct 14.

Authors

Qiong Wang¹, Changchang Li¹, Yanfang Guo², Adrian G Barnett³, Shilu Tong³, Dung Phung⁴, Cordia Chu⁴, Keith Dear⁵, Xuemei Wang⁶, Cunrui Huang⁷

Affiliations

¹ Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China.
² Department of Chronic Disease Prevention, Bao'an Hospital for Chronic Disease Prevention and Treatment, 99 Wenwei Road, Shenzhen 518101, China.
³ School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia.
⁴ Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia.
⁵ Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu 215316, China.
⁶ School of Atmospheric Sciences, Sun Yat-sen University, 135 Xingang Xi Road, Guangzhou 510275, China. Electronic address: eeswxm@mail.sysu.edu.cn.
⁷ Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia. Electronic address: huangcr@mail.sysu.edu.cn.

PMID: 27750133
DOI: 10.1016/j.scitotenv.2016.10.019

Abstract

Objective: Although many individual studies have examined the association between temperature and blood pressure (BP), they used different methods and also their results were somewhat inconsistent. The aims of this study are to quantitatively summarize previous studies and to systematically assess the methodological issues to make recommendations for future research.

Methods: We searched relevant empirical studies published before January 2016 concerning temperature and BP among adults using the MEDLINE, Embase and PubMed databases. Mean changes in systolic (SBP) and diastolic blood pressure (DBP) per 1°C reduction in temperature were pooled using a random-effects meta-analysis.

Results: Of 23 studies included, 14 were used for meta-analysis. Consistent, statistically significant, inverse associations were observed between ambient temperature (mean, maximum, minimum outdoor temperature and indoor temperature) and BP. An 1°C decrease in mean daily outdoor temperature was associated with an increase in SBP and DBP of 0.26mmHg (95% CI: 0.18-0.33) and 0.13 (95% CI: 0.11-0.16), respectively. The increase was greater in people with conditions related to cardiovascular disease. An 1°C decrease in indoor temperature was associated with 0.38mmHg (0.18-0.58) increase in SBP, while the effects on DBP were not estimated due to limited studies. Among the previous studies on temperature-BP relationship, temperature and BP measurements are not accurate enough and statistical methods need to be improved.

Conclusions: Lower ambient temperatures seem to increase adults' BP and people with conditions related to cardiovascular disease are more susceptible to drops in temperature. Indoor temperature appeared to have a stronger effect on BP than outdoor temperature. To understand temperature-BP relationship well, a study combining repeated personal temperature exposure and ambulatory BP monitoring, applying improved statistical methods to examine potential non-linear relationship is warranted.

Keywords: Cardiovascular disease; Mechanism; Meta-analysis; Meteorological factors; Methodology.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Adult
Blood Pressure Monitoring, Ambulatory
Blood Pressure*
Cardiovascular Diseases / epidemiology
Humans
Hypertension / epidemiology
Temperature*