Daylight hours were independently and inversely associated with carotid-femoral pulse wave velocity (β -0.170) in hypertensive patients, indicating a marked seasonality of arterial stiffness.
Cross-Sectional (n=731)
No
Does seasonality and exposure to air pollutants affect carotid-femoral pulse wave velocity and wave reflection in hypertensive patients?
Arterial stiffness, measured by pulse wave velocity, exhibits marked seasonality in hypertensive patients and may be acutely increased by environmental ozone exposure in women and untreated patients.
Effect estimate: β -0.170 (95% CI -0.273 to -0.067)
p-value: p=0.001
OBJECTIVE: The effects of seasonality on blood pressure (BP) and cardiovascular (CV) events are well established, while the influence of seasonality and other environmental factors on arterial stiffness and wave reflection has never been analyzed. This study evaluated whether seasonality (daily number of hours of light) and acute variations in outdoor temperature and air pollutants may affect carotid-femoral pulse wave velocity (PWV) and pressure augmentation. DESIGN AND METHOD: 731 hypertensive patients (30-88 years, 417 treated) were enrolled in a cross-sectional study during a 5-year period. PWV, central BP, Augmentation Index (AIx) and Augmentation Pressure (AP) were measured in a temperature-controlled (22-24°C) room. Data of the local office of the National Climatic Data Observatory were used to estimate meteorological conditions and air pollutants (PM10, O3, CO, N2O) exposure on the same day. RESULTS: PWV (mean value 8.5±1.8 m/s) was related to age (r = 0.467, p<0.001), body mass index (r = 0.132, p<0.001), central systolic (r = 0.414, p<0.001) and diastolic BP (r = 0.093, p = 0.013), daylight hours (r = -0.176, p<0.001), mean outdoor temperature (r = -0.082, p = 0.027), O3 (r = -0.135, p<0.001), CO (r = 0.096, p = 0.012), N2O (r = 0.087, p = 0.022). In multiple linear regression analysis, adjusted for confounders, PWV remained independently associated only with daylight hours (β = -0.170; 95% CI: -0.273 to -0.067, p = 0.001). No significant correlation was found between pressure augmentation and daylight hours, mean temperature or air pollutants. The relationship was stronger in untreated patients and women. Furthermore, a positive, independent association between O3 levels and PWV emerged in untreated patients (β: 0.018; p = 0.029; CI: 0.002 to 0.034) and in women (β: 0.027; p = 0.004; CI: 0.009 to 0.045). CONCLUSIONS: PWV showed a marked seasonality in hypertensive patients. Environmental O3 levels may acutely reduce arterial stiffness in hypertensive women and in untreated patients.
Pilla et al. (Thu,) conducted a cross-sectional in Hypertension (n=731). Seasonality (daylight hours) and air pollutants was evaluated on Carotid-femoral pulse wave velocity (cf-PWV) association with daylight hours (β -0.170, 95% CI -0.273 to -0.067, p=0.001). Daylight hours were independently and inversely associated with carotid-femoral pulse wave velocity (β -0.170) in hypertensive patients, indicating a marked seasonality of arterial stiffness.
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