在随机试验中室外温度作为血压的混杂因素

IF 8.2 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Science of the Total Environment Pub Date : 2025-05-17 DOI:10.1016/j.scitotenv.2025.179683

Doug Brugge , Misha Eliasziw , Amy Mertl , Sharly Palma , Chermaine Morson , Teresa Vazquez-Dodero , Warren Goldstein-Gelb , Anil Gurcan , Sangita Kunwar , Hunter Gates , Scott Oakley Hersey , Francesca Majluf , Wig Zamore

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引用次数: 0

摘要

背景：温度是与血压相关的时变因素，在随机交叉试验中有可能成为混杂因素。方法：我们在“交通相关空气污染家庭空气过滤研究”中评估了温度对血压的影响，这是一项家庭空气净化器的随机交叉试验。我们使用190对血压测量值来评估血压与室外和室内温度的关系，这些测量值在前一个月不受空气净化器存在的影响。结果平均（标准误差）外周收缩压每降低1°F，变化幅度为+0.24 (0.09)mmHg，升高1°F，变化幅度为- 0.28 (0.07)mmHg (P <；0.001)。结果相似，尽管外周舒张压稍小。与中心血压的关联几乎相同。我们发现室内温度的影响要小得多，没有一个接近统计意义，因为室内温度更稳定，在研究期间变化不大。结论：尽管室外温度的变冷或变暖与血压的升高或降低有关，但我们认为室外温度也可能是空气中颗粒物污染的替代指标。无论潜在的机制如何，以血压为结果的随机试验最好是测量体温，并将其视为分析中潜在的时变混杂因素。

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Outdoor temperature as a confounder of blood pressure in randomized trials

Background

Temperature is a time varying factor that is associated with blood pressure and has the potential to be a confounder in randomized crossover trials.

Methods

We assessed the effect of temperature on blood pressure within the Home Air Filtration for Traffic-Related Air Pollution study, a randomized crossover trial of air purifiers in homes. We assessed the association of blood pressure with both outdoor and indoor temperatures using 190 paired blood pressure measurements that were not affected by the presence of air purifiers in the preceding month.

Results

Mean (standard error) peripheral systolic blood pressure was observed to change by +0.24 (0.09) mmHg per 1 °F colder outdoor temperature and by −0.28 (0.07) mmHg per 1 °F warmer (P < 0.001). Results were similar, although somewhat smaller for peripheral diastolic blood pressure. Associations were nearly identical for central blood pressures. We found much smaller effects for indoor temperatures, none of which approached statistical significance, as indoor temperatures were more stable and did not change as much over the study period.

Conclusions

Despite the cooling and warming of outdoor temperatures being associated with increases and decreases in blood pressure, we believe that outdoor temperature may also be a surrogate marker of particulate matter air pollution. Regardless of the underlying mechanism, randomized trials using blood pressure as outcomes would be well advised to measure temperature and consider it a potential time-varying confounder in the analyses.

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来源期刊

Science of the Total Environment 环境科学-环境科学

CiteScore

17.60

自引率

10.20%

发文量

8726

审稿时长

2.4 months

期刊介绍： The Science of the Total Environment is an international journal dedicated to scientific research on the environment and its interaction with humanity. It covers a wide range of disciplines and seeks to publish innovative, hypothesis-driven, and impactful research that explores the entire environment, including the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. The journal's updated Aims & Scope emphasizes the importance of interdisciplinary environmental research with broad impact. Priority is given to studies that advance fundamental understanding and explore the interconnectedness of multiple environmental spheres. Field studies are preferred, while laboratory experiments must demonstrate significant methodological advancements or mechanistic insights with direct relevance to the environment.