Summer-winter variation in 24 h ambulatory blood pressure

Objective: To examine possible seasonal differences in circadian blood pressure patterns and the specific contribution of indoor temperature. Method: Twenty-four-hour ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) were monitored once in summer and once in winter in 101 healthy subjects aged 28-63 years. Subjects were interviewed concerning health-related habits, and measurements of environmental and occupational conditions were obtained. Results: After controlling for possible confounders, mean SBP during work was significantly higher in winter than in summer by 3.4 mmHg. Both in winter and in summer, the highest values were recorded during work. The daily SBP circadian amplitude was higher in winter, reflected by higher mean SBP during the day and lower mean SBP at night. All of the daytime DBP measurements were higher in winter than in summer, but at night there were no seasonal differences. The blood pressure showed an independent association with season and with environmental temperature (SBP) β=3.98 mmHg and - 1.14 mmHg/°C, respectively; DBP β=4.39 mmHg and -0.58 mmHg/°C, respectively). Conclusions: In healthy men, the daily amplitude of ambulatory blood pressure varies physiologically by season with the highest values being obtained during work time in the winter months. If these results can be extrapolated to hypertensives then it might be necessary to tailor drug therapy to these variations. The daily average or clinical measurements may lead to an underestimation of the extent of the seasonal variation in blood pressure. The season of the year must be controlled for in clinical and epidemiological studies comparing blood pressure levels and amplitudes between groups or between baseline and follow-up study.