Dear Editor-in-Chief,

We would like to thank Martin and Johannes for their pertinent concern about omitting temperature from our multivariate model. We agree that, as they suggested, the inclusion of temperature would have definitely added value to this research had we collected data on ambient temperature during each blood pressure measurement. However, we previously acknowledged that possible temperature differences in study districts might have modified the effect of altitude on blood pressure.

As described in the methods section, data were collected during the summer in the Mustang district (average ambient temperature 25 °C to 31 °C) and during spring in the Humla district (average ambient temperature ~15 °C). A recent systematic review by Wang and colleagues estimated that a 1 °C decrease in mean daily ambient temperature was associated with increases in systolic blood pressure and diastolic blood pressure of 0.26 and 0.13 mmHg, respectively [1]. According to this estimate, the difference in temperature in the two study districts alone could affect SBP by 2.6–4.2 mmHg and DBP by 1.3–2.1 mmHg. However, since blood pressure measurements were carried out indoors, this effect should have been less substantial.