Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Seasonal variation in 24 h blood pressure profile in healthy adults- A prospective observational study

Journal of Human Hypertension volume 33, pages 626–633 (2019)Cite this article

Subjects

Abstract

The clinical and experimental data on seasonal variation in blood pressure is mainly from office and home blood pressure (BP) monitoring studies. There are few studies from temperate climates on seasonal changes with ambulatory blood pressure (ABP) monitoring and none from India. This is a prospective, observational study among healthy adults. ABP was measured in four different seasons in 28 subjects. Mean arterial pressure (MAP), ambulatory systolic blood pressure (SBP), and ambulatory diastolic blood pressure (DBP) were significantly higher in winter compared to summer season. 24-hour MAP was lowest in summer while highest MAP was recorded in winter (97.04 ± 8.30 and 103.89 ± 8.54, respectively). The mean difference was −6.86 mm Hg (95% CI: −10.74 to −2.97, p = 0.001). This difference was mainly due to increase in day time MAP. There was no difference in 24 h systolic and diastolic blood pressure between summer and winter. There was significant difference between summer and winter in the SBP (day time) [125.61 ± 11.44 and 131.93 ± 9.46, mean difference −6.32 (95% CI: −10.69 to −1.95, p = 0.005)] and DBP (day time) [79.57 ± 9.95 and 87.07 ± 9.9, mean difference −7.50 (95% CI: −12.49 to −2.51, p = 0.003)]. The night time systolic and diastolic BP was similar during winter and summer. Thus, BP increases significantly during winter compared to summer season. This change is primarily in the day time systolic, diastolic and mean blood pressures. Larger studies are required to further validate our findings.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Goyal A, Aslam N, Kaur S, Soni RK, Midha V, Chaudhary A, et al. Factors affecting seasonal changes in blood pressure in North India: a population based four-seasons study. Indian Heart J. 2018;70:360–7.

    Article  Google Scholar 

  2. Keatinge WR, Coleshaw SR, Cotter F, Mattock M, Murphy M, Chelliah R. Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: factors in mortality from coronary and cerebral thrombosis in winter. Br Med J. 1984;289:1405–8.

    Article  CAS  Google Scholar 

  3. Sharma BK, Sagar S, Sood GK, Varma, Kalra S, Seasonal OP. variations of arterial blood pressure in normotensive and essential hypertensives. Indian Heart J. 1990;42:66–72.

    CAS  PubMed  Google Scholar 

  4. Aubinière-Robb L, Jeemon P, Hastie CE, Patel RK, McCallum L, Morrison D, et al. Blood pressure response to patterns of weather fluctuations and effect on mortality. Hypertension. 2013;62:190–6.

    Article  Google Scholar 

  5. Su D, Du H, Zhang X, Qian Y, Chen L, Chen Y, et al. Season and outdoor temperature in relation to detection and control of hypertension in a large rural Chinese population. Int J Epidemiol. 2014;43:1835–45.

    Article  Google Scholar 

  6. Lewington S, Li L, Sherliker P, Guo Y, Millwood I, Bian Z, et al. Seasonal variation in blood pressure and its relationship with outdoor temperature in 10 diverse regions of China: the China KadoorieBiobank. J Hypertens. 2012;30:1383–91.

    Article  CAS  Google Scholar 

  7. Madsen C, Nafstad P. Associations between environmental exposure and blood pressure among participants in the Oslo Health Study (HUBRO). Eur J Epidemiol. 2006;21:485–91.

    Article  Google Scholar 

  8. Barnett AG, Sans S, Salomaa V, Kuulasmaa K, Dobson AJ. WHO MONICA Project The effect of temperature on systolic blood pressure. Blood Press Monit. 2007;12:195–203.

    Article  Google Scholar 

  9. Jenner DA, English DR, Vandongen R, Beilin LJ, Armstrong BK, Dunbar D, et al. Environmental temperature and blood pressure in 9-year-old Australian children. J Hypertens. 1987;5:683–6.

    Article  CAS  Google Scholar 

  10. Sega R, Cesana G, Bombelli M, Grassi G, Stella ML, Zanchetti A, et al. Seasonal variations in home and ambulatory blood pressure in the PAMELA population. Pressione Arteriose Monitorate E Loro Associazioni. J Hypertens. 1998;16:1585–92.

    Article  CAS  Google Scholar 

  11. Modesti PA. Season, temperature and blood pressure: a complex interaction. Eur J Intern Med. 2013;24:604–7.

    Article  Google Scholar 

  12. Cuspidi C, Ochoa JE, Parati G. Seasonal variations in blood pressure: a complex phenomenon. J Hypertens. 2012;30:1315–20.

    Article  CAS  Google Scholar 

  13. Banegas JR, Ruilope LM, Sierra ADL, Vinyoles E, Gorostidi M, JJDL Cruz, et al. Relationship between clinic and ambulatory blood-pressure measurements and mortality. N Engl J Med. 2018;378:1509–20.

    Article  Google Scholar 

  14. Brennan PJ, Greenberg G, Miall WE, Thompson SG. Seasonal variation in arterial blood pressure. Br. Med. J.1982;285:919–23.

    Article  CAS  Google Scholar 

  15. Alperovitch A, Lacombe JM, Hanon O, Dartigues JF, Ritchie K, Ducimetière P, et al. Relationship between blood pressure and outdoor temperature in a large sample of elderly individuals: the Three-City study. Arch Intern Med. 2009;169:75–80.

    Article  Google Scholar 

  16. Modesti PA, Morabito M, Bertolozzi I, Massetti L, Panci G, Lumachi C, et al. Weather-related changes in 24-h blood pressure profile: effects of age and implications for hypertension management. Hypertension. 2006;47:155–61.

    Article  CAS  Google Scholar 

  17. O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G, et al. European society of hypertension position paper on ambulatory blood pressure monitoring. J Hypertens. 2013;31:1731–68.

    Article  Google Scholar 

  18. Sheth T, Nair C, Muller J, Yusuf S. Increased winter mortality from acute myocardial infarction and stroke: the effect of age. J Am Coll Cardiol. 1999;33:1916–9.

    Article  CAS  Google Scholar 

  19. Ockene IS, Chiriboga DE, Stanek EJ 3rd, Harmatz MG, Nicolosi R, Saperia G, et al. Seasonal variation in serum cholesterol levels: treatment implications and possible mechanisms. Arch Intern Med. 2004;164:863–70.

    Article  CAS  Google Scholar 

  20. Fedecostante M, Barbatelli P, Guerra F, Espinosa E, Dessì-Fulgheri P, Sarzani R. Summer does not always mean lower: seasonality of 24 h, daytime, and night-time blood pressure. J Hypertens. 2012;30:1392–8.

    Article  CAS  Google Scholar 

  21. Minami J, Kawano Y, Ishimitsu T, Espinosa E, Dessì-Fulgheri P, Sarzani R. Seasonal variations in office, home and 24 h ambulatory blood pressure in patients with essential hypertension. J Hypertens. 1996;14:1421–5.

    Article  CAS  Google Scholar 

  22. Winnicki M, Canali C, Accurso V, Dorigatti F, Giovinazzo P, Palatini P, et al. Relation of 24-h ambulatory blood pressure and short-term blood pressure variability to seasonal changes in environmental temperature in stage I hypertensive subjects. Results of the Harvest Trial. Clin Exp Hypertens. 1996;18:995–1012.

    Article  CAS  Google Scholar 

  23. Sun Z, Cade R, Morales C. Role of central angiotensin II receptors in coldinduced hypertension. Am J Hypertens. 2002;15:85–92.

    Article  CAS  Google Scholar 

  24. Sun Z, Cade R, Zhang Z, Alouidor J, Van H. Angiotensinogen gene knockout delays and attenuates cold-induced hypertension. Hypertension. 2003;41:322–7.

    Article  CAS  Google Scholar 

  25. Psaltopoulou T, Orfanos P, Naska A, Lenas D, Trichopoulos A. Prevalence, awareness, treatment and control of hypertension in a general population sample of 26 913 adults in the Greek EPIC study. Int. J. Epidemiol.2004;33:1345–52.

    Article  Google Scholar 

Download references

Funding

Institutional Research Fund.

Author information

Authors and Affiliations

  1. Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India

    Abhishek Goyal, Bhupinder Singh, Shibba T. Chhabra, Naved Aslam, Bishav Mohan & Gurpreet S. Wander

  2. Indraprastha Apollo Hospital, New Delhi, India

    Kanika Narang

  3. Dayanand Medical College & Hospital, Ludhiana, Punjab, India

    Gautam Ahluwalia & P. M. Sohal

Authors
  1. Abhishek Goyal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kanika Narang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gautam Ahluwalia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. M. Sohal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bhupinder Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shibba T. Chhabra
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Naved Aslam
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bishav Mohan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Gurpreet S. Wander
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gurpreet S. Wander.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Goyal, A., Narang, K., Ahluwalia, G. et al. Seasonal variation in 24 h blood pressure profile in healthy adults- A prospective observational study. J Hum Hypertens 33, 626–633 (2019). https://doi.org/10.1038/s41371-019-0173-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41371-019-0173-3

This article is cited by

Search

Advanced search

Quick links