Environmental ambient temperature and blood pressure in adults: a systematic review and meta-analysis

Objective: Although many individual studies have examined the association between temperature and blood pressure (BP), they used different methods and also their results were somewhat inconsistent. The aims of this study are to quantitatively summarize previous studies and to systematically assess the methodological issues to make recommendations for future research. Methods: We searched relevant empirical studies published before January 2016 concerning temperature and BP among adults using the MEDLINE, Embase and PubMed databases. Mean changes in systolic (SBP) and diastolic blood pressure (DBP) per 1 °C reduction in temperature were pooled using a random-effects meta-analysis. Results: Of 23 studies included, 14 were used for meta-analysis. Consistent, statistically significant, inverse associations were observed between ambient temperature (mean, maximum, minimum outdoor temperature and indoor temperature) and BP. An 1 °C decrease in mean daily outdoor temperature was associated with an increase in SBP and DBP of 0.26 mm Hg (95% CI: 0.18–0.33) and 0.13 (95% CI: 0.11–0.16), respectively. The increase was greater in people with conditions related to cardiovascular disease. An 1 °C decrease in indoor temperature was associated with 0.38 mm Hg (0.18–0.58) increase in SBP, while the effects on DBP were not estimated due to limited studies. Among the previous studies on temperature-BP relationship, temperature and BP measurements are not accurate enough and statistical methods need to be improved. Conclusions: Lower ambient temperatures seem to increase adults' BP and people with conditions related to cardiovascular disease are more susceptible to drops in temperature. Indoor temperature appeared to have a stronger effect on BP than outdoor temperature. To understand temperature-BP relationship well, a study combining repeated personal temperature exposure and ambulatory BP monitoring, applying improved statistical methods to examine potential non-linear relationship is warranted.Qiong Wanga, Changchang Li, Yanfang Guo, Adrian G.Barnett, Shilu Tong ... Keith Dear ... et al