Intervention study of the effect of insulation retrofitting on home blood pressure in winter: a nationwide Smart Wellness Housing survey
Intervention study of the effect of insulation retrofitting on home blood pressure in winter: a nationwide Smart Wellness Housing survey
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冬季保温改造对家庭血压影响的干预研究：全国智慧健康住房调查
DOI：
10.1097/hjh.0000000000002535
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发表时间：
2020
影响因子：
4.9
通讯作者：
Murakami Shuzo
中科院分区：
文献类型：
--
作者：
Umishio Wataru;Ikaga Toshiharu;Kario Kazuomi;Fujino Yoshihisa;Hoshi Tanji;Ando Shintaro;Suzuki Masaru;Yoshimura Takesumi;Yoshino Hiroshi;Murakami Shuzo
世界卫生组织的住房和健康指南（2018年）将“室内低温和隔热”列为五个优先领域之一，并指出隔热改造有助于减轻室内低温对健康的影响。然而，仍然没有足够的证据的绝缘改造的效果的基础上的客观index.Methods：我们进行了一项非随机对照试验比较家庭血压（HBP）之间的绝缘改造（942户和1578名参与者）和非绝缘改造组（67户和107名参与者）。在冬季干预前后连续2周测量HBP和室内温度。采用多元线性回归分析方法研究了保温改造对HBP的影响。结果：保温改造后早晨室内温度上升了1.4 ℃，室外温度下降了0.2 ℃。绝缘改造显著降低了早晨家庭SBP（HSBP）3.1 mmHg [95%置信区间（95% CI）：1.5-4.6]，早晨家庭DBP（HDBP）2.1 mmHg（95% CI：1.1-3.2），晚上HSBP 1.8 mmHg（95% CI：0.2-3.4）和晚上HDBP 1.5 mmHg（95% CI：0.4-2.6）。此外，室内温度与HBP之间存在剂量-反应关系，表明HBP对室内热环境有显著改善效果。此外，与血压正常的居住者相比，高血压患者的隔热改装对早晨HSBP的影响存在异质性（-7.7 vs-2.2 mmHg，交互作用P = 0.043）。结论：隔热改装显著降低了高血压患者的HBP，更有利于降低早晨HSBP。
Objective:The WHO's Housing and health guidelines (2018) listed ‘low indoor temperatures and insulation’as one of five priority areas, and indicated insulation retrofitting to help mitigate the effect of low indoor temperatures on health. However, there is still not enough evidence for the effect of insulation retrofitting based on an objective index.Methods:We conducted a nonrandomized controlled trial comparing home blood pressure (HBP) between insulation retrofitting (942 households and 1578 participants) and noninsulation retrofitting groups (67 households and 107 participants). HBP and indoor temperature were measured for 2 weeks before and after the intervention in winter. To examine the influence of insulation retrofitting on HBP, we used multiple linear regression analysis.Results:The analyses showed that indoor temperature in the morning rose by 1.4 C after insulation retrofitting, despite a slight decrease in outdoor temperature by 0.2 C. Insulation retrofitting significantly reduced morning home SBP (HSBP) by 3.1 mmHg [95% confidence interval (95% CI): 1.5–4.6], morning home DBP (HDBP) by 2.1 mmHg (95% CI: 1.1–3.2), evening HSBP by 1.8 mmHg (95% CI: 0.2–3.4) and evening HDBP by 1.5 mmHg (95% CI: 0.4–2.6). In addition, there was a dose–response relationship between indoor temperature and HBP, indicating the effectiveness of a significant improvement in the indoor thermal environment. Furthermore, there was heterogeneity in the effect of insulation retrofitting on morning HSBP in hypertensive patients compared with normotensive occupants (–7.7 versus–2.2 mmHg, P for interaction= 0.043).Conclusion:Insulation retrofitting significantly reduced HBP and was more beneficial for reducing the morning HSBP of hypertensive patients.