Impact of seasonality and air pollutants on carotid-femoral pulse wave velocity and wave reflection in hypertensive patientsReport as inadecuate

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The effects of seasonality on blood pressure BP and cardiovascular CV events are well established, while the influence of seasonality and other environmental factors on arterial stiffness and wave reflection has never been analyzed. This study evaluated whether seasonality daily number of hours of light and acute variations in outdoor temperature and air pollutants may affect carotid-femoral pulse wave velocity PWV and pressure augmentation.

Design and method

731 hypertensive patients 30–88 years, 417 treated were enrolled in a cross-sectional study during a 5-year period. PWV, central BP, Augmentation Index AIx and Augmentation Pressure AP were measured in a temperature-controlled 22–24°C room. Data of the local office of the National Climatic Data Observatory were used to estimate meteorological conditions and air pollutants PM10, O3, CO, N2O exposure on the same day.


PWV mean value 8.5±1.8 m-s was related to age r = 0.467, p<0.001, body mass index r = 0.132, p<0.001, central systolic r = 0.414, p<0.001 and diastolic BP r = 0.093, p = 0.013, daylight hours r = -0.176, p<0.001, mean outdoor temperature r = -0.082, p = 0.027, O3 r = -0.135, p<0.001, CO r = 0.096, p = 0.012, N2O r = 0.087, p = 0.022. In multiple linear regression analysis, adjusted for confounders, PWV remained independently associated only with daylight hours β = -0.170; 95% CI: -0.273 to -0.067, p = 0.001. No significant correlation was found between pressure augmentation and daylight hours, mean temperature or air pollutants. The relationship was stronger in untreated patients and women. Furthermore, a positive, independent association between O3 levels and PWV emerged in untreated patients β: 0.018; p = 0.029; CI: 0.002 to 0.034 and in women β: 0.027; p = 0.004; CI: 0.009 to 0.045.


PWV showed a marked seasonality in hypertensive patients. Environmental O3 levels may acutely reduce arterial stiffness in hypertensive women and in untreated patients.

Author: Marina Di Pilla , Rosa Maria Bruno , Francesco Stea, Luciano Massetti, Stefano Taddei, Lorenzo Ghiadoni, Pietro Amedeo Modesti



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