Background:The inverse association between ambient temperature and blood pressure (BP) has been investigated in the context of excess cardiovascular mortality in winter. However, the role of skin temperature (ST), which reflects our external and internal thermal environments, in BP regulation remains unclear. Therefore, we examined the association between ST and ambulatory BP and the mediation of ST in BP responses to ambient temperature in real-life settings.Methods:We conducted a longitudinal analysis using repeated measurements of ambulatory BP and ST for 48 hours (30 711 daytime readings and 17 382 nighttime readings) among 584 older adults between October and March (2012–2014). Linear mixed-effect models were used to examine the association of distal (mean of wrist and ankle) and proximal (abdomen) ST with systolic BP. The mediation of ST in BP responses to ambient temperature was examined using path analysis.Results:Distal and proximal STs were significantly associated with systolic BP during the daytime (regression coefficients: −4.27 mm Hg [95% CI, −4.58 to −3.96] and −2.74 mm Hg [95% CI, −3.14 to −2.56] per SD of ST, respectively), independent of potential confounders. The significant associations also existed during nighttime. The mediation effect of distal ST was 7.1 times higher than that of proximal ST during daytime, while those of distal and proximal STs during nighttime were almost identical.Conclusions:ST, especially in distal regions, was inversely associated with ambulatory BP. Our results have the potential for application to interventional studies targeting ST regulation to reduce excess cardiovascular deaths in winter.

中文翻译：

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皮肤温度与动态血压的负相关以及皮肤温度在血压对环境温度的反应中的中介作用

背景：在冬季心血管死亡率过高的背景下，已经研究了环境温度和血压 (BP) 之间的负相关关系。然而，反映我们外部和内部热环境的皮肤温度（ST）在血压调节中的作用仍不清楚。因此，我们检查了 ST 与动态 BP 之间的关联，以及 ST 在现实生活环境中 BP 对环境温度的反应中的中介作用。方法：我们使用 48 小时（30 711 白天）的动态 BP 和 ST 重复测量进行了纵向分析10 月至 3 月（2012 年至 2014 年）期间 584 名老年人的读数和 17 382 次夜间读数）。线性混合效应模型用于检查远端（手腕和脚踝的平均值）和近端（腹部）ST 与收缩压的关联。使用路径分析检查了 ST 在 BP 对环境温度的反应中的中介作用。结果：远端和近端 ST 与白天的收缩压显着相关（回归系数：-4.27 mm Hg [95% CI，-4.58 至 -3.96]和 -2.74 mm Hg [95% CI，-3.14 至 -2.56] 每个 ST 的 SD，分别），独立于潜在的混杂因素。夜间也存在显着的关联。白天ST段远端的调节作用是ST段近端的7.1倍，而夜间ST段远端和近端的调节作用几乎相同。结论：ST段，尤其是远端段，与动态血压呈负相关。我们的结果有可能应用于针对 ST 调节的介入研究，以减少冬季过多的心血管死亡。