Objective: To explore the relationships among ambient temperature, ischemic stroke severity, and blood pressure. Methods: Meteorological data (2005–2015) were collected from the Guangzhou Meteorological Data Service. Ischemic stroke patients from the Department of Neurology of the First Affiliated Hospital, Sun Yat-sen University were retrospectively evaluated, each winter from 2005 to 2015. Patient demographics, baseline measurements, and National Institute of Health Stroke Scale (NIHSS) score were evaluated. Results: Three hundred sixty-two patients were included. The median latency from symptom onset to admission was 2 d (IQR: 1–3 d). During recruitment, the highest and lowest temperatures were 39℃ and 1.3℃, respectively. Hypertension was the most common comorbidity (75.1%). NIHSS scores at admission and discharge were higher in the cold-exposed group than in the controls regardless of the average temperature at admission. In addition, systolic and diastolic blood pressure values at admission were higher in the cold-exposed group than in the controls. When stratified by hypertensive status, the average and minimum temperatures at admission were negatively associated with systolic and diastolic blood pressure values in hypertensive patients. Reductions in the average and minimum temperatures at symptom onset were associated with more severe stroke. Conclusion: Ischemic stroke patients with symptom onset in winter had higher systolic blood pressure values and more serious neurologic deficits upon admission.
Dawson J, Weir C, Wright F, et al., 2008, Associations Between Meteorological Variables and Acute Stroke Hospital Admissions in the West of Scotland. Acta Neurol Scand, 117(2): 85–89. https://doi.org/10.1111/j.1600-0404.2007.00916.x
Low RB, Bielory L, Qureshi AI, et al., 2006, The Relation of Stroke Admissions to Recent Weather, Airborne Allergens, Air Pollution, Seasons, Upper Respiratory Infections, and Asthma Incidence, September 11, 2001, and Day of the Week. Stroke, 37(4): 951–957. https://doi.org/10.1161/01.STR.0000214681.94680.66
Luo Y, Li H, Huang F, et al., 2018, The Cold Effect of Ambient Temperature on Ischemic and Hemorrhagic Stroke Hospital Admissions: A Large Database Study in Beijing, China between Years 2013 and 2014 – Utilizing a Distributed Lag Non-Linear Analysis. Environ Pollut, 232: 90–96. https://doi.org/10.1016/j.envpol.2017.09.021
Basu R, Pearson D, Malig B, et al., 2012, The Effect of High Ambient Temperature on Emergency Room Visits. Epidemiology, 23(6): 813–820. https://doi.org/10.1097/EDE.0b013e31826b7f97
Lichtman JH, Leifheit-Limson EC, Jones SB, et al., 2016, Average Temperature, Diurnal Temperature Variation, and Stroke Hospitalizations. J Stroke Cerebrovasc Dis, 25(6): 1489–1494. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.037
Phung D, Thai PK, Guo YM, et al., 2016, Ambient Temperature and Risk of Cardiovascular Hospitalization: An Updated Systematic Review and Meta-Analysis. Sci Total Environ, 550: 1084–1102. https://doi.org/10.1016/j.scitotenv.2016.01.154
Basu R, 2009, High Ambient Temperature and Mortality: A Review of Epidemiologic Studies from 2001 to 2008. Environ Health, 8: 40. https://doi.org/10.1186/1476-069X-8-40
Anderson BG, Bell ML, 2009, Weather-Related Mortality How Heat, Cold, and Heat Waves Affect Mortality in the United States. Epidemiology, 20(2): 205–213. https://doi.org/10.1097/EDE.0b013e318190ee08
Gasparrini A, Guo Y, Hashizume M, et al., 2015, Mortality Risk Attributable to High and Low Ambient Temperature: A Multicountry Observational Study. Lancet, 386(9991): 369–375. https://doi.org/10.1016/S0140-6736(14)62114-0
Palm F, Dos Santos M, Urbanek C, et al., 2013, Stroke Seasonality Associations with Subtype, Etiology and Laboratory Results in the Ludwigshafen Stroke Study (LuSSt). Eur J Epidemiol, 28(5): 373–381. https://doi.org/10.1007/s10654-013-9772-4
Sueda Y, Hosomi N, Tsunematsu M, et al., 2015, Effects of Meteorological Conditions on the Risk of Ischemic Stroke Events in Patients Treated with Alteplase-HEWS-tPA. J Stroke Cerebrovasc Dis, 24(7): 1500–1505. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.013
Wang Q, Gao C, Wang H, et al., 2013, Ischemic Stroke Hospital Admission Associated with Ambient Temperature in Jinan, China. PLoS One, 8(11): e80381. https://doi.org/10.1371/journal.pone.0080381
Chen R, Wang C, Meng X, et al., 2013, Both Low and High Temperature May Increase the Risk of Stroke Mortality. Neurology, 81(12): 1064–1070. https://doi.org/10.1212/WNL.0b013e3182a4a43c
Brennan PJ, Greenberg G, Miall WE, et al., 1982, Seasonal Variation in Arterial Blood Pressure. Br Med J (Clin Res Ed), 285(6346): 919–923. https://doi.org/10.1136/bmj.285.6346.919
Ma J, Yang M, Han L, et al., 2015, The Effect of the Temperature Drops in the Autumn and Winter of the Northern Part of China on Blood Pressure in the Patients with Essential Hypertension. Chinese Journal of Clinicians (Electronic Edition), 9(4): 559–562.
Lin J, Shi X, Liao S, et al., 2005, The Effect of Artificial Cold on Incidence of Stroke in Rats with Different Blood Pressure Levels. Chinese Journal of Nervous and Mental Diseases, 31(3): 180–184.
Koton S, Eizenberg Y, Tanne D, et al., 2016, Trends in Admission Blood Pressure and Stroke Outcome in Patients with Acute Stroke and Transient Ischemic Attack in a National Acute Stroke Registry. J Hypertens, 34(2): 316–322. https://doi.org/10.1097/HJH.0000000000000797
Kvistad CE, Logallo N, Oygarden H, et al., 2013, Elevated Admission Blood Pressure and Stroke Severity in Acute Ischemic Stroke: The Bergen NORSTROKE Study. Cerebrovasc Dis, 36(5–6): 351–354. https://doi.org/10.1159/000355685
Liu C-H, Wei Y-C, Lin J-R, et al., 2016, Initial Blood Pressure is Associated with Stroke Severity and is Predictive of Admission Cost and One-Year Outcome in Different Stroke Subtypes: A SRICHS Registry Study. BMC Neurol, 16: 27. https://doi.org/10.1186/s12883-016-0546-y
Xie L, Huang R, Li C, et al., 2004, Experimental Research of Artificial Cold Stream on the Occurrence of Stroke. Chinese Journal of Nervous and Mental Diseases, 30(3): 198–201.