BACKGROUND: Exposure to cold weather increases blood pressure (BP) and may aggravate the symptoms and influence the prognosis of subjects with a diagnosis of hypertension. We tested the hypothesis that subjects with hypertension alone or in combination with another cardiovascular disease (CVD) experience cold-related cardiorespiratory symptoms more commonly than persons without hypertension. This information is relevant for proper treatment and could serve as an indicator for predicting wintertime morbidity and mortality.
METHODS: A self-administered questionnaire inquiring of cold-related symptoms was obtained from 6591 men and women aged 25-74 yrs of the FINRISK Study 2002 population. BP was measured in association with clinical examinations. Symptom prevalence was compared between subjects with diagnosed hypertensive disease with (n = 395) or without (n = 764) another CVD, untreated diagnosed hypertension (n = 1308), measured high BP (n = 1070) and a reference group (n = 2728) with normal BP.
RESULTS: Hypertension in combination with another CVD was associated with increased cold-related dyspnoea (men: adjusted odds ratio 3.94, 95% confidence interval 2.57-6.02)/women: 4.41, 2.84-6.86), cough (2.64, 1.62-4.32/4.26, 2.60-6.99), wheezing (2.51, 1.42-4.43/;3.73, 2.08-6.69), mucus excretion (1.90, 1.24-2.91/2.53, 1.54-4.16), chest pain (22.5, 9.81-51.7/17.7, 8.37-37.5) and arrhythmias (43.4, 8.91-211/8.99, 3.99-20.2), compared with the reference group. Both diagnosed treated hypertension and untreated hypertension and measured high BP resulted in increased cardiorespiratory symptoms during the cold season.
CONCLUSION: Hypertension alone and together with another CVD is strongly associated with cold-related cardiorespiratory symptoms. As these symptoms may predict adverse health events, hypertensive patients need customized care and advice on how to cope with cold weather.
Circumpolar areas are associated with prolonged cold exposure where wind, precipitation, and darknessfurther aggravate the environmental conditions and the associated risks. Despite the climate warming, coldclimatic conditions will prevail in circumpolar areas and contribute to adverse health effects. Frostbite is afreezing injury where localized damage affects the skin and other tissues. It occurs during occupational orleisure-time activities and is common in the general population among men and women of various ages.Industries of the circumpolar areas where frostbite occurs frequently include transportation, mining, oil, andgas industry, construction, agriculture, and military operations. Cold injuries may also occur during leisuretimeactivities involving substantial cold exposure, such as mountaineering, skiing, and snowmobiling.Accidental situations (occupational, leisure time) often contribute to adverse cooling and cold injuries.Several environmental (temperature, wind, wetness, cold objects, and altitude) and individual (behavior,health, and physiology) predisposing factors are connected with frostbite injuries. Vulnerable populationsinclude those having a chronic disease (cardiovascular, diabetes, and depression), children and the elderly, orhomeless people. Frostbite results in sequelae causing different types of discomfort and functional limitationsthat may persist for years. A frostbite injury is preventable, and hence, unacceptable from a public healthperspective. Appropriate cold risk management includes awareness of the adverse effects of cold, individualadjustment of cold exposure and clothing, or in occupational context different organizational and technicalmeasures. In addition, vulnerable population groups need customized information and care for properprevention of frostbites.