Impact of barometric pressure on blood pressure during dialysis: Introducing intradialytic time-averaged cumulative systolic blood pressure (TACsBP-inD) as a new metric

气压变化对透析期间血压的影响:引入透析中时间平均累积收缩压(TACsBP-inD)作为一项新的指标

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Abstract

BACKGROUND: Blood pressure is a crucial risk factor for hemodialysis patients, but the specific impact of weather factors, particularly barometric pressure, on blood pressure remains unclear. This study aims to examine the relationship between barometric pressure and blood pressure in hemodialysis patients. METHODS: We conducted a single-center, retrospective study involving 122 hemodialysis patients in Japan, covering the period from August 2018 to October 2022. In addition to standard blood pressure indices, for the purpose of a more accurate assessment, we introduced the intradialytic time-averaged cumulative systolic blood pressure (TACsBP-inD). Multilevel mixed-effects linear regression models with random intercepts for each patient and spline analyses were used to evaluate the association between barometric pressure and blood pressure. RESULTS: Our analysis demonstrated a positive correlation between barometric pressure and various intradialytic blood pressure indices, including TACsBP-inD, in both univariate and multivariate models. Spline analyses revealed a U-shaped relationship between barometric pressure and TACsBP-inD. Furthermore, categorized barometric pressure showed significantly positive coefficients for TACsBP-inD at both lower and higher pressure ranges, supporting the U-shaped trend. Subgroup analyses revealed that this positive association was not observed at lower pressures among males, obese individuals, and patients with diabetes, cardiovascular disease, and smoking habits, suggesting that blood pressure responses vary depending on patient profiles. CONCLUSIONS: These findings emphasize the significant impact of barometric pressure on intradialytic blood pressure, suggesting that atmospheric conditions could be an important consideration in blood pressure management for hemodialysis patients.

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