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Does incident solar ultraviolet radiation lower blood pressure?

Does incident solar ultraviolet radiation lower blood pressure?
Does incident solar ultraviolet radiation lower blood pressure?

Background Hypertension remains a leading global cause for premature death and disease. Most treatment guidelines emphasize the importance of risk factors, but not all are known, modifiable, or easily avoided. Population blood pressure correlates with latitude and is lower in summer than winter. Seasonal variations in sunlight exposure account for these differences, with temperature believed to be the main contributor. Recent research indicates that UV light enhances nitric oxide availability by mobilizing storage forms in the skin, suggesting incident solar UV radiation may lower blood pressure. We tested this hypothesis by exploring the association between environmental UV exposure and systolic blood pressure (SBP) in a large cohort of chronic hemodialysis patients in whom SBP is determined regularly. Methods and Results We studied 342 457 patients (36% black, 64% white) at 2178 US dialysis centers over 3 years. Incident UV radiation and temperature data for each clinic location were retrieved from the National Oceanic and Atmospheric Administration database. Linear mixed effects models with adjustment for ambient temperature, sex/age, body mass index, serum Na+/K+ and other covariates were fitted to each location and combined estimates of associations calculated using the DerSimonian and Laird procedure. Pre-dialysis SBP varied by season and was ≈4 mm Hg higher in black patients. Temperature, UVA and UVB were all linearly and inversely associated with SBP. This relationship remained statistically significant after correcting for temperature. Conclusions In hemodialysis patients, in addition to environmental temperature, incident solar UV radiation is associated with lower SBP. This raises the possibility that insufficient sunlight is a new risk factor for hypertension, perhaps even in the general population.

cardiovascular disease, cardiovascular health, hypertension, nitric oxide, renal disease, seasonal variation
1-11
Weller, Richard B.
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Wang, Yuedong
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He, Jingyi
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Maddux, Franklin W
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Usvyat, Len
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Zhang, Hanjie
5ff80991-ceef-4be0-b624-78050eab0d19
Feelisch, Martin
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Kotanko, Peter
75ab6dc6-b38c-4618-8cb2-0cb61f1e75f3
Weller, Richard B.
6760c78a-63ae-484a-affa-b435f146e5a3
Wang, Yuedong
7b648c9a-f611-42f7-81bb-4533c1c141d7
He, Jingyi
9e8ef0d9-f5e3-47be-9e1e-fdc3236f874f
Maddux, Franklin W
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Usvyat, Len
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Zhang, Hanjie
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Feelisch, Martin
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Kotanko, Peter
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Weller, Richard B., Wang, Yuedong, He, Jingyi, Maddux, Franklin W, Usvyat, Len, Zhang, Hanjie, Feelisch, Martin and Kotanko, Peter (2020) Does incident solar ultraviolet radiation lower blood pressure? Journal of the American Heart Association, 9 (5), 1-11, [e013837]. (doi:10.1161/JAHA.119.013837).

Record type: Article

Abstract

Background Hypertension remains a leading global cause for premature death and disease. Most treatment guidelines emphasize the importance of risk factors, but not all are known, modifiable, or easily avoided. Population blood pressure correlates with latitude and is lower in summer than winter. Seasonal variations in sunlight exposure account for these differences, with temperature believed to be the main contributor. Recent research indicates that UV light enhances nitric oxide availability by mobilizing storage forms in the skin, suggesting incident solar UV radiation may lower blood pressure. We tested this hypothesis by exploring the association between environmental UV exposure and systolic blood pressure (SBP) in a large cohort of chronic hemodialysis patients in whom SBP is determined regularly. Methods and Results We studied 342 457 patients (36% black, 64% white) at 2178 US dialysis centers over 3 years. Incident UV radiation and temperature data for each clinic location were retrieved from the National Oceanic and Atmospheric Administration database. Linear mixed effects models with adjustment for ambient temperature, sex/age, body mass index, serum Na+/K+ and other covariates were fitted to each location and combined estimates of associations calculated using the DerSimonian and Laird procedure. Pre-dialysis SBP varied by season and was ≈4 mm Hg higher in black patients. Temperature, UVA and UVB were all linearly and inversely associated with SBP. This relationship remained statistically significant after correcting for temperature. Conclusions In hemodialysis patients, in addition to environmental temperature, incident solar UV radiation is associated with lower SBP. This raises the possibility that insufficient sunlight is a new risk factor for hypertension, perhaps even in the general population.

Text
2020 Weller JAHA - Version of Record
Available under License Creative Commons Attribution.
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More information

Accepted/In Press date: 12 December 2019
e-pub ahead of print date: 28 February 2020
Published date: 3 March 2020
Keywords: cardiovascular disease, cardiovascular health, hypertension, nitric oxide, renal disease, seasonal variation

Identifiers

Local EPrints ID: 439714
URI: http://eprints.soton.ac.uk/id/eprint/439714
PURE UUID: c1d72fe7-292c-41b5-8cb8-2f2f67c2a787
ORCID for Martin Feelisch: ORCID iD orcid.org/0000-0003-2320-1158

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Date deposited: 30 Apr 2020 16:31
Last modified: 10 Jan 2022 02:58

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Contributors

Author: Richard B. Weller
Author: Yuedong Wang
Author: Jingyi He
Author: Franklin W Maddux
Author: Len Usvyat
Author: Hanjie Zhang
Author: Martin Feelisch ORCID iD
Author: Peter Kotanko

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