Intervention study of home insulation retrofit and blood pressure for the prevention of cardiovascular diseases (本文)
Year: 2018
Type: dissertation
Abstract: Intervention Study of Home Insulation Retrofit and Blood Pressure for the Prevention of Cardiovascular DiseasesCardiovascular diseases (CVDs), the world's leading cause of death, cause 17.9 million deaths each year.Mortality due to CVDs rises in winter, a phenomenon known as "Excess winter mortality (EWM)".The rise is especially sharp in cold homes.EWM is partially explained by cold exposure-induced hypertension.Nevertheless, existing countermeasures for the prevention of hypertension and CVDs place emphasis only on improving lifestyle habits.While diet, physical activity, alcohol consumption, and smoking are included in existing policies, housing environment is not because the scientific evidence is insufficient.Therefore, we aim to examine the preventive effects of improving housing environment on the incidence of CVDs.In particular, this study focuses on the relationship between thermal environment inside houses and blood pressure, which is a widely used risk factor for CVDs.This dissertation consists of the 8 chapters summarized below.Chapter 1 describes the background, motivations and objectives of the study.Chapter 2 summarizes domestic and foreign policies and previous research on housing and health.Chapter 3 introduces the field surveys which became the basis of the nationwide survey in the next chapter.The results from the field surveys reveal 1) the impact of bedroom temperature on blood pressure variability in the early morning, and 2) the causal correlation between a rise in room temperature and a drop in blood pressure when subjects moved to houses with high thermal insulation.Issues associated with implementing the nationwide survey are summarized according to these results.Chapter 4 outlines the before-and-after insulation retrofit surveys conducted throughout Japan (SWH survey: Smart Wellness Housing survey).The research question, study design, intervention, and measurement items are described, and the ethical issues and online registration are summarized.Furthermore, the number of participants and baseline characteristics of participants are summarized.Chapter 5 describes findings on 1) the relationship between home blood pressure and room temperature, and 2) the sensitivity of home blood pressure to changes in room temperature, obtained in the baseline survey (before insulation retrofit).In addition, the nationwide survey was used to identify the areas with low indoor temperatures and the attributes of the residents who live in cold homes.Chapter 6 describes the results of comparative analysis between the "insulation retrofit group" and the "control group".The results were used to determine the causal relationship between a drop in blood pressure and insulation retrofit intervention.Chapter 7 shows the results of comparative analysis of health exam data between warm houses (indoor temperature ≥18°C) and cold houses (indoor temperature <18°C).A cross-sectional analysis is used to examine whether the risk of "arteriosclerosis" and "electrocardiogram abnormality", indices strongly related to CVDs, increases in cold houses.Chapter 8 summarizes the achievements of the present research.In addition, this chapter suggests the need to verify the long-term health effects of housing environment using a long-term cohort study.
Authors: ウミシオ, ワタル, Umishio, Wataru, 海塩, 渉
Language: Japanese
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7139157783