Impact of Hot and Cold Treatments on Blood Pressure
Temperature variations can affect blood pressure, with higher temperatures typically lowering blood pressure and colder temperatures raising it, but there is no strong evidence supporting hot and cold treatments as effective interventions specifically designed to manage hypertension.
Temperature Effects on Blood Pressure
- Blood pressure exhibits seasonal variation with lower levels at higher temperatures and higher levels at lower temperatures 1
- A meta-analysis showed an average blood pressure decline in summer of 5/3 mmHg (systolic/diastolic) 1
- Blood pressure changes due to temperature are larger in treated hypertensive patients and should be considered when symptoms of over-treatment appear with temperature rise, or when blood pressure increases during cold weather 1
Clinical Implications of Temperature Effects
- For patients on antihypertensive medications, physicians should consider possible downtitration of medication when blood pressure falls below the recommended goal during warmer weather, particularly if there are symptoms suggesting overtreatment 1
- Conversely, blood pressure may increase during colder weather, potentially requiring medication adjustments 1
- The International Society of Hypertension guidelines recommend reducing exposure to cold temperature as part of lifestyle modifications for hypertension management 1
Evidence for Deliberate Hot/Cold Treatments
- While temperature clearly affects blood pressure, current hypertension guidelines do not specifically recommend hot or cold treatments (such as saunas, cold plunges, contrast therapy) as interventions for blood pressure management 1
- The most recent comprehensive review of nonpharmacologic interventions for hypertension (2020) identified the DASH diet as the most effective intervention, followed by aerobic exercise, isometric training, and other lifestyle modifications, but did not identify hot/cold treatments as evidence-based interventions 2
Recommended Evidence-Based Approaches for Blood Pressure Management
- First-line therapy for hypertension is lifestyle modification, including weight loss, healthy dietary pattern with low sodium and high potassium intake, physical activity, and moderation or elimination of alcohol consumption 3
- The DASH diet has the strongest evidence for blood pressure reduction among nonpharmacologic interventions 2
- Regular aerobic and resistance exercise has been proven to reduce blood pressure effectively 4
- Moderate-intensity aerobic exercise for at least 30 minutes on 5-7 days per week or high-intensity interval training can help reduce blood pressure 1, 4
- A decrease of 5 mmHg in systolic BP with regular exercise may reduce mortality due to coronary heart disease by 9%, mortality due to stroke by 14%, and all-cause mortality by 7% 4
Practical Considerations
- While deliberate hot/cold treatments are not specifically recommended in guidelines, patients should be aware that environmental temperature affects their blood pressure readings 1
- Home blood pressure monitoring may help identify temperature-related fluctuations in blood pressure 5
- Patients should maintain consistent medication adherence despite seasonal blood pressure variations, consulting with healthcare providers before making any medication adjustments 1