Changes in blood pressure following the relocation of individuals to well-insulated and well-ventilated apartments building

Hypertension Research https://doi.org/10.1038/s41440-026-02673-x BRIEF COMMUNICATION Special Issue: Current evidence and perspectives for hypertension management in Asia Changes in blood pressure following the relocation of individuals to well-insulated and well-ventilated apartments building Hironori Nakagami1 Ryoichi Ohara2 Atsushi Iwamae3 ● ● 1234567890();,: 1234567890();,: Received: 11 February 2026 / Revised: 21 April 2026 / Accepted: 25 April 2026 © The Author(s) 2026. This article is published with open access Abstract To explore the effect of the indoor environment on blood pressure (BP) at home, individuals moving into newly constructed, well-insulated, and well-ventilated apartment buildings were targeted in this study. The BP of the participants was measured in February for two consecutive years before and after the participants moved. The analysis included 179 and 178 individuals with morning and evening BP measurements, respectively. No overall change in BP was observed before and after the participants moved. In the subgroup analysis, in the antihypertensive treatment group, the systolic and diastolic morning BP decreased by ~7 and 5 mmHg, respectively. In the hypertension and elderly participant groups, the systolic and diastolic BP decreased by ~4–6 mmHg and 2–4 mmHg, respectively. This reduction in BP correlated with the subjective temperature in the bedroom. These results demonstrate the impact of the indoor environment on BP control in apartments. Keywords Morning hypertension Indoor environment Apartment Digital hypertension Net zero energy house ● ● Introduction An increase in blood pressure (BP) in response to cold leads to increased mortality from cardiovascular disease in the winter [1–3]. Recently, Net Zero Energy House (ZEH) was proposed to refer to a residence that aims to achieve a net zero balance in annual primary energy consumption. This is accomplished by significantly improving the thermal insulation performance of the building envelope and introducing high-efficiency equipment systems to maintain quality of the indoor environment. However, there are few recent reports on the relationship between the indoor environment and BP. The focus of this study was individuals moving Supplementary information The online version contains supplementary material available at https://doi.org/10.1038/s41440026-02673-x. * Hironori Nakagami 1 Department of Health Development and Medicine, Graduate School of Medicine, The University of Osaka, Suita, Osaka, Japan 2 Department of Geriatric and General Medicine, Graduate School of Medicine, The University of Osaka, Suita, Osaka, Japan 3 Department of Architecture, Kindai University Faculty of Architecture, Higashi Osaka, Osaka, Japan ● ● into newly constructed, well-insulated, and well-ventilated apartment buildings. Home BP measurements were taken in February prior to relocation and one year later in February after moving. Changes attributable to the residential environment were evaluated on the basis of these BP measurements. Methods Study design This was a prospective observational study, and the study protocol was approved by the IRB of Kinki University (No. 2023-4). Participants were selected from prospective residents of apartments developed by DAIKYO or ANABUKI CONSTRUCTION with written informed consent. Measurement of vital data and collection of survey questionnaires Home BP was measured with an upper arm blood pressure monitor (HEM-7126, OMRON). The measurement period was 3 weeks in February for two consecutive years, and measurements were taken twice each after the participants woke up and before the participants went H. Nakagami et al. Graphical Abstract Changes in Blood Pressure following the relocaon of individuals to well-insulated and well-venlated apartments Building high low Standard housing Morning BP 113.9 / 75.7 mmHg Antihypertensive treated group 130.2 / 83.4 mmHg 125.7 / 80.7 mmHg Age≧ 60 years old BMI ≧ 25 122.2 / 80.6 mmHg Point of view ● ● ● Clinical relevance After the relocation to well-insulated and wellventilated apartments building, the systolic and diastolic BP significantly decreased in subgroup analysis with high BP. Future direction Improving living conditions was associated with a reduction in BP during the winter season, which supports the impact of the indoor environment on BP control. Consideration for the Asian population Climate change is accelerating in Asia as well, and improving the indoor environment is increasingly important for BP management. to bed. The questionnaire surveys on the perceived room temperature on a three-point scale: 1 = cold, 2 = slightly cold, 3 = not cold were conducted before and after the participants moved. ZEH housing moving 114.4 / 75.4 mmHg 122.9 / 78.0 mmHg 119.5 / 76.0 mmHg 123.1 / 80.8 mmHg Study endpoint The average and standard deviation (SD) values of home systolic BP (SBP) and diastolic BP (DBP) were calculated and analyzed before and after relocation. Furthermore, we conducted subgroup analyses by sex, hypertension status, antihypertensive treatment status, age, and obesity status. As a second endpoint, we examined the association between subjective changes in bedroom temperature and BP. Statistical analysis A paired t-test was performed to determine significant differences between groups (Microsoft Excel 365). Results and conclusion In this study, 185 individuals were included in the analysis (Fig. 1). We analyzed the morning and evening BP of 179 and 178 participants, respectively. The average age of the Changes in blood pressure following the relocation of individuals to well-insulated and well-ventilated. . . Fig. 1 Study design. Among the 350 households, 196 individuals were accepted, and 185 individuals were enrolled. We analyzed the morning and evening BP of 179 and 178 participants, respectively. The average age of the participants was 42.5 years, and the average BMI was 22.3. The antihypertensive medication group accounted for 9% of the participants. The morning and evening systolic hypertension groups accounted for 18 and 14% of the participants, respectively, and the morning and evening systolic hypertension groups accounted for 49% of the participants, respectively. BP blood pressure, BMI body mass index, SBP systolic blood pressure, DBP diastolic blood pressure participants was 42.5 years, with aged 60 years or older accounting for only 10% of the study population. Obese patients with a BMI of 25 or higher accounted for 11% of the participants, and the antihypertensive treatment group, in which the participants were prescribed blood pressure medication, constituted only 9%. Participants with high blood pressure with a SBP ≧125 mmHg or a DBP ≧75 mmHg accounted for 18 and 49% in the morning measurement group and 14 and 49% in the evening measurement group. As shown in Table 1, no overall changes in morning SBP or DBP were observed, although men tended to have slightly highe (...truncated)