The study’s author, Professor Stefan Agewall from the University of Oslo in Norway, said climate change is causing average global temperatures to rise, but also extreme cold in some regions. In the summer of 2003, more than 70,000 people died across Europe due to an intense heat wave. Cold weather also led to excessive deaths and hospitalizations.
Previous studies on the cardiovascular effects of heat and cold have mainly used aggregated data, such as daily deaths in cities. However, using individual data, EXHAUSTION allows us to identify vulnerable subpopulations for protective interventions that increase resilience to future weather events
The study analyzed 2.28 million adults from five cohort studies conducted between 1994 and 2010 in Italy, Germany, the UK, Norway and Sweden. The mean age ranged from 49.7 to 71.7 years, and the proportion of women ranged from 36.0% to 54.5%, including participants with and without cardiovascular disease at baseline. Data on mortality and new-onset disease were collected through death and disease registries and follow-up surveys. Average daily air temperatures at participants’ home addresses were collected from local weather stations or estimated using temperature data modeling from weather stations.
The relationship between temperature and cardiovascular disease and death was analyzed across all participants and subgroups with specific characteristics. A time-stratified case-crossover study design was used, and for each participant, scientists compared the temperature of the day of the week on which the adverse event occurred (e.g. Monday) with the temperature of the same day of the week without the adverse event (e.g. , all remaining Mondays) within the same month. Potential confounding effects of participant characteristics and temporal trends were removed using intra-participant comparisons within the same month.
The analysis revealed an increased overall risk of death from cardiovascular disease and ischaemic heart disease in particular, as well as an increased risk of new ischemic heart disease associated with cold weather. A drop in temperature of approximately 10°C (18°F) from 5°C to -5°C (41°F to 23°F) was associated with a 19% increased risk of dying from cardiovascular disease (relative risk [RR] 1.19; 95 % confidence interval [CI] 1.04–1.36) and a 22% increased likelihood of death from ischemic heart disease (RR 1.22; 95% CI 1.07–1.38). A decrease in temperature of approximately 11°C (20°F) from 2°C to -9°C (36°F to 16°F) was associated with a 4% increased risk of new ischemic heart disease (RR 1.04); 95% CI : 1.01–1.08).
Heat was not associated with harmful effects in the entire study population. However, temperature increases from 15°C to 24°C (27°F to 43°F) were associated with 25% (RR 1.25; 95% CI 1.12–1.39) and 30% (RR 1.30; 95% CI 1.10–1.53) ) had an increased risk of death from cardiovascular disease and stroke in people with heart disease at baseline.
1. EXHAUSTION was presented by Dr. Siqi Zhang from Helmholtz Munich during the sessionLatest science in primary and secondary prevention and environmental healthon Friday, August 26.
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