Extremely hot and cold temperatures have increased the risk of death in people with cardiovascular diseases, such as ischemic heart disease (heart problems caused by narrowing of the arteries in the heart), stroke, heart failure and arrhythmia , according to a new study published today in the American Heart Association. flagship magazine Circulation.
Of the cardiovascular diseases examined in this study, heart failure was linked to the highest excess deaths from extreme hot and cold temperatures.
“The decline in cardiovascular death rates since the 1960s is a huge public health achievement, as cardiologists have identified and treated individual risk factors such as smoking, physical inactivity, type 2 diabetes, high blood pressure and others. The current challenge now is the environment and what climate change could hold for us,” said Barrak Alahmad, MD, MPH, Ph.D., a Harvard research fellow TH Chan School of Public Health at Harvard University at Boston and faculty member of the College of Public Health in Kuwait. Kuwait City University.
Researchers have explored how extreme temperatures can affect heart disease – the leading cause of death worldwide. They analyzed health data from more than 32 million cardiovascular deaths that occurred in 567 cities in 27 countries on 5 continents between 1979 and 2019. The global data comes from the Multi-Country Multi-City (MCC) Collaborative Research Network, a consortium of epidemiologists. , biostatisticians and climatologists who study the health effects of climate and related environmental stressors on mortality rates.
Climate change is associated with substantial shifts in extreme hot and cold temperatures, so the researchers looked at both in this study. For this analysis, the researchers compared cardiovascular deaths on the hottest and coldest days in each city with cardiovascular deaths on days when the temperature was optimal (the temperature associated with the lowest death rates) in the same city. .
For every 1,000 cardiovascular deaths, the researchers found that:
- Extremely hot days caused 2.2 additional deaths.
- Extreme cold days accounted for 9.1 additional deaths.
- Among the types of heart disease, the highest number of excess deaths was seen in people with heart failure (2.6 excess deaths on extreme hot days and 12.8 on extreme cold days).
“One in 100 cardiovascular deaths can be attributed to extreme temperature days, and the effects of temperature were most pronounced when looking at heart failure deaths,” said study co-author Haitham Khraishah, MD. and cardiovascular disease researcher at the University of Maryland School of Medicine and the University of Maryland Medical Center in Baltimore. “Although we don’t know the reason for this, it may be explained by the progressive nature of heart failure as a disease, making patients susceptible to the effects of temperature. This is an important finding as one in four people with heart failure are readmitted to hospital. within 30 days of discharge, and only 20% of heart failure patients survive 10 years after diagnosis.”
The researchers suggest that targeted warning systems and advice to vulnerable people may be needed to prevent cardiovascular deaths during extreme temperatures.
“We need to be aware of emerging environmental exposures. I call on professional cardiology organizations to commission scientific guidelines and statements on the intersection of temperature extremes and cardiovascular health. In such statements, we can provide more guidance to healthcare professionals, as well as identify gaps in clinical data and future research priorities,” Alahmad said.
The underrepresentation of data from South Asia, the Middle East, and Africa limits the ability to apply these results to make global estimates of the impact of temperature extremes on cardiovascular deaths.
“This study brings important insights to ongoing societal discussions regarding the relationship between climate and human health. Further work is needed to better define these relationships in a world facing global climate change in the years to come, particularly as to how these environmental changes could impact the world’s leading cause of death and illness. ‘disability, heart disease,’ said former AHA President Robert A. Harrington, MD, FAHA, who is the Arthur L. Bloomfield Professor of Medicine and chair of Stanford University’s Department of Medicine.
The other co-authors of the study are Dominic Royé, Ph.D.; Ana Maria Vicedo-Cabrera, Ph.D. ; Yuming Guo, Ph.D. ; Stefania I Papatheodorou, MD; Souzana Achilleos, Sc.D.; Fiorella Aquaotta, Ph.D. ; Ben Armstrong, Ph.D. ; Michelle L. Bell, Ph.D. ; Shih-Chun Pan, Ph.D. ; Micheline Sousa Zanotti Stagliorio Coelho, Ph.D.; Valentina Colistro, Ph.D. ; Tran Ngoc Dang, Ph.D. ; Do Van Dung, Ph.D.; Francesca K. De’Donato, Ph.D. ; Alireza Entezari, Ph.D. ; Yue-Liang Leon Guo, Ph.D. ; Masahiro Hashizume, Ph.D. ; Yasushi Honda, Ph.D. ; Jan Indermitte, Ph.D. ; Carmen Iniguez, Ph.D. ; Jouni JK Jaakkola, Ph.D. ; Ho Kim, Ph.D.; Eric Lavigne, Ph.D.; Whanhee Lee, Ph.D. ; Shanshan Li, Ph.D. ; Joana Madureira, Ph.D.; Fatemeh Mayvaneh, Ph.D. ; Hans Orru, Ph.D. ; Wing Overcenco, Ph.D. ; Martina S. Ragettli, Ph.D.; Niilo R.I. Ryti, Ph.D. ; Paulo Hilario Nascimento Saldiva, Ph.D. ; Noah Scovronick, Ph.D.; Xerxes Seposo, Ph.D. ; Francesco Sera, Ph.D. ; Susana Pereira Silva, M.Sc.; Massimo Stafoggia, Ph.D. ; Aurelio Tobias, Ph.D. ; Eric Garshick, MD; Aaron S. Bernstein, MD; Antonella Zanobetti, Ph.D. ; Joel Schwartz, Ph.D.; Antonio Gasparrini, Ph.D. ; et Petros Koutrakis, Ph.D.
This analysis was funded by the Kuwait Foundation for the Advancement of Science (KFAS).