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Murtas R, Russo AG. Effects of pollution, low temperature and influenza syndrome on the excess mortality risk in winter 2016-2017. BMC Public Health 2019; 19:1445. [PMID: 31684915 PMCID: PMC6829994 DOI: 10.1186/s12889-019-7788-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 10/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the winter of 2016-2017, the number of deaths recorded in the north-west Europe was significantly higher than that in previous years. This spike in mortality was attributed principally to an influenza epidemic, but the contribution of air pollution and cold temperature has not been investigated. Information on the combined effect of low temperatures, influenza epidemic, and air pollution on mortality is inadequate. The objective of this study was to estimate the excess mortality in the winter of 2016-2017 in the metropolitan area of Milan, and to evaluate the independent short-term effect of 3 risk factors: low temperatures, the influenza epidemic, and air pollution. METHODS We used a case-crossover, time-stratified study design. Mortality data were collected on all people aged > 65 years who died of natural causes, due to respiratory diseases or cardiovascular diseases, between December 1, 2016 and February 15, 2017. Environmental data were extracted from the Regional Environmental Protection Agency. The National Surveillance Network provided data on influenza epidemic. RESULTS Among the 7590 natural deaths in people aged > 65 years, 965 (13%) were caused by respiratory conditions, and 2688 (35%) were caused by cardiovascular conditions. There were statistically significant associations between the minimum recorded temperature and deaths due to natural causes (OR = 0.966, 95% CI: 0.944-0.989), and cardiovascular conditions (OR = 0.961, 95% CI: 0.925-0.999). There were also statistically significant association between the influenza epidemic and deaths due to natural causes (OR = 1.198, 95% CI: 1.156-1.241), cardiovascular conditions (OR = 1.153, 95% CI: 1.088-1.223), and respiratory conditions (OR = 1.303, 95% CI: 1.166-1.456). High levels of PM10 (60 and 70 μg/m3) were associated with a statistically significant increase in natural and cause-specific mortality. There were statistically significant interactions between PM10 and influenza for cardiovascular-related mortality, and between influenza and temperature for deaths due to natural causes. CONCLUSIONS Excess of mortality in Milan during winter 2016-2017 was associated with influenza epidemic and concomitant environmental exposures, specifically, the combined effect of air pollution and low temperatures. Policies mitigating the effects of environmental risk factors should be implemented to prevent future excess mortality.
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Affiliation(s)
- Rossella Murtas
- Epidemiology Unit, Agency for Health Protection (ATS) of Milan, Corso Italia 19 -, 20122, Milan, Italy
| | - Antonio Giampiero Russo
- Epidemiology Unit, Agency for Health Protection (ATS) of Milan, Corso Italia 19 -, 20122, Milan, Italy.
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Mohammad MA, Koul S, Rylance R, Fröbert O, Alfredsson J, Sahlén A, Witt N, Jernberg T, Muller J, Erlinge D. Association of Weather With Day-to-Day Incidence of Myocardial Infarction: A SWEDEHEART Nationwide Observational Study. JAMA Cardiol 2019; 3:1081-1089. [PMID: 30422202 DOI: 10.1001/jamacardio.2018.3466] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Importance Whether certain weather conditions modulate the onset of myocardial infarction (MI) is of great interest to clinicians because it could be used to prevent MIs as well as guide allocation of health care resources. Objective To determine if weather is associated with day-to-day incidence of MI. Design, Setting, and Participants In this prospective, population-based and nationwide setting, daily weather data from the Swedish Meteorological and Hydrological Institute were extracted for all MIs reported to the Swedish nationwide coronary care unit registry, Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART), during 1998 to 2013 and then merged with each MI on date of symptom onset and coronary care unit. All patients admitted to any coronary care unit in Sweden owing to MI were included. A total of 280 873 patients were included, of whom 92 044 were diagnosed as having ST-elevation MI. Weather data were available for 274 029 patients (97.6%), which composed the final study population. Data were analyzed between February 2017 and April 2018. Exposures The nationwide daily mean air temperature, minimum air temperature, maximum air temperature, wind velocity, sunshine duration, atmospheric air pressure, air humidity, snow precipitation, rain precipitation, and change in air temperature. Main Outcomes and Measures The nationwide daily counts of MI as outcome. Results In 274 029 patients, mean (SD) age was 71.7 (12) years. Incidence of MI increased with lower air temperature, lower atmospheric air pressure, higher wind velocity, and shorter sunshine duration. The most pronounced association was observed for air temperature, where a 1-SD increase in air temperature (7.4°C) was associated with a 2.8% reduction in risk of MI (unadjusted incidence ratio, 0.972; 95% CI, 0.967-0.977; P <.001). Results were consistent for non-ST-elevation MI as well as ST-elevation MI and across a large range of subgroups and health care regions. Conclusions and Relevance In this large, nationwide study, low air temperature, low atmospheric air pressure, high wind velocity, and shorter sunshine duration were associated with risk of MI with the most evident association observed for air temperature.
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Affiliation(s)
- Moman A Mohammad
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Sasha Koul
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Rebecca Rylance
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Ole Fröbert
- Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden
| | - Joakim Alfredsson
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Anders Sahlén
- Karolinska Institutet, Department of Medicine Huddinge, Sweden.,National Heart Centre Singapore, 5 Hospital Drive, Singapore
| | - Nils Witt
- Department of Cardiology, Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyds University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - James Muller
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - David Erlinge
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
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53
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Onozuka D, Gasparrini A, Sera F, Hashizume M, Honda Y. Future projections of temperature-related excess out-of-hospital cardiac arrest under climate change scenarios in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 682:333-339. [PMID: 31125746 DOI: 10.1016/j.scitotenv.2019.05.196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/29/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Recent studies have reported associations between global climate change and mortality. However, future projections of temperature-related out-of-hospital cardiac arrest (OHCA) have not been thoroughly evaluated. Thus, we aimed to project temperature-related morbidity for OHCA concomitant with climate change. METHODS We collected national registry data on all OHCA cases reported in 2005-2015 from all 47 Japanese prefectures. We used a two-stage time series analysis to estimate temperature-OHCA relationships. Time series of current and future daily mean temperature variations were constructed according to four climate change scenarios of representative concentration pathways (RCPs) using five general circulation models. We projected excess morbidity for heat and cold and the net change in 1990-2099 for each climate change scenario using the assumption of no adaptation or population changes. RESULTS During the study period, 739,717 OHCAs of presumed cardiac origin were reported. Net decreases in temperature-related excess morbidity were observed under higher emission scenarios. The net change in 2090-2099 compared with 2010-2019 was -0.8% (95% empirical confidence interval [eCI]: -1.9, 0.1) for a mild emission scenario (RCP2.6), -2.6% (95% eCI: -4.4, -0.8) for a stabilization scenario (RCP4.5), -3.4% (95% eCI: -5.7, -1.0) for a stabilization scenario (RCP6.0), and - 4.2% (95% eCI: -8.3, -0.1) for an extreme emission scenario (RCP8.5). CONCLUSIONS Our study indicates that Japan is projected to experience a substantial net reduction in OHCAs in higher-emission scenarios. The decrease in risk is limited to a specific morbidity cause, and a broader assessment within climate change scenarios should consider other direct and indirect impacts.
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Affiliation(s)
- Daisuke Onozuka
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan; Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Masahiro Hashizume
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Chu ML, Shih CY, Hsieh TC, Chen HL, Lee CW, Hsieh JC. Acute Myocardial Infarction Hospitalizations between Cold and Hot Seasons in an Island across Tropical and Subtropical Climate Zones-A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152769. [PMID: 31382497 PMCID: PMC6696291 DOI: 10.3390/ijerph16152769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/21/2019] [Accepted: 07/30/2019] [Indexed: 12/16/2022]
Abstract
We investigated the effects of cold and hot seasons on hospital admissions for acute myocardial infarction (AMI) at the junction of tropical and subtropical climate zones. The hospitalization data of 6897 AMI patients from January 1997 to December 2011 were obtained from the database of the National Health Insurance, including date of admission, gender, age, and comorbidities of hypertension, diabetes mellitus (DM), and dyslipidemia. A comparison of AMI prevalence between seasons and the association of season-related AMI occurrences with individual variables were assessed. AMI hospitalizations in the cold season (cold-season-AMIs) were significantly greater than those in the hot season (OR 1.15; 95% CI 1.10–1.21). In the subtropical region, cold-season-AMIs were strongly and significantly associated with the ≥65 years group (OR1.28; 95% CI 1.11 to 1.48). In the tropical region, cold-season-AMIs, in association with dyslipidemia relative to non-dyslipidemia, were significantly strong in the non-DM group (OR 1.45; 95% CI 1.01 to 2.09) but weak in the DM group (OR 0.74; 95% CI 0.55 to 0.99). The cold season shows increased risks for AMI, markedly among the ≥65 years cohort in the subtropical region, and among the patients diagnosed with either DM or dyslipidemia but not both in the tropical region. Age and comorbidity of metabolic dysfunction influence the season-related incidences of AMI in different climatic regions.
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Affiliation(s)
- Min-Liang Chu
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan
| | - Chiao-Yu Shih
- Department of Physical Therapy, Tzu Chi University, Hualien 97004, Taiwan
| | - Tsung-Cheng Hsieh
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan
| | - Han-Lin Chen
- General Education Center, Tzu Chi University of Science and Technology, Hualien 97004, Taiwan
| | - Chih-Wei Lee
- Department of Physical Therapy, Tzu Chi University, Hualien 97004, Taiwan.
| | - Jen-Che Hsieh
- Division of Cardiology, Tzu Chi Medical Center, Hualien Tzu Chi Medical Center, Hualien 97004, Taiwan
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Pourshaikhian M, Moghadamnia MT, Yekaninejad MS, Ghanbari A, Rashti AS, Afraz Kamachli S. The effects of meteorological variables on ambulance attendance for cardiovascular diseases in Rasht, Iran. J Therm Biol 2019; 83:150-156. [PMID: 31331513 DOI: 10.1016/j.jtherbio.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/13/2019] [Accepted: 05/05/2019] [Indexed: 11/19/2022]
Abstract
Climate change has a devastating effect on human societies, including their economic, cultural and health conditions. Our objective was to investigate the association between meteorological variables and ambulance attendance in the event of cardiovascular diseases using time-series analyses. We used a time series analysis to investigate the relationship between meteorological variables and ambulance attendance in the event of cardiovascular diseases from 2010 to 2015. To examine the effect of high temperatures on ambulance attendance, we investigated the relative risk of the daily volume of high temperature attendance, the 99th temperature percentile compared to the 75th temperature percentile. Upon examining the effect of cold temperatures on ambulance attendance, or the relative risk of the daily volume of attendance with low temperatures, the 1st temperature percentile compared to the 25th temperature percentile. In 1826 days, from March 21, 2010 to March 19, 2015, there were 7051 emergency calls for cardiovascular diseases. Significant variations were identified in the monthly (P < 0.001) and seasonal (P < 0.001) distributions. The highest seasonal incidence occurred in the winter and lowest was observed in the summer. With regard to association between cold temperature and calls for ambulance attendance in the event of cardiovascular diseases according to lag days, our findings showed a significant increase in lag 7 ((RR, 1.026; 95% CI, 1.003 to 1.050), lag 8 (RR, 1.023; 95% CI, 1.005to 1.041) and lag 9 (RR, 1.019; 95% CI, 1.002 to 1.036) respectively. These results suggest that the demand for an ambulance for cardiovascular diseases was higher in the cold weather and that humidity can increase this demand in the warm seasons.
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Affiliation(s)
- Majid Pourshaikhian
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| | - Mohammad Taghi Moghadamnia
- Department of Medical-Surgical Nursing, Nursing and Midwifery School, Guilan University of Medical Sciences, Rasht, Iran.
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Ghanbari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Saadat Rashti
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Bladder drug mirabegron exacerbates atherosclerosis through activation of brown fat-mediated lipolysis. Proc Natl Acad Sci U S A 2019; 116:10937-10942. [PMID: 31085638 DOI: 10.1073/pnas.1901655116] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Mirabegron (Myrbetriq) is a β3-adrenoreceptor agonist approved for treating overactive bladder syndrome in human patients. This drug can activate brown adipose tissue (BAT) in adult humans and rodents through the β3-adrenoreceptor-mediated sympathetic activation. However, the effect of the mirabegron, approved by the US Food and Drug Administration, on atherosclerosis-related cardiovascular disease is unknown. Here, we show that the clinical dose of mirabegron-induced BAT activation and browning of white adipose tissue (WAT) exacerbate atherosclerotic plaque development. In apolipoprotein E-/- (ApoE -/-) and low-density lipoprotein (LDL) receptor-/- (Ldlr -/-) mice, oral administration of clinically relevant doses of mirabegron markedly accelerates atherosclerotic plaque growth and instability by a mechanism of increasing plasma levels of both LDL-cholesterol and very LDL-cholesterol remnants. Stimulation of atherosclerotic plaque development by mirabegron is dependent on thermogenesis-triggered lipolysis. Genetic deletion of the critical thermogenesis-dependent protein, uncoupling protein 1, completely abrogates the mirabegron-induced atherosclerosis. Together, our findings suggest that mirabegron may trigger cardiovascular and cerebrovascular diseases in patients who suffer from atherosclerosis.
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57
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Complex effects of atmospheric parameters on acute cardiovascular diseases and major cardiovascular risk factors: data from the Cardiometeorology SM study. Sci Rep 2019; 9:6358. [PMID: 31015485 PMCID: PMC6479062 DOI: 10.1038/s41598-019-42830-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 03/11/2019] [Indexed: 12/05/2022] Open
Abstract
Several studies have examined the cardiovascular effects of atmospheric parameters as separate factors; however, few have investigated atmospheric parameters’ joint effects. We aim to explore the joint effects of atmospheric parameters on acute cardiovascular diseases (ACVDs) and on major cardiovascular risk factors (CRFs). We correlated all ACVD admissions with major CRFs and local atmospheric conditions during a 5-year study period. A seasonal variation was detected in a higher incidence rate during cold atmospheric conditions. There were significant incidence relative ratios, including: 1.140 (95% CI [1.020, 1.283]) for daily temperature change (≥5 °C); 0.991 (95% CI [0.988, 0.994]) for average daily temperature; and 1.290 (95% CI [1.090, 1.599]) for the interaction of daily temperature change (≥5 °C) with humidity change (≥40%). We observed a significant association between the atmospheric parameters’ joint effects and hyperlipidaemia, diabetes, and previous ACVDs. Patients with diabetes had the highest significant incidence relative ratio at 2.429 (95% CI [1.088, 5.424]) for humidity-temperature interactions. Thus, the atmospheric parameters’ joint effects play an important role as minor CRFs. These unfavourable atmospheric situations are predicted to increase the number of ACVDs mainly. Our study may help to organize prevention strategies more effectively and to reduce cardiovascular risks.
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Chen TH, Du XL, Chan W, Zhang K. Impacts of cold weather on emergency hospital admission in Texas, 2004-2013. ENVIRONMENTAL RESEARCH 2019; 169:139-146. [PMID: 30453131 DOI: 10.1016/j.envres.2018.10.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 10/25/2018] [Accepted: 10/27/2018] [Indexed: 06/09/2023]
Abstract
Cold weather has been identified as a major cause of weather-related deaths in the U.S. Although the effects of cold weather on mortality has been investigated extensively, studies on how cold weather affects hospital admissions are limited particularly in the Southern United States. This study aimed to examine impacts of cold weather on emergency hospital admissions (EHA) in 12 major Texas metropolitan statistical areas (MSAs) for the 10-year period, 2004-2013. A two-stage approach was employed to examine the associations between cold weather and EHA. First, the cold effects on each MSA were estimated using distributed lag non-linear models (DLNM). Then a random effects meta-analysis was applied to estimate pooled effects across all 12 MSAs. Percent increase in risk and corresponding 95% confidence intervals (CIs) were estimated as with a 1 °C (°C) decrease in temperature below a MSA-specific threshold for cold effects. Age-stratified and cause-specific EHA were modeled separately. The majority of the 12 Texas MSAs were associated with an increased risk in EHA ranging from 0.1% to 3.8% with a 1 ⁰C decrease below cold thresholds. The pooled effect estimate was 1.6% (95% CI: 0.9%, 2.2%) increase in all-cause EHA risk with 1 ⁰C decrease in temperature. Cold wave effects were also observed in most eastern and southern Texas MSAs. Effects of cold on all-cause EHA were highest in the very elderly (2.4%, 95% CI: 1.2%, 3.6%). Pooled estimates for cause-specific EHA association were strongest in pneumonia (3.3%, 95% CI: 2.8%, 3.9%), followed by chronic obstructive pulmonary disease (3.3%, 95% CI: 2.1%, 4.5%) and respiratory diseases (2.8%, 95% CI: 1.9%, 3.7%). Cold weather generally increases EHA risk significantly in Texas, especially in respiratory diseases, and cold effects estimates increased by elderly population (aged over 75 years). Our findings provide insight into better intervention strategy to reduce adverse health effects of cold weather among targeted vulnerable populations.
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Affiliation(s)
- Tsun-Hsuan Chen
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Xianglin L Du
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Wenyaw Chan
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kai Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Southwest Center for Occupational and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Acute and Subacute Triggers of Cardiovascular Events. Am J Cardiol 2018; 122:2157-2165. [PMID: 30309628 DOI: 10.1016/j.amjcard.2018.08.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/24/2018] [Accepted: 08/28/2018] [Indexed: 11/23/2022]
Abstract
Inability to predict short-term cardiovascular (CV) events and take immediate preemptive actions has long been the Achilles heel of cardiology. However, certain triggers of these events have come to light. Although these triggers are nonspecific and are part of normal life, studying their temporal relationship with the onset of CV events provides an opportunity to alert high-risk atherosclerotic patients who may be most vulnerable to such triggers, the "vulnerable patient". Herein, we review the literature and shed light on the epidemiology and underlying pathophysiology of different triggers. We describe that certain adrenergic triggers can precipitate a CV event within minutes or hours; whereas triggers that elicit an immune or inflammatory response such as infections may tip an asymptomatic "vulnerable patient" to become symptomatic days and weeks later. In conclusion, healthcare providers should counsel high-risk CV patients (e.g., in secondary prevention clinics or those with coronary artery Calcium >75th percentile) on the topic, advise them to avoid such triggers, take protective measures once exposed, and seek emergency care immediately after becoming symptomatic after such triggers. Furthermore, clinical trials targeting triggers (prevention or intervention) are needed.
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Naddafi K, Yekaninejad MS. Association between apparent temperature and acute coronary syndrome admission in Rasht, Iran. HEART ASIA 2018; 10:e011068. [PMID: 30397414 DOI: 10.1136/heartasia-2018-011068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/13/2018] [Accepted: 09/13/2018] [Indexed: 11/04/2022]
Abstract
Objective Our objective was to assess the relations between apparent temperature and incidence of acute coronary syndrome (ACS) in Rasht, Iran. Methods We used a time-series analysis to investigate the relationship between apparent temperature and hospital admission from 2005 to 2014. Distributed lag non-linear models were used to estimate the association between ACS hospitalisation and apparent temperature. To examine the high-temperature effect on ACS hospital admission, the relative risk of ACS hospital admission associated with high temperature, the 99th percentile of temperature (34.7°C) compared with the 75th percentile of temperature (26.9°C), was calculated. To assess the cold effect on ACS hospital admission, the relative risk of ACS hospital admission associated with cold temperature, the first percentile of temperature (-0.2°C) compared with the 25th percentile of temperature (8.2°C), was evaluated. Results The cumulative effect of hot exposure on ACS admissions was statistically significant, with a relative risk of 2.04 (95% CI 1.06 to 4.16). The cumulative effect of cold temperature on ACS admissions was found to be non-significant. The highest risk of ACS admission in women was in 38°C (RR, 2.03, 95% CI 1.04 to 4.18). The effect of hot temperature on ACS admission occurred immediately (lag 0) (RR, 1.09, 95% CI 1.001 to 1.19). Conclusions The high apparent temperature is correlated with a higher ACS admission especially on the same day. These findings may have implications for developing intervention strategies to reduce and prevent temperature-related morbidity especially in the elderly.
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Ali Ardalan
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences; Institute for Environment Research, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences; Institute for Environment Research, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Liu X, Kong D, Fu J, Zhang Y, Liu Y, Zhao Y, Lian H, Zhao X, Yang J, Fan Z. Association between extreme temperature and acute myocardial infarction hospital admissions in Beijing, China: 2013-2016. PLoS One 2018; 13:e0204706. [PMID: 30332423 PMCID: PMC6192570 DOI: 10.1371/journal.pone.0204706] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022] Open
Abstract
Over the past few decades, a growing body of epidemiological studies found the effects of temperature on cardiovascular disease, including the risk for acute myocardial infarction (AMI). Our study aimed to investigate whether there is an association between extremely temperature and acute myocardial infarction hospital admission in Beijng, China. We obtained 81029 AMI cases and daily temperature data from January 1, 2013 to December 31, 2016. We employed a time series design and modeled distributed lag nonlinear model (DLNM) to analyze effects of temperature on daily AMI cases. Compared with the 10th percentile temperature measured by daily mean temperature (Tmean), daily minimum temperature (Tmin) and daily minimum apparent temperature (ATmin), the cumulative relative risks (CRR) at 1st percentile of Tmean, Tmin and ATmin for AMI hospitalization were 1.15(95% CI: 1.02, 1.30), 1.24(95% CI: 1.11, 1.38) and 1.41(95% CI: 1.18, 1.68), respectively. Moderate low temperature (10th vs 25th) also had adverse impact on AMI events. The susceptive groups were males and people 65 years and older. No associations were found between high temperature and AMI risk. The main limitation of the study is temperature exposure was not individualized. These findings on cold-associated AMI hospitalization helps characterize the public health burden of cold and target interventions to reduce temperature induced AMI occurrence.
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Affiliation(s)
- Xiaole Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Dehui Kong
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yongqiao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Lian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyi Zhao
- Department of Physical Medicine and Rehabilitation, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail:
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Lam HCY, Chan JCN, Luk AOY, Chan EYY, Goggins WB. Short-term association between ambient temperature and acute myocardial infarction hospitalizations for diabetes mellitus patients: A time series study. PLoS Med 2018; 15:e1002612. [PMID: 30016318 PMCID: PMC6049878 DOI: 10.1371/journal.pmed.1002612] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/14/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is the leading cause of death among people with diabetes mellitus (DM) and has been found to occur more frequently with extreme temperatures. With the increasing prevalence of DM and the rising global mean temperature, the number of heat-related AMI cases among DM patients may increase. This study compares excess risk of AMI during periods of extreme temperatures between patients with DM and without DM. METHODS Distributed lag nonlinear models (DLNMs) were used to estimate the short-term association between daily mean temperature and AMI admissions (International Classification of Diseases 9th revision [ICD-9] code: 410.00-410.99), stratified by DM status (ICD-9: 250.00-250.99), to all public hospitals in Hong Kong from 2002 to 2011, adjusting for other meteorological variables and air pollutants. Analyses were also stratified by season, age group, gender, and admission type (first admissions and readmissions). The admissions data and meteorological data were obtained from the Hong Kong Hospital Authority (HA) and the Hong Kong Observatory (HKO). FINDINGS A total of 53,769 AMI admissions were included in the study. AMI admissions among DM patients were linearly and negatively associated with temperature in the cold season (cumulative relative risk [cumRR] [95% confidence interval] in lag 0-22 days (12 °C versus 24 °C) = 2.10 [1.62-2.72]), while those among patients without DM only started increasing when temperatures dropped below 22 °C with a weaker association (cumRR = 1.43 [1.21-1.69]). In the hot season, AMI hospitalizations among DM patients started increasing when the temperature dropped below or rose above 28.8 °C (cumRR in lag 0-4 days [30.4 versus 28.8 °C] = 1.14 [1.00-1.31]), while those among patients without DM showed no association with temperature. The differences in sensitivity to temperature between patients with DM and without DM were most apparent in the group <75 years old and among first-admission cases in the cold season. The main limitation of this study was the unavailability of data on individual exposure to ambient temperature. CONCLUSIONS DM patients had a higher increased risk of AMI admissions than non-DM patients during extreme temperatures. AMI admissions risks among DM patients rise sharply in both high and low temperatures, with a stronger effect in low temperatures, while AMI risk among non-DM patients only increased mildly in low temperatures. Targeted health protection guidelines should be provided to warn DM patients and physicians about the dangers of extreme temperatures. Further studies to project the impacts of AMI risks on DM patients by climate change are warranted.
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Affiliation(s)
- Holly Ching Yu Lam
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - Juliana Chung Ngor Chan
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - Andrea On Yan Luk
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - Emily Ying Yang Chan
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
- * E-mail:
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63
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The Relationship Between Laoshan Winds and Respiratory and Cardiovascular Diseases in Hengchun Peninsula, Taiwan. HEALTH SCOPE 2018. [DOI: 10.5812/jhealthscope.80346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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64
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Odhiambo Sewe M, Bunker A, Ingole V, Egondi T, Oudin Åström D, Hondula DM, Rocklöv J, Schumann B. Estimated Effect of Temperature on Years of Life Lost: A Retrospective Time-Series Study of Low-, Middle-, and High-Income Regions. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:017004. [PMID: 29342452 PMCID: PMC6014689 DOI: 10.1289/ehp1745] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 05/16/2023]
Abstract
BACKGROUND Numerous studies have reported a strong association between temperature and mortality. Additional insights can be gained from investigating the effects of temperature on years of life lost (YLL), considering the life expectancy at the time of death. OBJECTIVES The goal of this work was to assess the association between temperature and YLL at seven low-, middle-, and high-income sites. METHODS We obtained meteorological and population data for at least nine years from four Health and Demographic Surveillance Sites in Kenya (western Kenya, Nairobi), Burkina Faso (Nouna), and India (Vadu), as well as data from cities in the United States (Philadelphia, Phoenix) and Sweden (Stockholm). A distributed lag nonlinear model was used to estimate the association of daily maximum temperature and daily YLL, lagged 0-14 d. The reference value was set for each site at the temperature with the lowest YLL. RESULTS Generally, YLL increased with higher temperature, starting day 0. In Nouna, the hottest location, with a minimum YLL temperature at the first percentile, YLL increased consistently with higher temperatures. In Vadu, YLL increased in association with heat, whereas in Nairobi, YLL increased in association with both low and high temperatures. Associations with cold and heat were evident for Phoenix (stronger for heat), Stockholm, and Philadelphia (both stronger for cold). Patterns of associations with mortality were generally similar to those with YLL. CONCLUSIONS Both high and low temperatures are associated with YLL in high-, middle-, and low-income countries. Policy guidance and health adaptation measures might be improved with more comprehensive indicators of the health burden of high and low temperatures such as YLL. https://doi.org/10.1289/EHP1745.
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Affiliation(s)
- Maquins Odhiambo Sewe
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
- KEMRI Centre for Global Health Research , Kisumu, Kenya
- Graduate School in Population Dynamics and Public Policy , Umeå University , Umeå, Sweden
| | - Aditi Bunker
- Network Aging Research, University of Heidelberg , Heidelberg, Germany
- Heidelberg Institute of Public Health , University of Heidelberg , Heidelberg, Germany
- Centre de Recherche en Santé de Nouna , Nouna, Burkina Faso
| | - Vijendra Ingole
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
- Graduate School in Population Dynamics and Public Policy , Umeå University , Umeå, Sweden
- Vadu Rural Health Program, KEM Hospital Research Centre , Pune, India
| | - Thaddaeus Egondi
- African Population and Health Research Center , Nairobi, Kenya
- Center for Research in Therapeutic Sciences (CREATES) , Strathmore University , Nairobi, Kenya
| | - Daniel Oudin Åström
- Department of Clinical Science, Center for Primary Health Care Research, Lund University , Malmö , Sweden
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University , Umeå , Sweden
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona USA
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
| | - Barbara Schumann
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University , Umeå, Sweden
- Centre for Demographic and Ageing Research , Umeå University , Umeå, Sweden
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65
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Luo Y, Li H, Huang F, Van Halm-Lutterodt N, Wang A, Guo J, Tao L, Li X, Liu M, Zheng D, Chen S, Zhang F, Yang X, Tan P, Wang W, Xie X, Guo X. The cold effect of ambient temperature on ischemic and hemorrhagic stroke hospital admissions: A large database study in Beijing, China between years 2013 and 2014-Utilizing a distributed lag non-linear analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 232:90-96. [PMID: 28941717 DOI: 10.1016/j.envpol.2017.09.021] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/02/2017] [Accepted: 09/07/2017] [Indexed: 05/03/2023]
Abstract
The effects of ambient temperature on stroke death in China have been well addressed. However, few studies are focused on the attributable burden for the incident of different types of stroke due to ambient temperature, especially in Beijing, China. We purpose to assess the influence of ambient temperature on hospital stroke admissions in Beijing, China. Data on daily temperature, air pollution, and relative humidity measurements and stroke admissions in Beijing were obtained between 2013 and 2014. Distributed lag non-linear model was employed to determine the association between daily ambient temperature and stroke admissions. Relative risk (RR) with 95% confidence interval (CI) and Attribution fraction (AF) with 95% CI were calculated based on stroke subtype, gender and age group. A total number of 147, 624 stroke admitted cases (including hemorrhagic and ischemic types of stroke) were documented. A non-linear acute effect of cold temperature on ischemic and hemorrhagic stroke hospital admissions was evaluated. Compared with the 25th percentile of temperature (1.2 °C), the cumulative RR of extreme cold temperature (first percentile of temperature, -9.6 °C) was 1.51 (95% CI: 1.08-2.10) over lag 0-14 days for ischemic type and 1.28 (95% CI: 1.03-1.59) for hemorrhagic stroke over lag 0-3 days. Overall, 1.57% (95% CI: 0.06%-2.88%) of ischemic stroke and 1.90% (95% CI: 0.40%-3.41%) of hemorrhagic stroke was attributed to the extreme cold temperature over lag 0-7 days and lag 0-3 days, respectively. The cold temperature's impact on stroke admissions was found to be more obvious in male gender and the youth compared to female gender and the elderly. Exposure to extreme cold temperature is associated with increasing both ischemic and hemorrhagic stroke admissions in Beijing, China.
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Affiliation(s)
- Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Fangfang Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Medical School, Henan University of Science and Technology, China
| | | | - Anxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Jin Guo
- Greenwood Medical Company, Australia
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Australia
| | - Mengyang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Sipeng Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Feng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xinghua Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Peng Tan
- Beijing Public Health Information Center, Beijing, China
| | - Wei Wang
- Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Joondalup WA6027, Australia
| | - Xueqin Xie
- Beijing Public Health Information Center, Beijing, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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66
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Ravljen M, Hovelja T, Vavpotič D. Immediate, lag and time window effects of meteorological factors on ST-elevation myocardial infarction incidence. Chronobiol Int 2017; 35:63-71. [DOI: 10.1080/07420528.2017.1381847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Mirjam Ravljen
- Nursing Department, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Tomaž Hovelja
- Information Systems Laboratory, Faculty of Computer and Information, University of Ljubljana, Ljubljana, Slovenia
| | - Damjan Vavpotič
- Information Systems Laboratory, Faculty of Computer and Information, University of Ljubljana, Ljubljana, Slovenia
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67
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Bai L, Li Q, Wang J, Lavigne E, Gasparrini A, Copes R, Yagouti A, Burnett RT, Goldberg MS, Cakmak S, Chen H. Increased coronary heart disease and stroke hospitalisations from ambient temperatures in Ontario. Heart 2017; 104:673-679. [PMID: 29101264 PMCID: PMC5890650 DOI: 10.1136/heartjnl-2017-311821] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/14/2017] [Accepted: 09/18/2017] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To assess the associations between ambient temperatures and hospitalisations for coronary heart disease (CHD) and stroke. METHODS Our study comprised all residents living in Ontario, Canada, 1996-2013. For each of 14 health regions, we fitted a distributed lag non-linear model to estimate the cold and heat effects on hospitalisations from CHD, acute myocardial infarction (AMI), stroke and ischaemic stroke, respectively. These effects were pooled using a multivariate meta-analysis. We computed attributable hospitalisations for cold and heat, defined as temperatures above and below the optimum temperature (corresponding to the temperature of minimum morbidity) and for moderate and extreme temperatures, defined using cut-offs at the 2.5th and 97.5th temperature percentiles. RESULTS Between 1996 and 2013, we identified 1.4 million hospitalisations from CHD and 355 837 from stroke across Ontario. On cold days with temperature corresponding to the 1st percentile of temperature distribution, we found a 9% increase in daily hospitalisations for CHD (95% CI 1% to 16%), 29% increase for AMI (95% CI 15% to 45%) and 11% increase for stroke (95% CI 1% to 22%) relative to days with an optimal temperature. High temperatures (the 99th percentile) also increased CHD hospitalisations by 6% (95% CI 1% to 11%) relative to the optimal temperature. These estimates translate into 2.49% of CHD hospitalisations attributable to cold and 1.20% from heat. Additionally, 1.71% of stroke hospitalisations were attributable to cold. Importantly, moderate temperatures, rather than extreme temperatures, yielded the most of the cardiovascular burdens from temperatures. CONCLUSIONS Ambient temperatures, especially in moderate ranges, may be an important risk factor for cardiovascular-related hospitalisations.
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Affiliation(s)
- Li Bai
- Public Health Ontario, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | | | - Jun Wang
- Public Health Ontario, Toronto, Canada
| | - Eric Lavigne
- Division of Air Health Science, Health Canada, Ottawa, Ontario, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Ray Copes
- Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Sabit Cakmak
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada
| | - Hong Chen
- Public Health Ontario, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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68
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Wichmann HE. Epidemiology in Germany-general development and personal experience. Eur J Epidemiol 2017; 32:635-656. [PMID: 28815360 DOI: 10.1007/s10654-017-0290-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/27/2017] [Indexed: 12/19/2022]
Abstract
Did you ever hear about epidemiology in Germany? Starting from an epidemiological desert the discipline has grown remarkably, especially during the last 10-15 years: research institutes have been established, research funding has improved, multiple curriculae in Epidemiology and Public Health are offered. This increase has been quite steep, and now the epidemiological infrastructure is much better. Several medium-sized and even big population cohorts are ongoing, and the number and quality of publications from German epidemiologists has reached a respectable level. My own career in epidemiology started in the field of environmental health. After German reunification I concentrated for many years on environmental problems in East Germany and observed the health benefits after improvement of the situation. Later, I concentrated on population-based cohorts in newborns (GINI/LISA) and adults (KORA, German National Cohort), and on biobanking. This Essay describes the development in Germany after worldwar 2, illustrated by examples of research results and build-up of epidemiological infractructures worth mentioning.
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Affiliation(s)
- Heinz-Erich Wichmann
- Institute of Epidemiology, 2, Helmholtz Center Munich, Munich, Germany. .,Chair of Epidemiology, University of Munich, Munich, Germany.
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69
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Borner A, Murray K, Trotter C, Pearson J. Baseline aortic pulse wave velocity is associated with central and peripheral pressor responses during the cold pressor test in healthy subjects. Physiol Rep 2017; 5:5/14/e13357. [PMID: 28733312 PMCID: PMC5532490 DOI: 10.14814/phy2.13357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 06/20/2017] [Indexed: 11/24/2022] Open
Abstract
Cold environmental temperatures increase sympathetic nerve activity and blood pressure, and increase the risk of acute cardiovascular events in aged individuals. The acute risk of cardiovascular events increases with aortic pulse wave velocity as well as elevated central and peripheral pulse pressures. The aim of this study was to examine the independent influence of aortic pulse wave velocity upon central and peripheral pressor responses to sympathetic activation via the cold pressor test (CPT). Twenty‐two healthy subjects (age: 18–73 years) completed a CPT with the left hand immersed in 2–4°C water for 3 min. During the CPT, central (from: 36 ± 7 to: 51 ± 12 mmHg) and peripheral pulse pressure increased (from: 54 ± 7 to: 66 ± 11; both P < 0.05). In all subjects the increase in central pulse pressure during the CPT was independently associated with baseline aortic pulse wave velocity (r2 = 0.221, P = 0.027) but not age (P > 0.05). In a subset of subjects with higher arterial stiffness, the increase in peripheral pulse pressure during the CPT was independently associated with baseline aortic pulse wave velocity (r2 = 0.415, P = 0.032) but not age (P > 0.05). These data indicate that central and peripheral pulse pressure responses during sympathetic activation are positively and independently associated with aortic pulse wave velocity through a wide age range. Decreasing aortic pulse wave velocity in aged individuals with elevated arterial stiffness may help reduce the incidence of acute cardiovascular events upon exposure to cold environmental temperatures.
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Affiliation(s)
- Anastasiya Borner
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado
| | - Kyle Murray
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado
| | - Claire Trotter
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado
| | - James Pearson
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado
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Mohammadi R, Khodakarim S, Alipour A, Bitaraf E, Soori H. Association between Air Temperature and Acute Myocardial Infarction Hospitalizations in Tehran, Iran: A Time-Stratified Case-Crossover. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:143-152. [PMID: 28689211 PMCID: PMC6679627 DOI: 10.15171/ijoem.2017.1069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/18/2017] [Indexed: 11/24/2022]
Abstract
Background: Although the effect of temperature on the incidence of acute myocardial infarction (AMI) has been extensively documented, no study has previously investigated the association between temperature and AMI in the Middle Eastern countries. Objective: To examine the association between daily mean temperature and AMI admission rates in Tehran, Iran. Methods: Data on daily number of admissions of patients with AMI to Tehran hospitals between March 21, 2013 and March 19, 2016, were retrieved from the Iranian Myocardial Infarction Registry (IMIR). Over the same period, data on daily mean temperature and relative humidity were measured at Mehrabad International Airport weather station of the Islamic Republic of Iran Meteorological Organization. Time-stratified case-crossover design was employed to investigate the short-term association between the daily mean temperature and the number of daily admissions of patients with AMI, after adjusting for public holidays, relative humidity, and air pollution. Results: An interquartile range (IQR) increase in daily mean temperature was associated with 15.1% (95% CI 1.3 to 30.8%) and 13% (95% CI 1.9% to 25.4%) increase in the risk of AMI hospitalizations during the entire year, and in the warm months of the year, respectively. There were no significant associations between IQR increase in the two-day cumulative average up to the six-day cumulative average of the daily mean temperature and AMI during the entire year, and warm or cold months of the year. Conclusion: An increase in temperature would increase the rate of AMI hospitalization.
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Affiliation(s)
- Rasool Mohammadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Bitaraf
- IT Office, Ministry of Health & Medical Education, Tehran, Iran
| | - Hamid Soori
- Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Abstract
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment because of migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex, and their natural, social, and personal domains are highly variable because of diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such as altitude, latitude, and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment and pollution, as well as by socioeconomic status and social networks. These attributes of the social environment shape lifestyle choices that significantly modify CVD risk. An understanding of how different domains of the environment, individually and collectively, affect CVD risk could lead to a better appraisal of CVD and aid in the development of new preventive and therapeutic strategies to limit the increasingly high global burden of heart disease and stroke.
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Affiliation(s)
- Aruni Bhatnagar
- From the Diabetes and Obesity Center and the Institute of Molecular Cardiology, University of Louisville, KY.
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72
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Wu S, Yang D, Pan L, Shan J, Li H, Wei H, Wang B, Huang J, Baccarelli AA, Shima M, Deng F, Guo X. Ambient temperature and cardiovascular biomarkers in a repeated-measure study in healthy adults: A novel biomarker index approach. ENVIRONMENTAL RESEARCH 2017; 156:231-238. [PMID: 28359041 DOI: 10.1016/j.envres.2017.02.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/27/2017] [Accepted: 02/21/2017] [Indexed: 05/15/2023]
Abstract
BACKGROUND Associations of ambient temperature with cardiovascular morbidity and mortality have been well documented in numerous epidemiological studies, but the underlying pathways remain unclear. We investigated whether systemic inflammation, coagulation, systemic oxidative stress, antioxidant activity and endothelial function may be the mechanistic pathways associated with ambient temperature. METHODS Forty study participants underwent repeated blood collections for 12 times in Beijing, China in 2010-2011. Ambient temperature and air pollution data were measured in central monitors close to student residences. We created five indices as the sum of weighted biomarker percentiles to represent the overall levels of 15 cardiovascular biomarkers in five pathways (systemic inflammation: hs-CRP, TNF-α and fibrinogen; coagulation: fibrinogen, PAI-1, tPA, vWF and sP-selectin; systemic oxidative stress: Ox-LDL and sCD36: antioxidant activity: EC-SOD and GPX1; and endothelial function: ET-1, E-selectin, ICAM-1 and VCAM-1). We used generalized mixed-effects models to estimate temperature effects controlling for air pollution and other covariates. RESULTS There were significant decreasing trends in the adjusted means of biomarker indices over the lowest to the highest quartiles of daily temperatures before blood collection. A 10°C decrease at 2-d average daily temperature were associated with increases of 2.5% [95% confidence interval (CI): 0.7, 4.2], 1.6% (95% CI: 0.1, 3.1), 2.7% (95% CI: 0.5, 4.8), 5.5% (95% CI: 3.8, 7.3) and 2.0% (95% CI: 0.3, 3.8) in the indices for systemic inflammation, coagulation, systemic oxidative stress, antioxidant activity and endothelial function, respectively. In contrast, the associations between ambient temperature and individual biomarkers had substantial variation in magnitude and strength. CONCLUSIONS The altered cardiovascular biomarker profiles in healthy adults associated with ambient temperature changes may help explain the temperature-related cardiovascular morbidity and mortality. The biomarker index approach may serve as a novel tool to capture ambient temperature effects.
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Affiliation(s)
- Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Lu Pan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Jiao Shan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Hongying Wei
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Bin Wang
- Institute of Reproductive & Child Health, School of Public Health, Peking University, Beijing, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Hyogo, Japan
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, China.
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Peng C, Sanchez-Guerra M, Wilson A, Mehta AJ, Zhong J, Zanobetti A, Brennan K, Dereix AE, Coull BA, Vokonas P, Schwartz J, Baccarelli AA. Short-term effects of air temperature and mitochondrial DNA lesions within an older population. ENVIRONMENT INTERNATIONAL 2017; 103:23-29. [PMID: 28351767 PMCID: PMC5849241 DOI: 10.1016/j.envint.2017.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/15/2017] [Accepted: 03/21/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Previous studies have linked both extreme and sub-optimal air temperature to cardiopulmonary morbidity and mortality, especially in older individuals. However, the underlying mechanisms are yet to be determined. OBJECTIVES We hypothesized that short-term increases in air temperature may induce blood mitochondrial DNA (mtDNA) lesions in older individuals, which could contribute to temperature-related pathogenesis. METHODS We repeatedly measured mtDNA lesions in blood samples from 654 participants in the Normative Aging Study from 1999 to 2013 (1142 observations) by quantitative long-amplicon polymerase chain reaction assay. Hourly temperature data were obtained from the Boston Logan Airport weather station (located approximately 12km from the clinical site). We calculated 2-, 7-, and 14-day moving averages of 24-hour mean and 24-hour variability of temperature. We fit covariate-adjusted linear-mixed models accounting for repeated measures to evaluate the association between short-term increases in mean and variability of temperature with mtDNA lesions within each season. RESULTS Interquartile increases in 7- and 14-day moving averages of 24-hour mean temperature in summer were associated with a 0.17 (95% CI: 0.07, 0.27; p=0.0007) and 0.21 (95% CI: 0.10, 0.32; p=0.0001) increase in the number of mtDNA lesions per 10kb, respectively. Results were similar when we further adjusted for temperature variability. We also observed significant associations between increases in temperature variability and mtDNA lesions independent of mean air temperature. An interquartile range increase in the 7-day moving average of 24-hour standard deviation in summer was associated with a 0.19 (95% CI: 0.07, 0.31; p=0.0023) increase in the number of mtDNA lesions per 10kb. CONCLUSIONS Short-term exposure to higher mean air temperature was associated with increased mtDNA lesions in older adults, supporting the hypothesis that sub-optimal meteorological conditions may induce pathophysiological responses among susceptible populations.
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Affiliation(s)
- Cheng Peng
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Marco Sanchez-Guerra
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collin, CO, USA
| | - Amar J Mehta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jia Zhong
- Department of Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kasey Brennan
- Department of Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alexandra E Dereix
- Department of Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Pantel Vokonas
- Normative Aging Study, Veterans Affairs Boston Healthcare System, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Laboratory, Harvard Medical School, Boston, MA, USA
| | - Andrea A Baccarelli
- Department of Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
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74
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Mendes A, Papoila AL, Carreiro-Martins P, Aguiar L, Bonassi S, Caires I, Palmeiro T, Ribeiro ÁS, Neves P, Pereira C, Botelho A, Neuparth N, Teixeira JP. The Influence of Thermal Comfort on the Quality of Life of Nursing Home Residents. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2017; 80:729-739. [PMID: 28534713 DOI: 10.1080/15287394.2017.1286929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Thermal comfort (TC) parameters were measured in 130 rooms from nursing homes (NH), following ISO 7730:2005 in order to evaluate the influence of winter season TC indices on quality of life (QoL) in older individuals. Mean radiant temperature (mrT), predicted mean vote (PMV) and predicted percent of dissatisfied people (PPD) indices, and the respective measurement uncertainties were calculated using Monte Carlo Method. The WHOQOL-BREF questionnaire was conducted from September 2012 to April 2013, during the winter season TC sampling campaign. Winter PMV and PPD indices showed significant differences between seasons in median values for comfort. There were also significant differences between seasons for air temperature, air velocity, mrT, and relative humidity. The winter PMV index displayed a "slightly cool" [≤-1] to "cool" [≤-2] in thermal sensation scale [-3 to 3]. PPD index reflected this discomfort as evidenced by a high rate of predicted dissatisfied occupants (64%). The influence of winter season TC on older individual QoL results demonstrated that values of PMV above -0.7 had higher mean score of QoL (coefficient estimate: 11.13 units) compared with values of PMV below -0.7. These findings are of relevance to public health and may be useful for understanding NH indoor environment variables thus implementing preventive policies in terms of standards and guidelines for these susceptible populations.
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Affiliation(s)
- Ana Mendes
- a Environmental Health Department , National Health , Porto , Portugal
- b Institute of Public Health (ISPUP) , Porto University, EpiUnit - Epidemiology Research Unit , Porto , Portugal
| | - Ana Luísa Papoila
- c CEAUL , NOVA Medical School , Lisbon , Portugal
- d Epidemiology and Statistics Analisys Unit, Research Centre , Centro Hospitalar de Lisboa Central, EPE , Lisbon , Portugal
| | - Pedro Carreiro-Martins
- d Epidemiology and Statistics Analisys Unit, Research Centre , Centro Hospitalar de Lisboa Central, EPE , Lisbon , Portugal
- e CEDOC - Respiratory Diseases Research Group , NOVA Medical School , Lisbon , Portugal
- f Serviço de Imunoalergologia, Hospital de Dona Estefânia , Centro Hospitalar de Lisboa Central , EPE , Lisbon , Portugal
| | - Lívia Aguiar
- a Environmental Health Department , National Health , Porto , Portugal
- b Institute of Public Health (ISPUP) , Porto University, EpiUnit - Epidemiology Research Unit , Porto , Portugal
| | - Stefano Bonassi
- g Unit of Clinical and Molecular Epidemiology , IRCCS San Raffaele , Pisana , Rome , Italy
| | - Iolanda Caires
- e CEDOC - Respiratory Diseases Research Group , NOVA Medical School , Lisbon , Portugal
| | - Teresa Palmeiro
- e CEDOC - Respiratory Diseases Research Group , NOVA Medical School , Lisbon , Portugal
| | | | - Paula Neves
- a Environmental Health Department , National Health , Porto , Portugal
| | - Cristiana Pereira
- a Environmental Health Department , National Health , Porto , Portugal
- b Institute of Public Health (ISPUP) , Porto University, EpiUnit - Epidemiology Research Unit , Porto , Portugal
| | - Amália Botelho
- e CEDOC - Respiratory Diseases Research Group , NOVA Medical School , Lisbon , Portugal
| | - Nuno Neuparth
- e CEDOC - Respiratory Diseases Research Group , NOVA Medical School , Lisbon , Portugal
- f Serviço de Imunoalergologia, Hospital de Dona Estefânia , Centro Hospitalar de Lisboa Central , EPE , Lisbon , Portugal
| | - João Paulo Teixeira
- a Environmental Health Department , National Health , Porto , Portugal
- b Institute of Public Health (ISPUP) , Porto University, EpiUnit - Epidemiology Research Unit , Porto , Portugal
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75
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Song X, Wang S, Hu Y, Yue M, Zhang T, Liu Y, Tian J, Shang K. Impact of ambient temperature on morbidity and mortality: An overview of reviews. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 586:241-254. [PMID: 28187945 DOI: 10.1016/j.scitotenv.2017.01.212] [Citation(s) in RCA: 181] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/02/2017] [Accepted: 01/30/2017] [Indexed: 05/18/2023]
Abstract
The objectives were (i) to conduct an overview of systematic reviews to summarize evidence from and evaluate the methodological quality of systematic reviews assessing the impact of ambient temperature on morbidity and mortality; and (ii) to reanalyse meta-analyses of cold-induced cardiovascular morbidity in different age groups. The registration number is PROSPERO-CRD42016047179. PubMed, Embase, the Cochrane Library, Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Global Health were systematically searched to identify systematic reviews. Two reviewers independently selected studies for inclusion, extracted data, and assessed quality. The Assessment of Multiple Systematic Reviews (AMSTAR) checklist was used to assess the methodological quality of included systematic reviews. Estimates of morbidity and mortality risk in association with heat exposure, cold exposure, heatwaves, cold spells and diurnal temperature ranges (DTRs) were the primary outcomes. Twenty-eight systematic reviews were included in the overview of systematic reviews. (i) The median (interquartile range) AMSTAR scores were 7 (1.75) for quantitative reviews and 3.5 (1.75) for qualitative reviews. (ii) Heat exposure was identified to be associated with increased risk of cardiovascular, cerebrovascular and respiratory mortality, but was not found to have an impact on cardiovascular or cerebrovascular morbidity. (iii) Reanalysis of the meta-analyses indicated that cold-induced cardiovascular morbidity increased in youth and middle-age (RR=1.009, 95% CI: 1.004-1.015) as well as the elderly (RR=1.013, 95% CI: 1.007-1.018). (iv) The definitions of temperature exposure adopted by different studies included various temperature indicators and thresholds. In conclusion, heat exposure seemed to have an adverse effect on mortality and cold-induced cardiovascular morbidity increased in the elderly. Developing definitions of temperature exposure at the regional level may contribute to more accurate evaluations of the health effects of temperature.
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Affiliation(s)
- Xuping Song
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Shigong Wang
- Mountain Environment and Meteorology Key Laboratory of Education Bureau of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China; Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Yuling Hu
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Man Yue
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Tingting Zhang
- School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
| | - Yu Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Jinhui Tian
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Kezheng Shang
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
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76
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Onozuka D, Hagihara A. Spatiotemporal variation in heat-related out-of-hospital cardiac arrest during the summer in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 583:401-407. [PMID: 28117163 DOI: 10.1016/j.scitotenv.2017.01.081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/13/2017] [Accepted: 01/13/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although several studies have reported the impacts of extremely high temperature on cardiovascular diseases, few studies have investigated the spatiotemporal variation in the incidence of out-of-hospital cardiac arrest (OHCA) due to extremely high temperature in Japan. METHODS Daily OHCA data from 2005 to 2014 were acquired from all 47 prefectures of Japan. We used time-series Poisson regression analysis combined with a distributed lag non-linear model to assess the temporal variability in the effects of extremely high temperature on OHCA incidence in each prefecture, adjusted for time trends. Spatial variability in the relationships between extremely high temperature and OHCA between prefectures was estimated using a multivariate random-effects meta-analysis. RESULTS We analyzed 166,496 OHCA cases of presumed cardiac origin occurring during the summer (June to September) that met the inclusion criteria. The minimum morbidity percentile (MMP) was the 51st percentile of temperature during the summer in Japan. The overall cumulative relative risk at the 99th percentile vs. the MMP over lags 0-10days was 1.21 (95% CI: 1.12-1.31). There was also a strong low temperature effect during the summer periods. No substantial difference in spatial or temporal variability was observed over the study period. CONCLUSIONS Our study demonstrated spatiotemporal homogeneity in the risk of OHCA during periods of extremely high temperature between 2005 and 2014 in Japan. Our findings suggest that public health strategies for OHCA due to extremely high temperatures should be finely adjusted and should particularly account for the unchanging risk during the summer.
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Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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77
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Claeys MJ, Rajagopalan S, Nawrot TS, Brook RD. Climate and environmental triggers of acute myocardial infarction. Eur Heart J 2017; 38:955-960. [PMID: 27106953 DOI: 10.1093/eurheartj/ehw151] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/20/2016] [Indexed: 12/17/2022] Open
Abstract
Over the past few decades, a growing body of epidemiological and clinical evidence has led to heightened concerns about the potential short- and long-term deleterious effects of the environment on cardiovascular health, including the risk for acute myocardial infarction (AMI). This review highlights the increased risk of AMI caused by exposure to air pollution and cold temperatures. These factors should be considered modifiable risk factors in the prevention of cardiovascular disease. The current body of knowledge about the biological mechanisms linking environmental changes to atherothrombotic events and the impact of climate change on cardiovascular health are discussed. Finally, recommendations for prevention and public policy are presented.
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Affiliation(s)
- Marc J Claeys
- Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem, Belgium
| | | | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium.,Department of Public Health and Primary Care, Centre for Environment and Health, Leuven University, Leuven, Belgium
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, AnnArbor, MI, USA
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78
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Yackerson NS, Zilberman A, Aizenberg A. Influence of atmospheric states in semi-arid areas on hospital admission in cardio-surgical department. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:729-738. [PMID: 27699499 DOI: 10.1007/s00484-016-1251-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 09/10/2016] [Accepted: 09/16/2016] [Indexed: 06/06/2023]
Abstract
The influence of the changes in atmospheric state, typical for areas close to big deserts, on acute myocardial infarction (AMI) was analyzed. Under test was the group of 3256 patients (77 % males, 23 % females), hospitalized in the Cardio-Surgical Department of Soroka Medical Center at Ben-Gurion University (BGU, Israel) during 2000-2008. To explore the relationship between atmospheric parameters and AMI, multivariate regression analysis has been performed. AMI was most frequent in winter to spring and least in summer. The highest number of cases was recorded in December and the lowest in September. Hospital admissions showed a higher prevalence in men than in women; the ratio is 3.3/1.0. About 60 % of males were aged between 45 and 65 years old with maximum ∼55 (21 %), whereas 60 % of women hospital admissions were aged between 65 and 80 years old with maximum ∼72 (24 %). The result suggested that the monthly mean relative humidity at daytime and its overall daily differences, wind speed, and respirable fraction of particulate concentration are associated with the admission for AMI. The results of the study confirm the importance of atmospheric state variability for cardiovascular diseases.
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Affiliation(s)
| | - Arkadi Zilberman
- Agriecology Group, The Katif R&D Center, Ministry of Science, Sdot Negev, 842500, Netivot, Israel.
| | - Alexander Aizenberg
- Department of Family Medicine, Clalit Health Services, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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79
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Xiao MM, Pan CS, Liu YY, Ma LQ, Yan L, Fan JY, Wang CS, Huang R, Han JY. Post-treatment with Ma-Huang-Tang ameliorates cold-warm-cycles induced rat lung injury. Sci Rep 2017; 7:312. [PMID: 28331194 PMCID: PMC5428516 DOI: 10.1038/s41598-017-00459-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/27/2017] [Indexed: 01/22/2023] Open
Abstract
Frequent and drastic ambient temperature variation may cause respiratory diseases such as common cold and pneumonia, the mechanism for which is not fully understood, however, due to lack of appropriate animal models. Ma-Huang-Tang (MHT) is widely used in China for treatment of respiratory diseases. The present study aimed to investigate the effect of MHT on temperature alternation induced rat lung injury and explore underlying mechanisms. Male Sprague-Dawley rats were exposed to a cold environment for 1 h and then shifted to a warm environment for 30 min. This cold and warm alteration cycled 4 times. Rats were administrated with MHT (1.87 g/kg) by gavage 6 h after cold-warm-cycles. Cold-warm-cycles induced pulmonary microcirculatory disorders, lung edema and injury, decrease in the expression of tight junction proteins, increase in VE-cadherin activation, increase in the expression and activation of Caveolin-1, Src and NF-κB, and NADPH oxidase subunits p47phox, p40phox and p67phox membrane translocation and inflammatory cytokines production. All alterations were significantly ameliorated by post-treatment with MHT. This study showed that rats subjected to cold-warm-cycles may be used as an animal model to investigate ambient temperature variation-induced lung injury, and suggested MHT as a potential strategy to combat lung injury induced by temperature variation.
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Affiliation(s)
- Meng-Meng Xiao
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.,Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China
| | - Chun-Shui Pan
- Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China
| | - Yu-Ying Liu
- Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China
| | - Li-Qian Ma
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.,Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China
| | - Li Yan
- Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China
| | - Jing-Yu Fan
- Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China
| | - Chuan-She Wang
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.,Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China
| | - Rong Huang
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.,Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China
| | - Jing-Yan Han
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China. .,Tasly Microcirculation Research Center, Peking University Health Science Center, Beijing, 100191, China. .,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China. .,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, 100191, China.
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80
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Yamaji K, Kohsaka S, Morimoto T, Fujii K, Amano T, Uemura S, Akasaka T, Kadota K, Nakamura M, Kimura T. Relation of ST-Segment Elevation Myocardial Infarction to Daily Ambient Temperature and Air Pollutant Levels in a Japanese Nationwide Percutaneous Coronary Intervention Registry. Am J Cardiol 2017; 119:872-880. [PMID: 28089413 DOI: 10.1016/j.amjcard.2016.11.041] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
Abstract
Effects of daily fluctuation of ambient temperature and concentrations of air pollutants on acute cardiovascular events have not been well studied. From January 2011 to December 2012, a total of 56,863 consecutive ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention were registered from 929 institutes with median interinstitutional distance of 2.6 km. We constructed generalized linear mixed models in which the presence or absence of patients with STEMI per day per institute was included as a binomial response variable, with daily meteorologic and environmental data obtained from their respective observatories nearest to the institutes (median distance of 9.7 and 5.6 km) as the explanatory variables. Both lower mean temperature and increase in maximum temperature from the previous day were independently associated with the STEMI occurrence throughout the year (odds ratio [OR] 0.925, 95% confidence interval [CI] 0.915 to 0.935, per 10°C, p <0.001; and OR 1.012, 95% CI 1.009 to 1.015, per °C, p <0.001, respectively). Decrement in minimum temperature from -4 days to -3 days before the event date was marginally associated with the STEMI occurrence, only during the wintertime (OR 0.991, 95% CI 0.982 to 0.999, per °C, p = 0.03). As for the air pollutants, nitrogen oxides and suspended particle matter were not correlated with the occurrence of STEMI after adjusting for the meteorologic and livelihood variables. Both the absolute value and relative change in the ambient temperature were associated with the occurrence of STEMI; the associations with the air pollutant levels were less clear after adjustment for these meteorologic variables in Japan.
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81
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82
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Out-of-hospital cardiac arrest risk attributable to temperature in Japan. Sci Rep 2017; 7:39538. [PMID: 28045031 PMCID: PMC5206734 DOI: 10.1038/srep39538] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/24/2016] [Indexed: 02/02/2023] Open
Abstract
Several studies have estimated the associations between extreme temperatures and mortality and morbidity; however, few have investigated the attributable fraction for a wide range of temperatures on the risk of out-of-hospital cardiac arrest (OHCA). We obtained daily records of OHCA cases in the 47 Japanese prefectures between 2005 and 2014. We examined the relationship between OHCA and temperature for each prefecture using a Poisson regression model combined with a distributed lag non-linear model. The estimated prefecture-specific associations were pooled at the nationwide level using a multivariate random-effect meta-analysis. A total of 659,752 cases of OHCA of presumed-cardiac origin met the inclusion criteria. Overall, 23.93% (95% empirical confidence interval [eCI]: 20.15–26.19) of OHCA was attributable to temperature. The attributable fraction to low temperatures was 23.64% (95% eCI: 19.76–25.87), whereas that of high temperatures was 0.29% (95% eCI: 0.21–0.35). The attributable fraction for OHCA was related to moderate low temperature with an overall estimate of 21.86% (95% eCI: 18.10–24.21). Extreme temperatures were responsible for a small fraction. The majority of temperature-related OHCAs were attributable to lower temperatures. The attributable risk of extremely low and high temperatures was markedly lower than that of moderate temperatures.
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83
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Onozuka D, Hagihara A. Extreme temperature and out-of-hospital cardiac arrest in Japan: A nationwide, retrospective, observational study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 575:258-264. [PMID: 27744154 DOI: 10.1016/j.scitotenv.2016.10.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/05/2016] [Accepted: 10/07/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Although several studies have estimated the effect of extreme temperatures on out-of-hospital cardiac arrest (OHCA) in a single city or region, few have investigated variations in this association on a national level in Japan. METHODS Daily data on OHCAs and weather variations were obtained from the 47 prefectures of Japan between 2005 and 2014. A time-series Poisson regression model with a distributed lag non-linear model was used to estimate the prefecture-specific effects. A multivariate meta-analysis was applied to pooled estimates on a national level. RESULTS A total of 659,752 OHCA cases of presumed-cardiac origin met the inclusion criteria. The minimum morbidity percentile (MMP) was identified as the 84th percentile for temperature, ranging from 20.8°C in Hokkaido to 28.8°C in Okinawa. The overall pooled relative risk versus the MMP was 2.10 (95% CI: 1.84, 2.40) at extremely low temperatures (1st percentile) and 1.06 (95% CI: 1.01, 1.12) at extremely high temperatures (99th percentile). The effects of extremely high temperatures were acute and disappeared after a few days, while those of extremely low temperatures were also acute, but persisted for several days. The multivariate Cochran's Q test indicated no heterogeneity between prefectures (p=0.699; I2=1.0%). CONCLUSIONS Extreme temperatures are associated with an increased risk of OHCA. Timely prevention strategies might reduce the risk of OHCA during extreme temperatures. Several days prevention should be also implemented for extremely low temperatures.
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Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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84
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Wang Q, Li C, Guo Y, Barnett AG, Tong S, Phung D, Chu C, Dear K, Wang X, Huang C. Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 575:276-286. [PMID: 27750133 DOI: 10.1016/j.scitotenv.2016.10.019] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/23/2016] [Accepted: 10/03/2016] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Although many individual studies have examined the association between temperature and blood pressure (BP), they used different methods and also their results were somewhat inconsistent. The aims of this study are to quantitatively summarize previous studies and to systematically assess the methodological issues to make recommendations for future research. METHODS We searched relevant empirical studies published before January 2016 concerning temperature and BP among adults using the MEDLINE, Embase and PubMed databases. Mean changes in systolic (SBP) and diastolic blood pressure (DBP) per 1°C reduction in temperature were pooled using a random-effects meta-analysis. RESULTS Of 23 studies included, 14 were used for meta-analysis. Consistent, statistically significant, inverse associations were observed between ambient temperature (mean, maximum, minimum outdoor temperature and indoor temperature) and BP. An 1°C decrease in mean daily outdoor temperature was associated with an increase in SBP and DBP of 0.26mmHg (95% CI: 0.18-0.33) and 0.13 (95% CI: 0.11-0.16), respectively. The increase was greater in people with conditions related to cardiovascular disease. An 1°C decrease in indoor temperature was associated with 0.38mmHg (0.18-0.58) increase in SBP, while the effects on DBP were not estimated due to limited studies. Among the previous studies on temperature-BP relationship, temperature and BP measurements are not accurate enough and statistical methods need to be improved. CONCLUSIONS Lower ambient temperatures seem to increase adults' BP and people with conditions related to cardiovascular disease are more susceptible to drops in temperature. Indoor temperature appeared to have a stronger effect on BP than outdoor temperature. To understand temperature-BP relationship well, a study combining repeated personal temperature exposure and ambulatory BP monitoring, applying improved statistical methods to examine potential non-linear relationship is warranted.
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Affiliation(s)
- Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Changchang Li
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Yanfang Guo
- Department of Chronic Disease Prevention, Bao'an Hospital for Chronic Disease Prevention and Treatment, 99 Wenwei Road, Shenzhen 518101, China
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Dung Phung
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Cordia Chu
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Keith Dear
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu 215316, China
| | - Xuemei Wang
- School of Atmospheric Sciences, Sun Yat-sen University, 135 Xingang Xi Road, Guangzhou 510275, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia.
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85
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Vaičiulis V, Radišauskas R, Ustinavičienė R, Kalinienė G, Tamošiūnas A. Associations of morbidity and mortality from coronary heart disease with heliogeophysical factors. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:18630-18638. [PMID: 27306208 DOI: 10.1007/s11356-016-7056-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to evaluate the associations among morbidity of acute myocardial infarction (AMI) and mortality from ischemic heart disease (IHD) with heliogeophysical factors among the Kaunas population. The study population was stratified into three age categories: 25-54, 55-64, and ≥65 years. In this study, solar flares (SF), solar proton fluences (SPF), and geomagnetic activity (GMA) were employed as heliogeophysical factors and used Poisson regression and two methods of time series modeling (lag and lead). Influence of GMA in different age and sex category is uneven. The mean number of AMI events per day was greatest (23 %) among men aged 25-54 years on the third day and the same sex aged 55-64 years-increased 10 % 2 days before when the GMA intensity was A+S. Both for men and women aged ≥65 years, the highest increase in the mean number of deaths from IHD events per day was observed on the second day when the GMA intensity was A+S-51 and 34 %, respectively. Evaluating the impact of SF of 10(-5) ≤ SF < 10(-4) W/m(2) (M+X) intensity, the mean number of AMI events per day was greatest for 55-64-year-old women and men on the same and second days. Such SF were associated with a 13 and 20 % increase, respectively. Evaluating the impact of large fluence SPF, it was determined that the increase in the mean number of AMI events per day among 25-54-year-old men was greatest (30 %) 1 day, and death from IHD (54 %) was observed among women aged ≥65 years 2 days before the energy of the SPF has increased.
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Affiliation(s)
- Vidmantas Vaičiulis
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilžės str. 18, LT-50009, Kaunas, Lithuania.
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilžės str. 18, LT-50009, Kaunas, Lithuania
| | - Rūta Ustinavičienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilžės str. 18, LT-50009, Kaunas, Lithuania
| | - Gintarė Kalinienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilžės str. 18, LT-50009, Kaunas, Lithuania
| | - Abdonas Tamošiūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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86
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Pintaric S, Jelavic MM, Nesek V, Babic Z, Vrsalovic M, Knezovic M, Bielen J, Zeljkovic I, Pintaric H. The influence of air pollutants on appearance of acute myocardial infarction in the region with humid continental climate. Am J Emerg Med 2016; 34:1679-82. [DOI: 10.1016/j.ajem.2016.04.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 04/29/2016] [Accepted: 04/30/2016] [Indexed: 01/06/2023] Open
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87
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Argacha JF, Collart P, Wauters A, Kayaert P, Lochy S, Schoors D, Sonck J, de Vos T, Forton M, Brasseur O, Beauloye C, Gevaert S, Evrard P, Coppieters Y, Sinnaeve P, Claeys MJ. Air pollution and ST-elevation myocardial infarction: A case-crossover study of the Belgian STEMI registry 2009-2013. Int J Cardiol 2016; 223:300-305. [PMID: 27541680 DOI: 10.1016/j.ijcard.2016.07.191] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Previous studies have shown that air pollution particulate matter (PM) is associated with an increased risk for myocardial infarction. The effects of air pollution on the risk of ST-elevation myocardial infarction (STEMI), in particular the role of gaseous air pollutants such as NO2 and O3 and the susceptibility of specific populations, are still under debate. METHODS All patients entered in the Belgian prospective STEMI registry between 2009 and 2013 were included. Based on a validated spatial interpolation model from the Belgian Environment Agency, a national index was used to address the background level of air pollution exposure of Belgian population. A time-stratified and temperature-matched case-crossover analysis of the risk of STEMI was performed. RESULTS A total of 11,428 STEMI patients were included in the study. Each 10μg/m3 increase in PM10, PM2.5 and NO2 was associated with an increased odds ratio (ORs) of STEMI of 1.026 (CI 95%: 1.005-1.048), 1.028 (CI 95%: 1.003-1.054) and 1.051 (CI 95%: 1.018-1.084), respectively. No effect of O3 was found. STEMI was associated with PM10 exposure in patients ≥75y.o. (OR: 1.046, CI 95%: 1.002-1.092) and with NO2 in patients ≤54y.o. (OR: 1.071, CI 95%: 1.010-1.136). No effect of air pollution on cardiac arrest or in-hospital STEMI mortality was found. CONCLUSION PM2.5 and NO2 exposures incrementally increase the risk of STEMI. The risk related to PM appears to be greater in the elderly, while younger patients appear to be more susceptible to NO2 exposure.
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Affiliation(s)
- J F Argacha
- Cardiology Department, Universitair Ziekenhuis Brussel, VUB, Belgium.
| | - P Collart
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Belgium
| | - A Wauters
- Cardiology Department, Erasme Hospital, ULB, Belgium
| | - P Kayaert
- Cardiology Department, Universitair Ziekenhuis Brussel, VUB, Belgium
| | - S Lochy
- Cardiology Department, Universitair Ziekenhuis Brussel, VUB, Belgium
| | - D Schoors
- Cardiology Department, Universitair Ziekenhuis Brussel, VUB, Belgium
| | - J Sonck
- Cardiology Department, Universitair Ziekenhuis Brussel, VUB, Belgium
| | - T de Vos
- Laboratory of Environmental Research, Brussels Environment, Brussels, Belgium
| | - M Forton
- Laboratory of Environmental Research, Brussels Environment, Brussels, Belgium
| | - O Brasseur
- Laboratory of Environmental Research, Brussels Environment, Brussels, Belgium
| | - C Beauloye
- Division of Cardiology, Cliniques Universitaires Saint Luc Hospital and Pole de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium
| | - S Gevaert
- Cardiology Department, Ghent University Hospital, Gent, Belgium
| | - P Evrard
- Cardiology Department, Mont Godine Hospital, UCL, Belgium
| | - Y Coppieters
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Belgium
| | - P Sinnaeve
- Cardiology Department, Universitair Ziekenhuis Leuven, KUL, Belgium
| | - M J Claeys
- Cardiology Department, Universitair Ziekenhuis Antwerpen, UA, Belgium
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88
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Dahlquist M, Raza A, Bero-Bedada G, Hollenberg J, Lind T, Orsini N, Sjögren B, Svensson L, Ljungman PL. Short-term departures from an optimum ambient temperature are associated with increased risk of out-of-hospital cardiac arrest. Int J Hyg Environ Health 2016; 219:389-97. [DOI: 10.1016/j.ijheh.2016.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 03/18/2016] [Accepted: 03/22/2016] [Indexed: 11/27/2022]
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89
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Wu WC, Chen YT, Chen PH, Su CW, Huang WM, Yang TC, Li SY, Chen TJ, Lin HC, Lee FY, Hou MC. Low air temperature increases the risk of oesophageal variceal bleeding: a population and hospital-based case-crossover study in Taiwan. Liver Int 2016; 36:856-64. [PMID: 26235679 DOI: 10.1111/liv.12930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/23/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Studies concerning seasonal variations and the impact of air temperature on oesophageal variceal bleeding have yielded conflicting results. We aimed to explore the impact of air temperature on the occurrence of variceal bleeding. METHODS A case-crossover study design was employed, and two cohorts were used, including the NHI-EVB cohort from the National Health Insurance Research Database of Taiwan from 1 January 1999 to 31 December 2010, and the VGH-EVB cohort from the Taipei Veterans General Hospital, from 4 May 2002 to 31 December 2010. A conditional logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS In total, 2542 cases from the NHI-EVB cohort and 220 cases from the VGH-EVB cohort were analysed. Our analysis showed that low air temperature (LAT) increased the risk of variceal bleeding regardless of age, sex, decompensated cirrhosis, Child-Pugh classification, aetiology of liver disease and concomitant hepatocellular carcinoma; the lag effect was also observed. The ORs per 5°C decrease in daily mean air temperature were 1.144 (95% CI, 1.060-1.235) for the NHI-EVB cohort and 1.307 (95% CI: 1.031-1.658) for the VGH-EVB cohort. Oesophageal variceal bleeding in patients with small varices, end-stage liver disease score ≧15 or those using non-selective beta blockers was not influenced by air temperature. CONCLUSIONS Patients have higher risk of oesophageal variceal bleeding at low air temperature regardless of age, sex, aetiology of cirrhosis, Child-Pugh classification, decompensated cirrhosis and concomitant hepatocellular carcinoma and can be protected by use non-selective beta blockers.
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Affiliation(s)
- Wen-Chieh Wu
- Division of Gastroenterology, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan.,School of Medicine, National Yang-Ming University School, Taipei, Taiwan
| | - Yung-Tai Chen
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Nephrology, Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan
| | - Ping-Hsien Chen
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chien-Wei Su
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ming Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tsung-Chieh Yang
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Szu-Yuan Li
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Han-Chieh Lin
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
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90
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Short-term effects of instruction in home heating on indoor temperature and blood pressure in elderly people: a randomized controlled trial. J Hypertens 2016; 33:2338-43. [PMID: 26372318 DOI: 10.1097/hjh.0000000000000729] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Increased mortality from cardiovascular disease in winter is partly explained by increased blood pressure (BP) caused by cold exposure. For physicians, instruction in home heating is feasible option to reduce cold exposure, but the effectiveness remains unknown. OBJECTIVES To determine whether instruction in home heating increases indoor temperatures and decreases ambulatory BP among elderly people, we conducted an open-label, simply randomized, controlled trial in the winters. METHODS As an intervention, the participants were asked to set the heating device in the living room to start 1 h before estimated rising time with target temperature at 24°C, and to stay in the living room until 2 h after rising as long as possible. Repeatedly measured ambulatory BP, physical activity, and indoor temperatures until 4 h after rising were assessed using multilevel linear regression model with random intercept among individual. RESULTS A total of 359 eligible participants (mean age ± standard deviation: 71.6 ± 6.6) were randomly allocated to the control group (n = 173) and intervention group (n = 186). Intervention significantly increased living room temperature by 2.09°C (95% confidence interval 1.28-2.90), and significantly decreased SBP and DBP by 4.43/2.33 mmHg (95% confidence interval 0.97-7.88/0.08-4.58 mmHg) after adjusting for confounders including age, sex, antihypertensive medication, household income, and physical activity. DISCUSSION Short-term effect of instruction in home heating showed larger increase of indoor temperature than that of insulation intervention. Significant reduction of BPsuggests the effectiveness on preventing cardiovascular incidence in winter. CONCLUSION To summarize, instruction in heating significantly decreased BP.
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91
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Phung D, Thai PK, Guo Y, Morawska L, Rutherford S, Chu C. Ambient temperature and risk of cardiovascular hospitalization: An updated systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 550:1084-1102. [PMID: 26871555 DOI: 10.1016/j.scitotenv.2016.01.154] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 12/22/2015] [Accepted: 01/23/2016] [Indexed: 05/18/2023]
Abstract
The association between temperatures and risk of cardiovascular mortality has been recognized but the association drawn from previous meta-analysis was weak due to the lack of sufficient studies. This paper presented a review with updated reports in the literature about the risk of cardiovascular hospitalization in relation to different temperature exposures and examined the dose-response relationship of temperature-cardiovascular hospitalization by change in units of temperature, latitudes, and lag days. The pooled effect sizes were calculated for cold, heat, heatwave, and diurnal variation using random-effects meta-analysis, and the dose-response relationship of temperature-cardiovascular admission was modelled using random-effect meta-regression. The Cochrane Q-test and index of heterogeneity (I(2)) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Sixty-four studies were included in meta-analysis. The pooled results suggest that for a change in temperature condition, the risk of cardiovascular hospitalization increased 2.8% (RR, 1.028; 95% CI, 1.021-1.035) for cold exposure, 2.2% (RR, 1.022; 95% CI, 1.006-1.039) for heatwave exposure, and 0.7% (RR, 1.007; 95% CI, 1.002-1.012) for an increase in diurnal temperature. However no association was observed for heat exposure. The significant dose-response relationship of temperature - cardiovascular admission was found with cold exposure and diurnal temperature. Increase in one-day lag caused a marginal reduction in risk of cardiovascular hospitalizations for cold exposure and diurnal variation, and increase in latitude was associated with a decrease in risk of cardiovascular hospitalizations for diurnal temperature only. There is a significant short-term effect of cold exposure, heatwave and diurnal variation on cardiovascular hospitalizations. Further research is needed to understand the temperature-cardiovascular relationship for different climate areas.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health, Griffith University, Australia.
| | - Phong K Thai
- International Laboratory for Air Quality & Health, Queensland University of Technology, Australia.
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality & Health, Queensland University of Technology, Australia
| | - Shannon Rutherford
- Centre for Environment and Population Health, Griffith University, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Australia
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92
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Schneider A, Breitner S. Temperature effects on health - current findings and future implications. EBioMedicine 2016; 6:29-30. [PMID: 27211545 PMCID: PMC4856774 DOI: 10.1016/j.ebiom.2016.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Alexandra Schneider
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Neuherberg, Germany.
| | - Susanne Breitner
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Neuherberg, Germany
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93
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Marcus Y, Stern N. Blood Pressure Seasonality in Diabetic Patients: A Call for Attention. J Clin Hypertens (Greenwich) 2016; 18:267-9. [PMID: 26718624 PMCID: PMC8031866 DOI: 10.1111/jch.12744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yonit Marcus
- Institute of Endocrinology, Metabolism and HypertensionTel Aviv Sourasky Medical CenterTel AvivIsrael
| | - Naftali Stern
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
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94
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Sen T, Astarcioglu MA, Asarcikli LD, Kilit C, Kafes H, Parspur A, Yaymaci M, Pinar M, Tüfekcioglu O, Amasyali B. The effects of air pollution and weather conditions on the incidence of acute myocardial infarction. Am J Emerg Med 2016; 34:449-54. [DOI: 10.1016/j.ajem.2015.11.068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022] Open
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95
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Yang C, Meng X, Chen R, Cai J, Zhao Z, Wan Y, Kan H. Long-term variations in the association between ambient temperature and daily cardiovascular mortality in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 538:524-30. [PMID: 26318688 DOI: 10.1016/j.scitotenv.2015.08.097] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/22/2015] [Accepted: 08/17/2015] [Indexed: 05/24/2023]
Abstract
OBJECTIVE The objective of this study was to explore the long-term variation in the association between ambient temperature and daily cardiovascular (CVD) mortality in Shanghai, China. MATERIALS AND METHODS We collected daily data on ambient temperature and CVD mortality from a central urban district in Shanghai, China, during the period from 1981 to 2012. We used overdispersed generalized additive Poisson regression together with a distributed lag nonlinear model to estimate potentially lagged and nonlinear effects of temperature on CVD mortality after controlling for the seasonality, relative humidity, day of the week, holidays and population size. To allow for the evaluation of long-term variations in the effects, we divided the entire study period into six sub-periods (1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2012) and analyzed the effect estimates in each sub-period separately. RESULTS The association between temperature and daily CVD mortality was J-shaped with both low and high temperatures increasing the risk of CVD deaths. The effects of extremely low temperatures were delayed and persisted for two weeks, while extreme hot effects were limited to the first five days followed by a significant mortality displacement (9days). The relative risks (RRs) of extremely low, moderately low, moderately high, and extremely high temperatures comparing the 1st, 10th, 90th, and 99th percentile with the reference temperature (26°C) over the cumulative lags of 0-14days were 1.95 [95% confidence interval (CI): 1.84,2.07], 1.61 (95% CI: 1.57,1.66), 1.03 (95% CI: 1.01,1.05), and 1.14 (95% CI: 1.07,1.21). The RRs for extremely low and moderately low temperature attenuated substantially from 9.78 and 5.52 in 1981-1985 to 1.42 and 1.18 in 2006-2012, respectively, but the RRs remained almost stable for extremely high and moderately high temperatures. CONCLUSIONS This time-series study suggested that there might have been some human adaptation to low ambient temperature in Shanghai, China, over the last 3 decades.
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Affiliation(s)
- Changyuan Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Yue Wan
- Division of Environment and Health Management, Department of Science, Technology and Standards, Ministry of Environmental Protection, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
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96
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Saeki K, Obayashi K, Tone N, Kurumatani N. Daytime cold exposure and salt intake based on nocturnal urinary sodium excretion: A cross-sectional analysis of the HEIJO-KYO study. Physiol Behav 2015; 152:300-6. [PMID: 26476000 DOI: 10.1016/j.physbeh.2015.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 10/10/2015] [Accepted: 10/12/2015] [Indexed: 12/01/2022]
Abstract
Increased cardiovascular incidence in winter is partly explained by higher blood pressure due to cold exposure. Although higher salt intake induced by cold exposure has been reported in mice, the association remains unclear in humans. To investigate the association between salt intake and cold exposure in winter, a cross-sectional study was conducted among 860 elderly subjects (mean ± standard deviation: 72.0 ± 7.1 years). We determined ambient temperature at every 10 min according to indoor temperature measured in the subjects' home, outdoor temperature, and self-administered diary logging time spent outdoors. Salt intake was estimated by nocturnal sodium excretion rate of overnight urine collection. A 1°C lower daytime ambient temperature was significantly associated with a higher urinary sodium excretion rate by 0.07 mmol/h in the subsequent night independent of age, sex, body weight, alcohol intake, calcium channel blocker use, diabetes, household income, estimated glomerular filtration rate, daytime physical activity (p=0.02). After further adjustment for outdoor temperature and day length, the lowest tertile groups of ambient daytime temperature (10.1 ± 2.3°C) showed the nocturnal urinary sodium excretion rate was higher by 14.2% (7.62 vs. 6.54 mmol/h) compared with the highest tertile group (19.3 ± 1.8°C). Higher sodium excretion rate was associated with higher nighttime ambulatory blood pressure (p<0.01) and its lower nocturnal dipping (p<0.01). Significant association between higher salt intake and daytime cold exposure partly explain the mechanism of higher blood pressure in winter, and suggest that a reduction of cold exposure might be effective to decrease salt intake.
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Affiliation(s)
- Keigo Saeki
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
| | - Kenji Obayashi
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Nobuhiro Tone
- Center for Academic Industrial and Governmental Relations, Nara Medical University School of Medicine, Nara, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan
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97
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Does ambient temperature interact with air pollution to alter blood pressure? A repeated-measure study in healthy adults. J Hypertens 2015; 33:2414-21. [DOI: 10.1097/hjh.0000000000000738] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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98
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Kozlovskaya IL, Bulkina OS, Lopukhova VV, Chernova NA, Ivanova OV, Kolmakova TE, Karpov YA. [Heat and cardiovascular diseases: A review of epidemiological surveys]. TERAPEVT ARKH 2015; 87:84-90. [PMID: 26591558 DOI: 10.17116/terarkh201587984-90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The review summarizes epidemiologic data on the effects of heat on cardiovascular morbidity and mortality. Patients with heart failure and cardiac arrhythmias are most susceptible to negative heat exposure. At the same time, measures aimed at preserving the health of the population lead to a considerable reduction in losses associated with an abnormal rise in air temperature.
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Affiliation(s)
- I L Kozlovskaya
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - O S Bulkina
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - V V Lopukhova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - N A Chernova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - O V Ivanova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - T E Kolmakova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - Yu A Karpov
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
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99
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Liu B, Taioli E. Seasonal Variations of Complete Blood Count and Inflammatory Biomarkers in the US Population - Analysis of NHANES Data. PLoS One 2015; 10:e0142382. [PMID: 26544180 PMCID: PMC4636256 DOI: 10.1371/journal.pone.0142382] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 10/21/2015] [Indexed: 12/15/2022] Open
Abstract
Background Recent studies reported seasonal differences in gene expression in white blood cells, adipose tissue, and inflammatory biomarkers of the immune system. There is no data on the seasonal variations of these biomarkers in the US general population of both children and adults. Then aim of this study is to explore the seasonal trends in complete blood count (CBC), and C-reactive protein (CRP) in a large non-institutionalized US population. Methods Seven cross-sectional data collected in the National Health and Nutrition Examination Survey (NHANES) during 1999–2012 were aggregated; participants reporting recent use of prescribed steroids, chemotherapy, immunomodulators and antibiotics were excluded. Linear regression models were used to compare levels of CBC and CRP between winter-spring (November-April) and summer-fall (May-October), adjusting for demographics, personal behavioral factors, and chronic disease conditions. Results A total of 27,478 children and 36,644 adults (≥18 years) were included in the study. Levels of neutrophils, white blood cell count (WBC), and CRP were higher in winter-spring than summer-fall (p≤0.05). Red blood cell components were lower in winter-spring than in summer-fall, while the opposite was seen for platelets. Conclusions This large population-based study found notable seasonal variations in blood cell composition and inflammatory biomarkers, with a more pro-inflammatory immune system seen in winter-spring than summer-fall. The red blood cell patterns could have implications for the observed cardio-vascular seasonality.
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Affiliation(s)
- Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, and Institute for Translational Epidemiology, New York, New York, United States of America
| | - Emanuela Taioli
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, and Institute for Translational Epidemiology, New York, New York, United States of America
- * E-mail:
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100
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Schwartz BG, Qualls C, Kloner RA, Laskey WK. Relation of Total and Cardiovascular Death Rates to Climate System, Temperature, Barometric Pressure, and Respiratory Infection. Am J Cardiol 2015; 116:1290-7. [PMID: 26297511 DOI: 10.1016/j.amjcard.2015.07.050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/03/2015] [Accepted: 07/03/2015] [Indexed: 11/28/2022]
Abstract
A distinct seasonal pattern in total and cardiovascular death rates has been reported. The factors contributing to this pattern have not been fully explored. Seven locations (average total population 71,354,000) were selected where data were available including relatively warm, cold, and moderate temperatures. Over the period 2004 to 2009, there were 2,526,123 all-cause deaths, 838,264 circulatory deaths, 255,273 coronary heart disease deaths, and 135,801 ST-elevation myocardial infarction (STEMI) deaths. We used time series and multivariate regression modeling to explore the association between death rates and climatic factors (temperature, dew point, precipitation, barometric pressure), influenza levels, air pollution levels, hours of daylight, and day of week. Average seasonal patterns for all-cause and cardiovascular deaths were very similar across the 7 locations despite differences in climate. After adjusting for multiple covariates and potential confounders, there was a 0.49% increase in all-cause death rate for every 1°C decrease. In general, all-cause, circulatory, coronary heart disease and STEMI death rates increased linearly with decreasing temperatures. The temperature effect varied by location, including temperature's linear slope, cubic fit, positional shift on the temperature axis, and the presence of circulatory death increases in locally hot temperatures. The variable effect of temperature by location suggests that people acclimatize to local temperature cycles. All-cause and circulatory death rates also demonstrated sizable associations with influenza levels, dew point temperature, and barometric pressure. A greater understanding of how climate, temperature, and barometric pressure influence cardiovascular responses would enhance our understanding of circulatory and STEMI deaths.
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Affiliation(s)
- Bryan G Schwartz
- Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico; Heart Institute, Good Samaritan Hospital, Los Angeles, California.
| | - Clifford Qualls
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico; Clinical Translational Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - Robert A Kloner
- Heart Institute, Good Samaritan Hospital, Los Angeles, California; Huntington Medical Research Institute, Pasadena, California; Division of Cardiovascular Medicine, Department of Internal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Warren K Laskey
- Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
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