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Zhou L, Wei Y, Ge Y, Li Y, Liu K, Gao Y, Song B, Li Y, Zhang D, Bo Y, Zhang J, Xu Y, Duan X. Global, regional, and national burden of stroke attributable to extreme low temperatures, 1990-2019: A global analysis. Int J Stroke 2024; 19:676-685. [PMID: 38425241 DOI: 10.1177/17474930241238636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Extreme ambient temperatures have been linked to increased risks of stroke morbidity and mortality. However, global estimates of the burden of stroke due to extreme low temperatures are not well-defined. AIMS This study aimed to determine the global burden of stroke due to extreme low temperatures and its spatiotemporal trend from 1990 to 2019. METHODS Based on the Global Burden of Disease Study 2019, we obtained global, regional, and national data on deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized rate of DALYs (ASDR) of stroke attributed to extreme low temperatures, further stratified by age, sex, and sociodemographic index (SDI). RESULTS Globally, in 2019, an estimated 474,000 stroke deaths with the corresponding ASMR (6.2 (95% uncertainty interval (UI): 4.6-7.9)) and ASDR (103.9 (95% UI: 77.0-134.5)) per 100,000 population, were attributable to extreme low temperatures. The most significant burden was observed in Central Asia, followed by Eastern Europe and East Asia. From 1990 to 2019, the global burden of stroke and its subtypes (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage) attributable to extreme low temperatures exhibited a decrease in both ASMR and ASDR. Significant decreases in stroke burden occurred in the high-SDI regions, high-income Asia Pacific, and subarachnoid hemorrhage cases. Moreover, the ASMR and ASDR increased with age and were higher in males than females. CONCLUSION The global stroke burden due to extreme low temperatures remains high despite a decreasing trend over the past three decades. The stroke burden due to extreme low temperatures was more notable for Central Asia, older people, and the male sex.
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Affiliation(s)
- Lue Zhou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yujie Wei
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yahao Ge
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yapeng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kai Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yusheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Daping Zhang
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, China
| | - Yacong Bo
- Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Junxi Zhang
- NHC Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoran Duan
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Qu C, Chen Y, Liu C, Hu Z, Zhang J, Yan L, Zhang H, Liu Y, Liu W, Cheng Q, Luo P, Liu Z. Burden of Stroke Attributable to Nonoptimal Temperature in 204 Countries and Territories: A Population-Based Study, 1990-2019. Neurology 2024; 102:e209299. [PMID: 38598742 PMCID: PMC11175652 DOI: 10.1212/wnl.0000000000209299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/30/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Stroke attributable to nonoptimal temperature needs more attention with dramatic climate change. The aim of this study was to estimate the global burden and distribution characteristics of the burden. METHODS In this ecological study, we collected data from the Climate Research Unit Gridded Time Series, the World Bank databases, and the Global Burden of Diseases study to estimate the distribution of burden. We used the joinpoint model, decomposition analysis, age-period-cohort model, panel data analysis, and health inequality analysis to assess the different types of stroke burden attributable to different climatic conditions. RESULTS The burden of stroke attributable to nonoptimal temperature continued to grow, and aging was a key factor in this increase. In 2019, 521,031 (95% uncertainty interval [UI] 402,433-663,996) deaths and 9,423,649 (95% UI 7,207,660-12,055,172) disability-adjusted life years [DALYs] attributable to stroke due to nonoptimal temperature were recorded globally. Globally, men (age-standardized mortality rate [ASMR] 7.70, 95% UI 5.80-9.73; age-standardized DALY rate [ASDR] 139.69, 95% UI 102.96-178.54 in 2019) had a heavier burden than women (ASMR 5.89, 95% UI 4.50-7.60; ASDR 96.02, 95% UI 72.62-123.85 in 2019). Central Asia (ASMR 18.12, 95% UI 13.40-24.53; ASDR 327.35, 95% UI 240.24-440.61 in 2019) had the heaviest burden at the regional level. In the national level, North Macedonia (ASMR 32.97, 95% UI 20.57-47.44 in 2019) and Mongolia (ASDR 568.54, 95% UI 242.03-1,031.14 in 2019) had the highest ASMR/ASDR, respectively. Low temperature currently contributes to the main burden (deaths 474,002, 95% UI 355,077-606,537; DALYs 8,357,198, 95% UI 6,186,217-10,801,911 attributable to low temperature vs deaths 48,030, 95% UI 5,630-104,370; DALYs 1,089,329, 95% UI 112,690-2,375,345 attributable to high temperature in 2019). However, the burden due to high temperature has increased rapidly, especially among people aged older than 10 years, and was disproportionately concentrated in low sociodemographic index (SDI) regions such as Africa. In addition, the rapid increase in the stroke burden due to high temperature in Central Asia also requires special attention. DISCUSSION This is the first study to assess the global stroke burden attributed to nonoptimal temperature. The dramatic increase in the burden due to high temperature requires special attention, especially in low-SDI countries.
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Affiliation(s)
- Chunrun Qu
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu Chen
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Liu
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhiwen Hu
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingwei Zhang
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Luzhe Yan
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hao Zhang
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yifan Liu
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wanyao Liu
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Quan Cheng
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Peng Luo
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhixiong Liu
- From the Department of Neurosurgery (C.Q., Y.C., J.Z., Q.C., Z.L.), National Clinical Research Center for Geriatric Disorders (C.Q., Y.C., J.Z., Q.C., Z.L.), Xiangya Hospital, and XiangYa School of Medicine (C.Q., Y.C., C.L., Z.H., L.Y., Y.L., W.L.), Central South University, Changsha, Hunan; Department of Neurosurgery (H.Z.), The Second Affiliated Hospital, Chongqing Medical University; and Department of Oncology (P.L.), Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Guo J, Xue T, Cao M, Han X, Pan Z, Huang D, Sun W, Mi J, Liu Y, Guan T. Ambient temperature anomalies induce electrocardiogram abnormalities: Findings from a nationwide longitudinal study. ENVIRONMENTAL RESEARCH 2024; 246:117996. [PMID: 38128602 DOI: 10.1016/j.envres.2023.117996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/02/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
Electrocardiogram (ECG) outcomes serve as early manifestations of cardiovascular functional or structural changes. While temperature fluctuation has been demonstrated to be a risk factor for cardiovascular diseases, few epidemiological studies have reported its relationship with ECG outcomes. In this study, we employed temperature anomaly (TA) as an innovative indicator of temperature fluctuation to quantify its detrimental impacts on ECG outcomes. A longitudinal study design was conducted using the repeated ECG records of the China National Stroke Screening Survey from 2013 to 2019. Only individuals undergoing at least two ECG tests were included. The daily temperature was assimilated by combining three kinds of data: in situ observations, satellite remote sensing measurements and weather research forecast simulations. We used generalized estimating equations to control for autocorrelation among repeated records and to estimate the association between TA and the risk of ECG abnormalities. We found 6837 events of ECG abnormalities in 47,286 individuals with 102,030 visits. Each unit increment of TA increased the risk of ECG abnormalities [odds ratio (OR) = 1.009, 95% confidence interval (CI): 1.001-1.017] and the risk of myocardial ischemia (OR = 1.061, 95% CI: 1.012-1.111). Hierarchic analyses presented a similar association of TA with both ECG abnormalities (OR = 1.017, 95% CI: 1.008-1.026) and myocardial ischemia (OR = 1.061, 95%CI: 1.011-1.114) in Northern China, but not in Southern China. The exposure-response relationship was estimated as a U-shaped curve centered at the TA value of zero. Sudden warming tended to increase the risk of ECG abnormalities and myocardial ischemia, and sudden cooling tended to increase the risk of atrial fibrillation. All these detrimental effects of TA could be modified by specific individual characteristics. In summary, ambient temperature fluctuation increased the risk of ECG abnormalities. This result indicated that regular ECG tests could be an early-warning measure for monitoring the adverse health effects of temperature fluctuations.
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Affiliation(s)
- Jian Guo
- State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China; Department of Cardiology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Tao Xue
- Department of Epidemiology and Biostatistics/Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, 100191, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management, Center for Environment and Health, Peking University, Beijing, 100871, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China.
| | - Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Zhaoyang Pan
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Dengmin Huang
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Wei Sun
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Jiarun Mi
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10005, China.
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Song J, Choi JY, Lee BW, Eom D, Song CH. Visualizing a Cold Stress-Specific Pulse Wave in Traditional Pulse Diagnosis ('Tight Pulse') Correlated with Vascular Changes in the Radial Artery Induced by a Cold Pressor Trial. SENSORS (BASEL, SWITZERLAND) 2024; 24:2086. [PMID: 38610298 PMCID: PMC11014190 DOI: 10.3390/s24072086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024]
Abstract
Radial pulse diagnosis is the most common method to examine the human health state in Traditional East Asian Medicine (TEAM). A cold stress-related suboptimal health state (subhealth) is often undetectable during routine medical examinations, however, it can be detected through the palpation of specific pulse waves, particularly a 'tight pulse', in TEAM. Therefore, this study examined a correlation between 'tight pulse' and vascular changes in the radial artery (RA) induced by a cold pressor trial (CPT). Twenty healthy subjects underwent sequentially control trial and CPT with room-temperature and ice-cold water, respectively, on the right forearm. The radial pulse and vascular changes were then examined on the left arm. The radial pulse scores for frequencies of 'tight pulse' with strong arterial tension increased after the CPT compared with the control trial. The pulse scores were reversely correlated with the RA thickness and volumes in ultrasonography, but not with changes in the systolic/diastolic blood pressure. The RA thickness-based vascular surface and three-dimensional images visualized a 'tight pulse' showing the vasoconstriction and bumpy-/rope-shaped vascular changes in the radial pulse diagnostic region after the CPT. These findings provide valuable insights into the potential integration of clinical radial pulse diagnosis with ultrasonography for cold-related subhealth.
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Affiliation(s)
- Jichung Song
- Department of Medical History, College of Korean Medicine, Daegu Haany University, Gyeongsan 38610, Republic of Korea;
| | - Jae Young Choi
- Department of Urology, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea;
| | - Byung-Wook Lee
- Department of Medical Classics & History, College of Korean Medicine, Dongguk University, Gyeongju 38066, Republic of Korea;
| | - Dongmyung Eom
- Department of Medical Classics, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea;
| | - Chang-Hyun Song
- Department of Anatomy and Histology, College of Korean Medicine, Daegu Haany University, Gyeongsan 38610, Republic of Korea
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Chen Z, Liu P, Xia X, Cao C, Ding Z, Li X. Low ambient temperature exposure increases the risk of ischemic stroke by promoting platelet activation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169235. [PMID: 38097078 DOI: 10.1016/j.scitotenv.2023.169235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/16/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Accumulating epidemiological evidence suggests the association between low ambient temperature exposure and the risk of ischemic stroke, but the underlying mechanisms remain unclear. OBJECTIVE Given the crucial role of platelet activation and thrombosis in ischemic stroke, this study aims to investigate the effect of ambient temperature on platelet activation through multi-center clinical data in Tianjin as well as animal experiments. METHODS From 2018 to 2020, nearly 3000 ischemic stroke patients from three stroke centers in Tianjin were included in the analysis, among them the ADP induced platelet aggregation rate was available. Meteorological data from the same period had also been collected. After controlling for confounding factors, the generalized additive mixed model (GAMM) was used to evaluate the correlation between environmental temperature and platelet aggregation rate. In further animal experiments, platelet function assessments were conducted on mice from the cold exposure group and the normal temperature group, including platelet aggregation, spreading, and clot retraction. Additionally, tail bleeding and mesentery thrombosis were also tested to monitor hemostasis and thrombosis in vivo. RESULT A nonlinear "S" shaped relationship between outdoor temperature and platelet aggregation was found. Each 1 °C decrease of mean temperature was associated with an increase of 7.77 % (95 % CI: 2.06 % - 13.48 %) in platelet aggregation. The ambient temperature is not related to other platelet parameters. Subgroup analysis found that males, people aged ≥65 years, and hypertensive individuals are more susceptible to temperature changes. Furthermore, animal experiments demonstrated that the increased CIRBP levels and subsequent activation of p-AKT/p-ERK may be one of the reasons for cold exposure induced platelets activation. CONCLUSION Both clinical data and basic research support that low ambient temperature exposure has the potential to increase platelet activation. These results provide a basis for understanding the potential mechanism of temperature variations on the pathogenesis of cerebrovascular diseases.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Chen Cao
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhongren Ding
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China; School of Pharmacy, Tianjin Medical University, China.
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China.
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Zhu S, Zhang J, Liu C, Li D, Hong Y, Zhang F. Global burden of non-optimal temperature attributable stroke: The long-term trends, population growth and aging effects. Prev Med 2024; 178:107813. [PMID: 38092330 DOI: 10.1016/j.ypmed.2023.107813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
Since the 20th century, the world has undergone climate change, population growth and population aging, which may result in alterations in the epidemiology of non-optimal temperature-associated strokes. We employed multiple methodologies and data from the global burden of disease 2019 to unveil the long-term curvilinear trends in strokes attributed to non-optimal temperature and the impact of aging and population growth on its changing epidemiology. From 1990 to 2019, the age-standardized DALYs rate (ASDR) of strokes attributable to low temperature had been decreasing, but from 2016, the continued downward trend in ASDR disappeared and began to remain stable. On the contrary, the ASDR of strokes attributable to high temperature continued to increase. The high socio-demographic index (SDI) region experienced the fastest decreased trend. The disease burden of stroke attributable to low temperature is increased by aging in 178 countries (87.25%), compared with 130 (63.73%) for high temperature. After excluding aging and population growth, the DALY rate for strokes attributed to high temperature was increasing in 87 countries and territories (42.64%). The disease burden of strokes attributed to low temperature is far greater than that of high temperature in absolute figures. However, globally, there is a significant trend toward an increase in strokes attributed to high temperature. Social development has largely offset the burden of strokes attributed to low temperature, but most regions of the world are equally affected by strokes attributed to high temperature. Simultaneously, in the framework of climate change, aging is also largely hindering stroke prevention efforts.
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Affiliation(s)
- Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Jian Zhang
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang 110004, China; Department of Neurosurgery, the Seventh Clinical College of China Medical University, Fushun 113000, China
| | - Chunlong Liu
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang 236000, China
| | - Dejia Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Yang Hong
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang 110004, China.
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
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Yang M, Yoo H, Kim SY, Kwon O, Nam MW, Pan KH, Kang MY. Occupational Risk Factors for Stroke: A Comprehensive Review. J Stroke 2023; 25:327-337. [PMID: 37813670 PMCID: PMC10574301 DOI: 10.5853/jos.2023.01011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 10/11/2023] Open
Abstract
For primary prevention, it is important for public health and clinical medicine to identify and characterize modifiable risk factors of stroke. In existing literature, the impact of occupational variables on ischemic and hemorrhagic stroke has been extensively studied. This review summarizes the available data on the significance of occupational variables in stroke. The results of this review suggest that there is sufficient evidence for the relationship between increased risk of stroke and job stress, working in extreme temperatures, long working hours, and/or shift work. The association between long working hours and occupational exposure to noise and chemicals remains inconclusive although several studies have reported this finding. This review will act as a step toward future research and provide information that may serve as a baseline for developing targeted interventions to prevent stroke in the working population.
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Affiliation(s)
- Munyoung Yang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyoungseob Yoo
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seo-Young Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ohwi Kwon
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Woo Nam
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Kwang Hyun Pan
- Department of Neurology, Anam Hospital, Korea University, Seoul, Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Liu P, Chen Z, Xia X, Wang L, Li X. Potential role of ambient temperature as a trigger for intracerebral hemorrhage: a time-stratified case-crossover study in Tianjin, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:80988-80995. [PMID: 37310604 DOI: 10.1007/s11356-023-27942-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/23/2023] [Indexed: 06/14/2023]
Abstract
The adverse effects of ambient temperature on human health are receiving increasing attention, yet evidence of its impact on intracerebral hemorrhage (ICH) onset is limited. Here, the relationship between ambient temperature and ICH was evaluated. A time-stratified case-crossover analysis was performed based on 4051 ICH patients admitted to five stroke units in Tianjin between January 2014 and December 2020. Conditional logistic regression was applied to evaluate the associations between the daily mean temperature (Tm) or daily temperature range (DTR) and ICH onset. We found a negative association between Tm and ICH onset (OR = 0.977, 95% CI 0.968-0.987) but not between DTR and ICH onset. In stratified analyses, men and individuals aged ≥ 60 years were more susceptible to low-ambient temperature effects; corresponding adjusted ORs were 0.970 (95% CI 0.956-0.983) and 0.969 (95% CI 0.957-0.982), respectively. Tm significantly affected patients with deep ICH (OR = 0.976, 95% CI 0.965-0.988), but had no effect on lobar ICH. There was also seasonal heterogeneity in the effect of Tm on ICH onset, with Tm being negatively associated with ICH onset only in the warm season (OR = 0.961, 95% CI 0.941-0.982). Results suggest that the low-ambient temperature might trigger ICH onset, especially for the male and elderly population, providing important health guidance to prevent cold exposure-induced ICH.
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Affiliation(s)
- Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China
| | - Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Tianjin, 300211, China.
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Henderson SB, McLean KE, Ding Y, Yao J, Turna NS, McVea D, Kosatsky T. Hot weather and death related to acute cocaine, opioid and amphetamine toxicity in British Columbia, Canada: a time-stratified case-crossover study. CMAJ Open 2023; 11:E569-E578. [PMID: 37369523 DOI: 10.9778/cmajo.20210291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Previous research has shown that cocaine-associated deaths occur more frequently in hot weather, which has not been described for other illicit drugs or combinations of drugs. The study objective was to evaluate the relation between temperature and risk of death related to cocaine, opioids and amphetamines in British Columbia, Canada. METHODS We extracted data on all deaths with cocaine, opioid or amphetamine toxicity recorded as an underlying or contributing cause from BC vital statistics for 1998-2017. We used a time-stratified case-crossover design to estimate the effect of temperature on the risk of death associated with acute drug toxicity during the warmer months (May through September). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for each 10°C increase in the 2-day average maximum temperature at the residential location. RESULTS We included 4913 deaths in the analyses. A 10°C increase in the 2-day average maximum temperature was associated with an OR of 1.43 (95% CI 1.11-1.86) for deaths with only cocaine toxicity recorded (n = 561), an OR of 1.15 (95% CI 0.99-1.33) for deaths with opioids only (n = 1682) and an OR of 1.11 (95% CI 0.60-2.04) for deaths with amphetamines only (n = 133). There were also elevated effects when toxicity from multiple drugs was recorded. Sensitivity analyses showed differences in the ORs by sex, by climatic region, and when the location of death was used instead of the location of residence. INTERPRETATION Increasing temperatures were associated with higher odds of death due to drug toxicity, especially for cocaine alone and combined with other drugs. Targeted interventions are necessary to prevent death associated with toxic drug use during hot weather.
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Affiliation(s)
- Sarah B Henderson
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Kathleen E McLean
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Yue Ding
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Jiayun Yao
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Nikita Saha Turna
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - David McVea
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Tom Kosatsky
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
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10
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Chen Z, Liu P, Xia X, Wang L, Li X. Temperature variability increases the onset risk of ischemic stroke: A 10-year study in Tianjin, China. Front Neurol 2023; 14:1155987. [PMID: 37122307 PMCID: PMC10140412 DOI: 10.3389/fneur.2023.1155987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Background Epidemiological evidence suggests a correlation between ambient temperature and ischemic stroke. However, evidence on the impact of daily temperature variability on the onset of ischemic stroke is lacking and limited. Objective We aimed to investigate the short-term association between temperature variability and ischemic stroke occurrence in Tianjin. Methods We performed a 10-year analysis of ischemic stroke patients hospitalized in two affiliated hospitals of Tianjin Medical University from 2011 to 2020. Daily meteorological data were collected from the Tianjin Meteorological Bureau. Temperature variability was calculated from the standard deviation (SD) of daily minimum and maximum temperatures over exposure days. A quasi-Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) was used to estimate the effect of temperature variability on daily stroke onset, while controlling for daily mean temperature, relative humidity, long-term trend and seasonality, public holiday, and day of the week. Results Temperature variability was positively associated with ischemic stroke. A 1°C increase in temperature variability at 0-1 days (TV0-1) was associated with a 4.1% (1.9-6.3%) increase of ischemic stroke onset. In a stratified analysis, men, people aged ≤65 years, and individuals with pre-existing hypertension, hyperlipidemia, hyperhomocysteinemia were more susceptible to temperature variability. Furthermore, the influence pattern of temperature variability on ischemic stroke was different in the cold season (November-April) and the warm season (May-October). Conclusion Our findings suggested that short-term temperature variability exposure could increase the risk of ischemic stroke, which may provide new insights into the impact of climate change on health.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Lin Wang
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
- *Correspondence: Xin Li,
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11
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Simić M, Stavrakis AK, Stojanović GM. Portable Heating and Temperature-Monitoring System with a Textile Heater Embroidered on the Facemask. ACS OMEGA 2022; 7:47214-47224. [PMID: 36570303 PMCID: PMC9773964 DOI: 10.1021/acsomega.2c06431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Personal heating systems are getting increasing interest because of the need to reduce the negative impact of cold weather on the health of people and animals. Heating the air before inhalation is of great importance as it can reduce the probability of various diseases. In this paper, we present a textile-based heater composed of commercial conductive threads, embroidered on an ordinary protective facemask. We also present the design and implementation details of the temperature monitoring and controlling circuit. Air temperature inside the facemask was monitored by a thermocouple placed in close proximity to the nose (nostrils). Preliminary testing revealed that the difference among temperatures in repeated heating cycles is in the range of ±1.5 °C. The response time for temperature increase from 29.9 to 40.5 °C was about 4 min, while the recovery time from 40.5 to 31.3 °C was about 4.3 min. Safety for human use and wireless data transmission to an application installed on a mobile phone are also demonstrated.
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12
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He F, Wei J, Dong Y, Liu C, Zhao K, Peng W, Lu Z, Zhang B, Xue F, Guo X, Jia X. Associations of ambient temperature with mortality for ischemic and hemorrhagic stroke and the modification effects of greenness in Shandong Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158046. [PMID: 35987239 DOI: 10.1016/j.scitotenv.2022.158046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence is scant on the relative and attributable contributions of ambient temperature on stroke subtypes mortality. Few studies have examined modification effects of multiple greenness indicators on such contributions, especially in China. We quantified the associations between ambient temperature and overall, ischemic, and hemorrhagic stroke mortality; further examined whether the associations were modified by greenness. METHODS We conducted a multicenter time-series analysis from January 1, 2013 to December 31, 2019. we adopted a distributed lag non-linear model to evaluate county-specific temperature-stroke mortality associations. We then applied a random-effects meta-analysis to pool county-specific effects. Attributable mortality was calculated for cold and heat, defined as temperatures below and above the minimum mortality temperature (MMT). Finally, We conducted a multivariate meta-regression to determine associations between greenness and stroke mortality risks for cold and heat, using normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), and enhanced vegetation index (EVI) as quantitative indicators of greenness exposure. RESULTS In the study period, 138,749 deaths from total stroke were reported: 86,873 ischemic and 51,876 hemorrhagic stroke. We observed significant W-shaped relationships between temperature and stroke mortality, with substantial differences among counties and regions. With MMT as the temperature threshold, 17.16 % (95 % empirical CI, 13.38 %-19.75 %) of overall, 20.05 % (95 % eCI, 16.46 %-22.70 %) of ischemic, and 12.55 % (95 % eCI, 5.59 %-16.24 %) of hemorrhagic stroke mortality were attributable to non-optimum temperature (combining cold and heat), more mortality was caused by cold (14.94 %; 95 % eCI, 11.57 %-17.34 %) than by heat (2.22 %; 95 % eCI, 1.54 %-2.72 %). Higher levels of NDVI, SAVI and EVI were related to mitigated effects of non-optimum temperatures-especially heat. CONCLUSIONS Exposure to non-optimum temperatures aggravated stroke mortality risks; increasing greenness could alleviate that risks. This evidence has important implications for local communities in developing adaptive strategies to minimize the health consequences of adverse temperatures.
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Affiliation(s)
- Fenfen He
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Yilin Dong
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
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Chen Z, Liu P, Xia X, Wang L, Li X. The underlying mechanisms of cold exposure-induced ischemic stroke. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 834:155514. [PMID: 35472344 DOI: 10.1016/j.scitotenv.2022.155514] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/13/2022] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
Growing evidence suggests that cold exposure is to some extent a potential risk factor for ischemic stroke. At present, although the mechanism by which cold exposure induces ischemic stroke is not fully understood, some potential mechanisms have been mentioned. First, the seasonal and temperature variability of cerebrovascular risk factors (hypertension, hyperglycemia, hyperlipidemia, atrial fibrillation) may be involved. Moreover, the activation of sympathetic nervous system and renin-angiotensin system and their downstream signaling pathways (pro-inflammatory AngII, activated platelets, and dysfunctional immune cells) are also major contributors. Finally, the influenza epidemics induced by cold weather are also influencing factors that cannot be ignored. This article is the first to systematically and comprehensively describe the underlying mechanism of cold-induced ischemic stroke, aiming to provide more preventive measures and medication guidance for stroke-susceptible individuals in cold season, and also provide support for the formulation of public health policies.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China.
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14
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Chen J, Gao Y, Jiang Y, Li H, Lv M, Duan W, Lai H, Chen R, Wang C. Low ambient temperature and temperature drop between neighbouring days and acute aortic dissection: a case-crossover study. Eur Heart J 2021; 43:228-235. [PMID: 34849712 DOI: 10.1093/eurheartj/ehab803] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/04/2021] [Accepted: 11/10/2021] [Indexed: 01/01/2023] Open
Abstract
AIMS The incidence of acute aortic dissection (AAD) has been shown to have seasonal variation, but whether this variation can be explained by non-optimum ambient temperature and temperature change between neighbouring days (TCN) is not clear. METHODS AND RESULTS We performed a time-stratified case-crossover study in the Registry of Aortic Dissection in China covering 14 tertiary hospitals in 11 cities from 2009 to 2019. A total of 8182 cases of AAD were included. Weather data at residential address were matched from nearby monitoring stations. Conditional logistic regression model and distributed lag nonlinear model were used to estimate the associations of daily temperature and TCN with AAD, adjusting for possible confounders. We observed an increase of AAD risk with lower temperature cumulated over lag 0-1 day and this association became statistically significant when daily mean temperature was below 24°C. Relative to the referent temperature (28°C), the odds ratios (ORs) of AAD onset at extremely low (-10°C) and low (1°C) temperature cumulated over lag 0-1 day were 2.84 [95% confidence interval (CI): 1.69, 4.75] and 2.36 (95% CI: 1.61, 3.47), respectively. A negative TCN was associated with increased risk of AAD. The OR of AAD cumulated over lag 0-6 days was 2.66 (95% CI: 1.76, 4.02) comparing the extremely negative TCN (-7°C) to no temperature change. In contrast, a positive TCN was associated with reduced AAD risk. CONCLUSION This study provides novel and robust evidence that low ambient temperature and temperature drop between neighbouring days were associated with increased risk of AAD onset. KEY QUESTION Incidence of acute aortic dissection (AAD) was reported to have seasonal trends, but it remains unclear whether non-optimum ambient temperature and temperature change between neighbouring days (TCN) is associated with AAD onset. KEY FINDING Daily mean temperature lower than 24°C was significantly associated with increased risk of AAD at lag 0-1 day. A negative TCN (temperature drop) was associated with increased risk of AAD, whereas a positive TCN was associated with decreased risk. TAKE HOME MESSAGE This multi-centre, case-crossover study provides novel and robust evidence that low ambient temperature and temperature drop between neighbouring days were associated with increased AAD risk.
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Affiliation(s)
- Jinmiao Chen
- Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai 200032, China
| | - Ya Gao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, 130 Dong'an Rd, Shanghai 200032, China
| | - Yixuan Jiang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, 130 Dong'an Rd, Shanghai 200032, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Minzhi Lv
- Department of Biostatistics, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai 200032, China
| | - Weixun Duan
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Military Medical University, 127 West Changle Rd, Xi'an, Shanxi 710032, China
| | - Hao Lai
- Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai 200032, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, 130 Dong'an Rd, Shanghai 200032, China
| | - Chunsheng Wang
- Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai 200032, China
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15
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Alghamdi SAM, Aldriweesh MA, Al Bdah BA, Alhasson MA, Alsaif SA, Alluhidan WA, Almutairi FM, Alskaini MA, Alotaibi N, Al Khathaami AM. Stroke Seasonality and Weather Association in a Middle East Country: A Single Tertiary Center Experience. Front Neurol 2021; 12:707420. [PMID: 34733227 PMCID: PMC8558216 DOI: 10.3389/fneur.2021.707420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/16/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Stroke is a medical condition that leads to major disability and mortality worldwide. Some evidence suggests that weather and seasonal variations could have an impact on stroke incidence and outcome. However, the current evidence is inconclusive. Therefore, this study examines the seasonal variations and meteorological influences on stroke incidence and outcome in the largest city in Saudi Arabia. Methods: From February 2016 to July 2019, we retrospectively reviewed data from all patients with acute ischemic (AIS) or hemorrhagic stroke (HS) admitted to the stroke unit in a tertiary academic center in Saudi Arabia. The corresponding daily meteorological data were obtained for the same period. We considered the months from November to March as the cold season and April to October as the hot season. Results: The final cohort included 1,271 stroke patients; 60.89% (n = 774) cases occurred in the hot season, while 39.1% (n = 497) in the cold season. Males accounted for 69.6% (n = 884) of the cases. The proportion of ischemic stroke was 83.2% [hot season 83.9% (n = 649) vs. cold season 82.3% (n = 409)]. We found no statistically significant difference between seasons (hot or cold) in stroke incidence, severity [National Institutes of Health Stroke Scale (NIHSS)], hospital course (pneumonia, thromboembolism, intensive care stay, or length of stay), or outcome [modified Rankin scale (mRS) on discharge and death]. Conclusions: In Riyadh, Saudi Arabia, our study found no impact of weather or seasonal variations on stroke incidence, hospital course, or outcomes. However, our findings warrant further research in different country regions.
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Affiliation(s)
- Saeed A M Alghamdi
- Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mohammed A Aldriweesh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Bayan A Al Bdah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Muath A Alhasson
- Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Sultan A Alsaif
- College of Medicine, Almaarefa University, Riyadh, Saudi Arabia
| | - Waleed A Alluhidan
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Faisal M Almutairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed A Alskaini
- Department of Neurology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Naser Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ali M Al Khathaami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
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16
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Matters of the Heart: Case-Crossover Analysis of Myocardial Infarction on Valentine's Day. CJC Open 2021; 3:1075-1078. [PMID: 34505046 PMCID: PMC8413234 DOI: 10.1016/j.cjco.2021.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/14/2021] [Indexed: 11/23/2022] Open
Abstract
We studied the risk of myocardial infarction on Valentine's Day. We conducted a case-crossover study of 51,450 adults with myocardial infarctions in February, 1989-2019. The exposure was Valentine's Day, and the 2 days before and after Valentine's Day. We estimated odds ratios (OR) to compare days when myocardial infarction occurred with neighboring control days. Compared with other days, Valentine's Day was associated with lower odds of myocardial infarction the following day for men (OR 0.91, 95% confidence interval 0.85-0.98), but not for men and women combined (OR 0.95, 95% confidence interval 0.91-1.01). Risk of myocardial infarction in men is lower the day after Valentine's Day.
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17
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Li L, Huang S, Duan Y, Liu P, Lei L, Tian Y, Xiang M, Peng J, Cheng J, Yin P. Effect of ambient temperature on stroke onset: a time-series analysis between 2003 and 2014 in Shenzhen, China. Occup Environ Med 2021; 78:oemed-2020-106985. [PMID: 33509904 DOI: 10.1136/oemed-2020-106985] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/08/2020] [Accepted: 12/18/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Evidence on the relationship between ambient temperature and morbidity of different stroke subtypes in China is limited. This study aimed to assess the influence of ambient temperature on stroke risk in Shenzhen, China. METHODS From 1 January 2003 to 31 December 2014, 114 552 stroke cases in Shenzhen were collected. A generalised additive model with quasi-Poisson regression combined with a distributed lag non-linear model was applied to evaluate the temperature effects on stroke subtypes. Furthermore, this study explored the variability of the effects across sex, age and education. RESULTS The immediate heat effects on ischaemic stroke (IS) and the persistent effects of ambient temperature on intracerebral haemorrhage (ICH) were significant. Overall, the cold-related relative risks (RRs) of IS, ICH and subarachnoid haemorrhage (SAH) were 1.02 (0.97-1.07), 1.16 (1.04-1.30) and 1.12 (0.61-2.04), whereas the heat-related RRs were 1.00 (0.97-1.04), 0.80 (0.73-0.88) and 1.05 (0.63-1.78), respectively. For IS, a weakly beneficial cold effect was found among men while a detrimental heat effect among both men and women, the elderly and higher-educated population at lag0. However, regarding ICH, the temperature effects in men, the young and higher-educated population are stronger at lag0-4, lag0-7 as cold reveals threat and heat reveals protection. CONCLUSION Responses of diverse stroke subtypes to ambient temperature varied. Effective measures should be taken to increase public awareness about the effects of ambient temperature on stroke attack and to educate the public about self-protection.
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Affiliation(s)
- Lei Li
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology Tongji Medical College School of Public Health, Wuhan, Hubei, China
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology Tongji Medical College School of Public Health, Wuhan, Hubei, China
| | - Peiyi Liu
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
- Department of Occupational and Environment Health, Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lin Lei
- Department of Chronic Disease Prevention and Treatment, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Yuchen Tian
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology Tongji Medical College School of Public Health, Wuhan, Hubei, China
| | - Ming Xiang
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology Tongji Medical College School of Public Health, Wuhan, Hubei, China
| | - Ji Peng
- Department of Chronic Disease Prevention and Treatment, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Jinquan Cheng
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology Tongji Medical College School of Public Health, Wuhan, Hubei, China
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18
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Cannabis use disorder and the future risk of cardiovascular disease in parous women: a longitudinal cohort study. BMC Med 2020; 18:328. [PMID: 33208143 PMCID: PMC7677785 DOI: 10.1186/s12916-020-01804-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 10/01/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cannabis use is increasing in women of reproductive age, but whether cannabis use disorders increase the long-term risk of cardiovascular disease in this population is not known. Cannabis may cause tachycardia, hypertension, cerebral vasoconstriction, and other adverse cardiovascular effects and has been associated with acute myocardial infarction and stroke. Data on the long-term effects of cannabis on the cardiovascular system are more limited. We assessed the relationship between cannabis use disorders early in life and the future risk of cardiovascular disease in women. METHODS We analyzed a longitudinal cohort of 1,247,035 pregnant women in Quebec, Canada, between 1989 and 2019. The main exposure was current or past history of cannabis use disorders at cohort entry. The main outcome measure included future hospital admission for any cardiovascular disorder during 18,998,986 person years of follow-up. We used Cox proportional hazards regression models adjusted for patient characteristics to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association of cannabis use disorder with the later risk of cardiovascular hospitalization. RESULTS Women with cannabis use disorders had a higher incidence of cardiovascular hospitalization than unexposed women (58.4 vs. 33.6 per 10,000 person years). Cannabis use disorder was associated with 1.48 times the risk of cardiovascular hospitalization (95% CI 1.27-1.72), compared with no cannabis use disorder. The association was greater for cannabis with concomitant use of other substances (HR 1.84, 95% CI 1.53-2.21) than for cannabis alone (HR 1.30, 95% CI 0.99-1.72). Cannabis use disorder was strongly associated with hemorrhagic stroke, even with adjustment for other substance use (HR 2.08, CI 1.07-4.05). CONCLUSIONS Cannabis use disorders may increase the long-term risk of cardiovascular disease in women, particularly hemorrhagic stroke. However, some of the excess risk may be due to concomitant use of other substances.
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19
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Xie J, Zhu Y, Fan Y, Xin L, Liu J. Association between rainfall and readmissions of rheumatoid arthritis patients: a time-stratified case-crossover analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:145-153. [PMID: 31650297 DOI: 10.1007/s00484-019-01805-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 06/10/2023]
Abstract
It has been reported that local weather is associated with the symptoms of joint pain in patients with rheumatoid arthritis (RA), and many people believe their pain becomes worse when facing rainy days. However, limited studies explored the effects of weather on RA patients' healthcare-seeking behavior. Our study aimed to investigate the relationship between rainfall and readmission behavior of patients with RA in Hefei, China, based on hospitalization data from the First Affiliated Hospital of Anhui University of Chinese Medicine from May 2012 to June 2016 and weather data from National Meteorological Information Center during the same study period. Using a time-stratified case-crossover study design and conditional logistic regression, we found a negative association between current day rainfall and readmission (unadjusted: OR = 0.82, p < 0.05; adjusted: OR = 0.83, p < 0.1), which is contrary to our common belief. In lagged models, we observed that rainfall was significantly and positively associated with readmissions at lag 6 days (unadjusted: OR = 1.12, p < 0.1; adjusted: OR = 1.17, p < 0.05) and lag 7 days (unadjusted: OR = 1.13, p < 0.05; adjusted: OR = 1.21, p < 0.01). Additionally, stratified analyses showed the unanticipated finding was only statistically significant for younger patients (< 65 years) and females. Our study adds new evidence that the association between the healthcare-seeking behavior of patients with RA and local rainfall may be different, compared with the positive relationship between symptoms of joint pain and rainfall.
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Affiliation(s)
- Jingui Xie
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026, Anhui, People's Republic of China
| | - Yongjian Zhu
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026, Anhui, People's Republic of China
| | - Yiming Fan
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026, Anhui, People's Republic of China.
| | - Ling Xin
- Department of Information Center, The First Hospital Affiliated to Anhui University of Chinese Medicine, Hefei, 230031, Anhui, People's Republic of China
| | - Jian Liu
- Department of Rheumatism and Immunity, The First Hospital Affiliated to Anhui University of Chinese Medicine, Hefei, 230031, Anhui, People's Republic of China
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20
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Su YY, Li HM, Yan ZX, Li MC, Wei JP, Zheng WX, Liu SQ, Deng YT, Xie HF, Li CG. Renin-angiotensin system activation and imbalance of matrix metalloproteinase-9/tissue inhibitor of matrix metalloproteinase-1 in cold-induced stroke. Life Sci 2019; 231:116563. [PMID: 31200003 DOI: 10.1016/j.lfs.2019.116563] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 12/12/2022]
Abstract
AIMS In the present study, we investigated the roles of renin-angiotensin system (RAS) activation and imbalance of matrix metalloproteinase-9 (MMP-9)/tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in cold-induced stroke during chronic hypertension, as well as the protective effects of captopril and recombinant human TIMP-1 (rhTIMP-1). MAIN METHODS Rats were randomly assigned to sham; 2-kidney, 2-clip (2K-2C); 2K-2C + captopril, and 2K-2C + rhTIMP-1 groups. After blood pressure values had stabilized, each group was randomly divided into an acute cold exposure (ACE) group (12-h light at 22 °C/12-h dark at 4 °C) and a non-acute cold exposure (NACE) group (12-h light/12-h dark at 22 °C), each of which underwent three cycles of exposure. Captopril treatment was administered via gavage (50 mg/kg/d), while rhTIMP-1 treatment was administered via the tail vein (60 μg/kg/36 h). KEY FINDINGS In the 2K-2C group, angiotensin II (AngII) and MMP-9 levels increased in both the plasma and cortex, while no such changes in TIMP-1 expression were observed. Cold exposure further upregulated AngII and MMP-9 levels and increased stroke incidence. Captopril and rhTIMP-1 treatment inhibited MMP-9 expression and activation and decreased stroke incidence in response to cold exposure. SIGNIFICANCE The present study is the first to demonstrate that cold exposure exacerbates imbalance between MMP-9 and TIMP-1 by activating the RAS, which may be critical in the initiation of stroke during chronic hypertension. In addition, our results suggest that captopril and rhTIMP-1 exert protective effects against cold-induced stroke by ameliorating MMP-9/TIMP-1 imbalance.
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Affiliation(s)
- Yu-Ying Su
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China
| | - Huan-Min Li
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, No. 183, West Zhongshan Avenue, Tianhe District, Guangzhou, Guangdong 510630, PR China
| | - Zhen-Xing Yan
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China
| | - Ming-Chun Li
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China
| | - Ji-Peng Wei
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China
| | - Wen-Xia Zheng
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China
| | - Si-Qin Liu
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China
| | - Yi-Ting Deng
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China
| | - Hui-Fang Xie
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China.
| | - Chun-Guang Li
- Department of Neurology, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong 510282, PR China.
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