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Cheng BJ, Li H, Meng K, Li TL, Meng XC, Wang J, Wang C, Jiang N, Sun MJ, Yang LS, Zhu XY, Liu R. Short-term effects of heatwaves on clinical and subclinical cardiovascular indicators in Chinese adults: A distributed lag analysis. ENVIRONMENT INTERNATIONAL 2024; 183:108358. [PMID: 38056095 DOI: 10.1016/j.envint.2023.108358] [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: 07/06/2023] [Revised: 11/11/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023]
Abstract
AIMS Previous studies have related heat waves to morbidity and mortality of cardiovascular diseases; however, potential mechanisms remained limited. Our aims were to investigate the short-term effects of heat waves on a series of clinical/subclinical indicators associated with cardiovascular health. METHODS Our study used 80,574 health examination records from the Health Management Center of Nanjing Zhongda Hospital during the warm seasons of 2019-2021, including 62,128 participants. A total of 11 recognized indicators of cardiovascular risk or injury were assessed. Air pollution and meteorological data were obtained from the Nanjing Ecological Environment Bureau and the China Meteorological Data Network, respectively. Heat waves were defined as a daily average temperature over the 95th percentile for three or more consecutive days from May to September. We used a combination of linear mixed effects models and distributed lag nonlinear models to assess the lagged effects of heat waves on clinical and subclinical cardiovascular indicators. Stratified analyses based on individuals' characteristics, including gender, age, body mass index (BMI), diabetes, and hypertension, were also performed. RESULTS Heat waves were related to significant changes in most indicators, with the magnitude of effects generally peaking at a lag of 0 to 3 days. Moreover, the cumulative percentage changes over lag 0-7 days were -0.82 % to -2.55 % in blood pressure, 1.32 % in heart rate, 0.20 % to 2.66 % in systemic inflammation markers, 0.36 % in a blood viscosity parameter, 9.36 % in homocysteine, and 1.35 % to 3.25 % in injuring myocardial enzymes. Interestingly, females and males showed distinct susceptibilities in different indicators. Stronger effects were also found in participants aged 50 years or over, individuals with abnormal BMI status, and patients with diabetes. CONCLUSION Short-term exposure to heat waves could significantly alter clinical/subclinical cardiovascular indicator profiles, including blood pressure changes, increased heart rate, acute systemic inflammation, elevated blood viscosity, and myocardial injury.
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Affiliation(s)
- Bei-Jing Cheng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Hui Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Ke Meng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Tian-Lin Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Xing-Chen Meng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Jia Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Chun Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Nan Jiang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Ming-Jun Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Lin-Sheng Yang
- School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Xin-Yi Zhu
- The Affiliated Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, Jiangsu, China
| | - Ran Liu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China.
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Poudineh M, Mansoori A, Sadooghi Rad E, Hosseini ZS, Salmani Izadi F, Hoseinpour M, Mahmoudi Zo M, Ghoflchi S, Tanbakuchi D, Nazar E, Ferns G, Effati S, Esmaily H, Ghayour-Mobarhan M. Platelet distribution widths and white blood cell are associated with cardiovascular diseases: data mining approaches. Acta Cardiol 2023; 78:1033-1044. [PMID: 37694924 DOI: 10.1080/00015385.2023.2246199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/12/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To investigate the association between cardiovascular diseases (CVDs) and haematologic factors in a cohort of Iranian adults. METHOD For a total population of 9,704 aged 35 to 65, a prospective study was designed. Haematologic factors and demographic characteristics (such as gender, age, and smoking status) were completed for all participants. The association between haematologic factors and CVDs was assessed through logistic regression (LR) analysis, decision tree (DT), and bootstrap forest (BF). RESULTS Almost all of the included factors were significantly associated with CVD (p<.001). Among the included factors, were: age, white blood cell (WBC), and platelet distribution width (PDW) had the strongest correlation with the development of CVD. For unit OR interpretation, WBC has been represented as the most remarkable risk factor for CVD (OR: 1.22 (CI 95% (1.18, 1.27))). Also, age is associated with an increase in the odds of CVD + occurrence (OR: 1.12 (CI 95% (1.11, 1.13))). Moreover, males are times more likely to develop CVD than females (OR: 1.39 (CI 95% (1.22, 1.58))). In DT model, age is the best classifier factor in CVD development, followed by WBC and PDW. Furthermore, based on the BF algorithm, the most crucial factors correlated with CVD are age, WBC, PDW, sex, and smoking status. CONCLUSION The obtained result from LR, DT, and BF models confirmed that age, WBC, and PDW are the most crucial factors for the development of CVD.
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Affiliation(s)
- Mohadeseh Poudineh
- Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elias Sadooghi Rad
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Faezeh Salmani Izadi
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdieh Hoseinpour
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Mahmoudi Zo
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Ghoflchi
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Davoud Tanbakuchi
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Eisa Nazar
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - Sohrab Effati
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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