Scientists Warn of Potential Threat to Heart Health From Extreme Weather



In a study of roughly 2.3 million Europeans, negative correlations between cold weather and heart disease fatalities, particularly in underprivileged areas, were discovered. At the ESC Congress 2022, the recent research was presented. [1] In people with cardiac problems, excessive deaths from heart disease and stroke have been linked to hot weather.                                                                           
The University of Oslo in Norway's Professor Stefan Agewall, the study's lead author, stated: "Climate change is causing both an increase in the average world temperature and extreme cold in specific locations. Intense heatwaves across Europe during the summer of 2003 resulted in over 70,000 additional deaths. [2] Excess hospital admissions and mortality are related to cold weather. [3,4] Previous research on the effects of heat and cold on the cardiovascular system generally relied on aggregated data, like the number of deaths per day in a city. In order to identify susceptible subgroups for protective measures and boost resilience for upcoming weather disasters, the EXHAUSTION study used individual data.

2.28 million adults from five cohort studies carried out in Italy, Germany, the UK, Norway, and Sweden between 1994 and 2010 were included in the research. The proportion of women varied from 36.0% to 54.5%, while the average age ranged from 49.7 to 71.7 years. Participants were included both with and without cardiovascular disease at baseline. Through death and disease registries, as well as follow-up questionnaires, information on mortality and newly diagnosed diseases, was gathered. Daily average air temperatures at the participants' residences were measured at nearby weather stations or extrapolated using modeling of the station-measured temperature data.

All participants and subgroups with specific characteristics were examined for any correlations between body temperature, cardiovascular disease, and death. The researchers utilized a time-stratified case-crossover study design in which, for each participant, they compared the temperature on the same day of the week on which an adverse event did not occur (for example, Monday) with the temperature on all other Mondays during the same month. The potential confounding effects of participant characteristics and time trends were removed using within-participant comparisons between days in the same month.

The analysis revealed heightened risks of new-onset ischemic heart disease and increased chances of death from cardiovascular disease overall and ischaemic heart disease in particular that are related to cold weather. The risk of death from cardiovascular disease increased by 19% (relative risk [RR] 1.19; 95% confidence interval [CI] 1.04-1.36) and the risk of death from ischaemic heart disease increased by 22% (RR 1.22; 95% CI 1.07-1.38) with a temperature drop of about 10°C (18°F), from 5°C to -5°C (41°F to 23°F). When the temperature dropped by about 11°C (20°F), from 2°C to -9°C (36°F to 16°F), the risk of developing new-onset ischemic heart disease increased by 4% (RR 1.04; 95% CI: 1.01-1.08).

"The links between cold temperatures and mortality were more obvious in men and persons residing in low socioeconomic neighborhood," said Professor Agewall. In women and persons over 65, there were greater correlations between the common cold and newly diagnosed ischemic heart disease.

In the entire study population, heat had no negative impacts. However, in individuals with heart disease at baseline, temperature increases from 15°C to 24°C (27°F to 43°F) were linked to 25% (RR 1.25; 95% CI 1.12-1.39) and 30% (RR 1.30; 95% CI 1.10-1.53) increased odds of death from cardiovascular disease and stroke, respectively.

Clinicians can utilize this information to offer personalized guidance to people most at risk of negative health consequences on hot and cold days, according to Professor Agewall. In hot weather, patients with heart problems should drink plenty of fluids and take their medications as prescribed by their cardiologist. We may all monitor the news for warnings about excessive heat and cold and heed local authorities' safety advice.

Dr. Siqi Zhang from Helmholtz Munich spoke EXHAUSTION on Friday, August 26, in the session Latest science in primary and secondary preventive and environmental health.

Death risk related to high and low ambient temperature: a multicountry observational study by Dr. Antonio Gasparrini, PhD; Yuming Guo, PhD; Prof. Masahiro Hashizume, PhD; Eric Lavigne, PhD; Antonella Zanobetti, PhD; Prof. Joel Schwartz, PhD; Aurelio Tobias, PhD; Prof. Shilu Tong, PhD; Joacim Rocklöv, PhD; Prof. Bertil Forsberg, PhD; Michel The Lancet, 20 May 2015.

Financed by the European Union's Horizon 2020 research and innovation initiative, this study was carried out as part of the EXHAUSTION project (Exposure to Heat and Air Pollution in Europe - Cardiopulmonary Impacts and Benefits of Mitigation and Adaptation).                                                                    
By EUROPEAN SOCIETY OF CARDIOLOGY 

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