Global and Regional Cardiovascular Mortality Attributable to Nonoptimal Temperatures Over Time.

Hundessa, S; Huang, W; Zhao, Q; Wu, Y; Wen, B; Alahmad, B; Armstrong, BORCID logo; Gasparrini, AORCID logo; Sera, F; Tong, S; +9 more...Madureira, J; Kyselý, J; Schwartz, J; Vicedo-Cabrera, AM; Hales, S; Johnson, A; Li, S; Guo, Y; MCC Collaborators∗ and (2024) Global and Regional Cardiovascular Mortality Attributable to Nonoptimal Temperatures Over Time. Journal of the American College of Cardiology, 83 (23). pp. 2276-2287. ISSN 0735-1097 DOI: 10.1016/j.jacc.2024.03.425
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BACKGROUND: The association between nonoptimal temperatures and cardiovascular mortality risk is recognized. However, a comprehensive global assessment of this burden is lacking. OBJECTIVES: The goal of this study was to assess global cardiovascular mortality burden attributable to nonoptimal temperatures and investigate spatiotemporal trends. METHODS: Using daily cardiovascular deaths and temperature data from 32 countries, a 3-stage analytical approach was applied. First, location-specific temperature-mortality associations were estimated, considering nonlinearity and delayed effects. Second, a multivariate meta-regression model was developed between location-specific effect estimates and 5 meta-predictors. Third, cardiovascular deaths associated with nonoptimal, cold, and hot temperatures for each global grid (55 km × 55 km resolution) were estimated, and temporal trends from 2000 to 2019 were explored. RESULTS: Globally, 1,801,513 (95% empirical CI: 1,526,632-2,202,831) annual cardiovascular deaths were associated with nonoptimal temperatures, constituting 8.86% (95% empirical CI: 7.51%-12.32%) of total cardiovascular mortality corresponding to 26 deaths per 100,000 population. Cold-related deaths accounted for 8.20% (95% empirical CI: 6.74%-11.57%), whereas heat-related deaths accounted for 0.66% (95% empirical CI: 0.49%-0.98%). The mortality burden varied significantly across regions, with the highest excess mortality rates observed in Central Asia and Eastern Europe. From 2000 to 2019, cold-related excess death ratios decreased, while heat-related ratios increased, resulting in an overall decline in temperature-related deaths. Southeastern Asia, Sub-Saharan Africa, and Oceania observed the greatest reduction, while Southern Asia experienced an increase. The Americas and several regions in Asia and Europe displayed fluctuating temporal patterns. CONCLUSIONS: Nonoptimal temperatures substantially contribute to cardiovascular mortality, with heterogeneous spatiotemporal patterns. Effective mitigation and adaptation strategies are crucial, especially given the increasing heat-related cardiovascular deaths amid climate change.


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Available under Creative Commons: Attribution-NonCommercial-No Derivative Works 4.0

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