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Global and Regional Cardiovascular Mortality Attributable to Nonoptimal Temperatures Over Time

  • MCC Collaborators∗
  • Monash University
  • Cheeloo College of Medicine, Shandong University
  • Harvard T.H. Chan School of Public Health
  • London School of Hygiene and Tropical Medicine
  • University of Florence
  • Queensland University of Technology
  • Chinese Center for Disease Control and Prevention
  • National Institute of Health
  • University of Porto
  • Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR)
  • Institute of Atmospheric Physics of the Academy of Sciences of the Czech Republic
  • Czech University of Life Sciences Prague
  • Institute of Social and Preventive Medicine
  • Universität Bern
  • University of Otago
  • University of Oulu
  • Oulu University Hospital
  • Spanish Council for Scientific Research
  • Nagasaki University
  • Centro de Investigación Biomédica en Red de Epidemiología y Salud Publica
  • University of Ottawa
  • Swiss Tropical and Public Health Institute Swiss TPH
  • University of Basel
  • Umeå University
  • Hebrew University of Jerusalem
  • Santé Publique France
  • Fudan University
  • Technological University Dublin
  • Brunel University London
  • Graduate School of Medicine
  • National Institute of Public Health
  • Escola Nacional de Saúde Pública, Universidade Nova de Lisboa
  • Seoul National University
  • Yale University
  • Ewha Womans University School of Medicine
  • University of Valencia
  • National Taiwan University College of Medicine
  • National Health Research Institutes Taiwan
  • National Taiwan University
  • Duy Tan University
  • University of Medicine and Pharmacy at Ho Chi Minh City
  • German Research Center for Environmental Health
  • Hakim Sabzevari University
  • University of Athens
  • Centre for Sustainability and Environmental Health
  • Scripps Institution of Oceanography
  • University of Tartu
  • University of Torino
  • Department of Epidemiology Lazio Regional Health Service
  • King’s College London
  • University of São Paulo
  • Universidad de los Andes, Chile
  • Rollins School of Public Health
  • INSPER
  • Instituto de Investigaciones Gino Germani
  • University of the Republic
  • Universidad Pablo de Olavide, de Sevilla
  • National Institute for Environmental Studies of Japan
  • University of Mazandaran
  • Norwegian Institute of Public Health
  • Instituto Nacional de Saúde Dr. Ricardo Jorge

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)2276-2287
Number of pages12
JournalJournal of the American College of Cardiology
Volume83
Issue number23
DOIs
StatePublished - 11 Jun 2024

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 13 - Climate Action
    SDG 13 Climate Action

Keywords

  • Global Burden of Disease
  • cardiovascular death
  • death ratio
  • excess death
  • nonoptimal temperatures

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