Environmental Science and Pollution Research

, Volume 24, Issue 10, pp 9286–9293 | Cite as

Relationship of meteorological factors and acute stroke events in Kaunas (Lithuania) in 2000–2010

  • Laura TamasauskieneEmail author
  • Daiva Rastenyte
  • Ricardas Radisauskas
  • Abdonas Tamosiunas
  • Domantas Tamasauskas
  • Vidmantas Vaiciulis
  • Daina Kranciukaite-Butylkiniene
  • Egle Milinaviciene
Research Article


Some researchers have hypothesised that meteorological factors may have an impact on acute cerebrovascular diseases. The aim of this study was to determine an impact of some meteorological factors on occurrence of acute cerebrovascular events in the middle-aged Kaunas population. Kaunas stroke register data were used. Data on meteorological factors for the time period from 2000 to 2010 were obtained from the Lithuanian Hydrometeorological Service Kaunas Meteorological Station. We analysed 4038 cases with stroke. Ischemic strokes composed 80.4% and haemorrhagic strokes—19.6%. According to Poisson regression analysis, significant negative correlation between ischemic, haemorrhagic and all types of stroke and ambient air temperature was found (β coefficient − 0.007, −0.016, −0.009, p < 0.001, respectively). Results of ARIMA showed that ambient temperature of the day of stroke onset was associated with the occurrence of ischemic, haemorrhagic and all types of stroke: when temperature was lower, the risk of stroke was higher (−0.006, −0.003, −0.009, p < 0.001, respectively). Low temperature on the event day and 1 and 2 days before the event was associated with higher incidence of haemorrhagic stroke in women. Low ambient temperature on the event day increased incidence of haemorrhagic stroke in subjects 55–64 years. High wind speed on the event day was associated with higher incidence of ischemic stroke in older subjects. Meteorological factors may have some impact on the risk of acute cerebrovascular events. Health care providers should focus on preventive measures, which can reduce these risks.


Stroke Occurrence Register Meteorological factors 



Authors express their gratitude to Dr. R. Rauleckas from Kaunas Technology University for his help with statistical analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Abe T, Ohde S, Ishimatsu S, Ogata H, Hasegawa T, Nakamura T, Tokuda Y (2008) Effects of meteorological factors on the onset of subarachnoid hemorrhage: a time-series analysis. J Clin Neurosci 15(9):1005–1010CrossRefGoogle Scholar
  2. Cevik Y, Doğan NO, Daş M, Ahmedali A, Kul S, Bayram H (2015) The association between weather conditions and stroke admissions in Turkey. Int J Biometeorol 59(7):899–905CrossRefGoogle Scholar
  3. Chen R, Wang C, Meng X, Chen H, Thach TQ, Wong CM, Kan H (2013) Both low and high temperature may increase the risk of stroke mortality. Neurology 81(12):1064–1070CrossRefGoogle Scholar
  4. Christensen R (1997) Log-linear models and logistic regression. Springer texts in statistics, 2nd edn. Springer-Verlag, New York, p 483Google Scholar
  5. Coelho FM, Santos BF, Cendoroglo Neto M, Lisboa LF, Cypriano AS, Lopes TO, Miranda MJ, Avila AM, Alonso JB, Pinto HS (2010) Temperature variation in the 24 hours before the initial symptoms of stroke. Arq Neuropsiquiatr 68(2):242–245CrossRefGoogle Scholar
  6. Cowperthwaite MC, Burnett MG (2011) An analysis of admissions from 155 United States hospitals to determine the influence of weather on stroke incidence. J Clin Neurosci 18:618–623CrossRefGoogle Scholar
  7. Dawson J, Weir C, Wright F, Bryden C, Aslanyan S, Lees K, Bird W, Walters M (2008) Associations between meteorological variables and acute stroke hospital admissions in the west of Scotland. Acta Neurol Scand 117(2):85–89Google Scholar
  8. European Registers of Stroke (EROS) Investigators, Heuschmann PU, Di Carlo A, Bejot Y, Rastenyte D, Ryglewicz D, Sarti C, Torrent M, Wolfe CD (2009) Incidence of stroke in Europe at the beginning of the 21st century. Stroke 40(5):1557–1563CrossRefGoogle Scholar
  9. Feigin VL, Nikitin YP, Bots ML, Vinogradova TE, Grobbee DE (2000) A population-based study of the associations of stroke occurrence with weather parameters in Siberia, Russia (1982-92). Eur J Neurol 7(2):171–178CrossRefGoogle Scholar
  10. Gill RS, Hambridge HL, Schneider EB, Hanff T, Tamargo RJ, Nyquist P (2013) Falling temperature and colder weather are associated with an increased risk of aneurysmal subarachnoid hemorrhage. World Neurosurg 79(1):136–142CrossRefGoogle Scholar
  11. Goggins WB, Woo J, Ho S, Chan EY, Chau PH (2012) Weather, season, and daily stroke admissions in Hong Kong. Int J Biometeorol 56(5):865–872CrossRefGoogle Scholar
  12. Gottman JM (1981) Time-series analysis. Cambridge University Press, Cambridge, MAGoogle Scholar
  13. Halonen JI, Zanobetti A, Sparrow D, Vokonas PS, Schwartz J (2010) Associations between outdoor temperature and markers of inflammation: a cohort study. Environ Health 9:42CrossRefGoogle Scholar
  14. Han MH, Yi HJ, Kim YS, Kim YS (2015) Effect of seasonal and monthly variation in weather and air pollution factors on stroke incidence in Seoul, Korea. Stroke 46(4):927–935CrossRefGoogle Scholar
  15. Heuschmann PU, Di Carlo A, Bejot Y, Rastenyte D, Ryglewicz D, Sarti C, Torrent M, Wolfe CD (2009) Incidence of stroke in Europe at the beginning of the 21st century. Stroke 40(5):1557–1563CrossRefGoogle Scholar
  16. Heuschmann PU, Wiedmann S, Wellwood I, Rudd A, Di Carlo A, Bejot Y, Ryglewicz D, Rastenyte D, Wolfe CD (2011) Three-month stroke outcome: the European Registers of Stroke (EROS) investigators. Neurology 76(2):159–165CrossRefGoogle Scholar
  17. Hong YC, Rha JH, Lee JT, Ha EH, Kwon HJ, Kim H (2003) Ischemic stroke associated with decrease in temperature. Epidemiology 14:473–478Google Scholar
  18. Hori A, Hashizume M, Tsuda Y, Tsukahara T, Nomiyama T (2012) Effects of weather variability and air pollutants on emergency admissions for cardiovascular and cerebrovascular diseases. Int J Environ Health Res 22(5):416–430CrossRefGoogle Scholar
  19. IBM Corp. (2012). IBM SPSS Modeler 15 Algorithms Guide, p. 360–370.
  20. Jimenez-Conde J, Ois A, Gomis M, Rodriguez-Campello A, Cuadrado-Godia E, Subirana I, Roquer J (2008) Weather as a trigger of stroke. Daily meteorological factors and incidence of stroke subtypes. Cerebrovasc Dis 26(4):348–354CrossRefGoogle Scholar
  21. Kim HJ, Kim JH, Kim DR, Kang HI, Moon BG, Kim JS (2014) Age and meteorological factors in the occurrence of spontaneous intracerebral hemorrhage in a metropolitan city. Cerebrovasc Endovasc Neurosurg 16(3):209–215CrossRefGoogle Scholar
  22. Kyobutungi C, Grau A, Stieglbauer G, Becher H (2005) Absolute temperature, temperature changes and stroke risk: a case crossover study. Eur J Epidemiol 20:693–698CrossRefGoogle Scholar
  23. Macrez R, Ali C, Toutirais O, Le Mauff B, Defer G, Dirnagl U, Vivien D (2011) Stroke and the immune system: from pathophysiology to new therapeutic strategies. Lancet Neurol 10(5):471–480CrossRefGoogle Scholar
  24. Magalhães R, Silva MC, Correia M, Bailey T (2011) Are stroke occurrence and outcome related to weather parameters? Results from a population-based study in northern Portugal. Cerebrovasc Dis 32(6):542–551CrossRefGoogle Scholar
  25. Massen F (2001) The new windchill formula. A short explanation.
  26. Masterton JM, Richardson FA (1979) Humidex: a method of quantifying human discomfort due to excessive heat and humidity. CLI 1-79. Environment Canada, Downsview, OntarioGoogle Scholar
  27. Matsumoto M, Ishikawa S, Kajii E (2010) Rurality of communities and incidence of stroke: a confounding effect of weather conditions? Rural Remote Health 10(3):1493Google Scholar
  28. McArthur K, Dawson J, Walters M (2010) What is it with the weather and stroke? Expert Rev Neurother 10(2):243–249CrossRefGoogle Scholar
  29. McDonald RJ, McDonald JS, Bida JP, Kallmes DF, Cloft HJ (2012) Subarachnoid hemorrhage incidence in the United States does not vary with season or temperature. Am J Neuroradiol 33(9):1663–1668CrossRefGoogle Scholar
  30. Morabito M, Crisci A, Orlandini S, Maracchi G, Gensini GF, Modesti PA (2008) A synoptic approach to weather conditions discloses a relationship with ambulatory blood pressure in hypertensives. Am J Hypertens 21:748–752CrossRefGoogle Scholar
  31. Morabito M, Crisci A, Vallorani R, Modesti PA, Gensini GF, Orlandini S (2011) Innovative approaches helpful to enhance knowledge on weather-related stroke events over a wide geographical area and a large population. Stroke 42:593–600CrossRefGoogle Scholar
  32. Mostofsky E, Wilker EH, Schwartz J, Zanobetti A, Gold DR, Wellenius GA, Mittleman MA (2014) Short-term changes in ambient temperature and risk of ischemic stroke. Cerebrovasc Dis Extra 4(1):9–18CrossRefGoogle Scholar
  33. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, DK MG, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB, American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2015) Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation 131(4):e29–322CrossRefGoogle Scholar
  34. Neild PJ, Syndercombe-Court D, Keatinge WR, Donaldson GC, Mattock M, Caunce M (1994) Cold-induced increases in erythrocyte count, plasma cholesterol and plasma fibrinogen of elderly people without a comparable rise in protein C or factor X. Clin Sci 86:43–48CrossRefGoogle Scholar
  35. Rastenyte D, Sopagiene D, Virviciute D, Jureniene K (2006) Diverging trends in the incidence and mortality of stroke during the period 1986–2002: a study from the stroke register in Kaunas, Lithuania. Scand J Public Health 34(5):488–495CrossRefGoogle Scholar
  36. Shaposhnikov D, Revich B, Gurfinkel Y, Naumova E (2014) The influence of meteorological and geomagnetic factors on acute myocardial infarction and brain stroke in Moscow, Russia. Int J Biometeorol 58(5):799–808CrossRefGoogle Scholar
  37. Slatina E, Music M, Babic N, Dervisevic A, Mujaric E, Salibasic M, Tuna E, Corovic J (2013) Correlation between change in air humidity and the incidence of stroke. Mater Sociomed 25(4):242–245CrossRefGoogle Scholar
  38. Tanaka H, Shinjo M, Tsukuma H, Kawazuma Y, Shimoji S, Kinoshita N, Morita T (2000) Seasonal variation in mortality from ischemic heart disease and cerebrovascular disease in Okinawa and Osaka: the possible role of air temperature. J Epidemiol 10(6):392–398CrossRefGoogle Scholar
  39. Vermeer SE, Sandee W, Algra A, Koudstaal PJ, Kappelle LJ, Dippel DW, Dutch TIA Trial Study Group (2006) Impaired glucose tolerance increases stroke risk in nondiabetic patients with transient ischemic attack or minor ischemic stroke. Stroke 37(6):1413–1417CrossRefGoogle Scholar
  40. Vlak MHM, Rinkel GJE, Greebe P, Van Der Bom JG, Algra A (2011) Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case-crossover study. Stroke 42:1878–1882CrossRefGoogle Scholar
  41. Wang TJ, Massaro JM, Levy D, Vasan RS, Wolf PA, D’Agostino RB, Larson MG, Kannel WB, Benjamin EJ (2003) A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community; the Framingham Heart Study. JAMA 290:1049–1056CrossRefGoogle Scholar
  42. Wang XY, Barnett AG, Hu W, Tong S (2009) Temperature variation and emergency hospital admissions for stroke in Brisbane, Australia, 1996–2005. Int J Biometeorol 53:535–541CrossRefGoogle Scholar
  43. Wang Q, Gao C, Wang H, Lang L, Yue T, Lin H (2013) Ischemic stroke hospital admission associated with ambient temperature in Jinan, China. PLoS One 8(11):e80381CrossRefGoogle Scholar
  44. WHO MONICA Project (1990) MONICA Manual, Part IV: Event Registration, Section 2: Stroke event registration data component.
  45. Wolf PA, Abbott RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. \Stroke 22(8):983–988CrossRefGoogle Scholar
  46. World Health Organisation (2015)

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Laura Tamasauskiene
    • 1
    Email author
  • Daiva Rastenyte
    • 2
  • Ricardas Radisauskas
    • 3
    • 4
  • Abdonas Tamosiunas
    • 3
  • Domantas Tamasauskas
    • 5
  • Vidmantas Vaiciulis
    • 4
  • Daina Kranciukaite-Butylkiniene
    • 3
  • Egle Milinaviciene
    • 3
  1. 1.Department of Immunology and AllergologyLithuanian University of Health SciencesKaunasLithuania
  2. 2.Department of NeurologyLithuanian University of Health SciencesKaunasLithuania
  3. 3.Institute of CardiologyLithuanian University of Health SciencesKaunasLithuania
  4. 4.Department of Environmental and Occupational MedicineLithuanian University of Health SciencesKaunasLithuania
  5. 5.Department of NeurosurgeryLithuanian University of Health SciencesKaunasLithuania

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