Abstract
Hazardous thermal conditions resulting from climate change may play a role in cardiovascular disease development. We chose the Universal Thermal Climate Index (UTCI) as the exposure metric to evaluate the relationship between thermal conditions and cardiovascular mortality in Shenzhen, China. We applied quasi-Poisson regression non-linear distributed lag models to evaluate the exposure-response associations. The findings suggest that cardiovascular mortality risks were significantly increased under heat and cold stress, and the adverse effects of cold stress were stronger than heat stress. Referencing the 50th percentile of UTCI (25.4°C), the cumulative risk of cardiovascular mortality was 75% (RRlag0-21 =1.75, 95%CI: 1.32, 2.32) higher in the 1st percentile (3.5°C), and 40% (RRlag0-21=1.40, 95%CI: 1.09, 1.80) higher in the 99th percentile (34.1°C). We observed that individuals older than 65 years were more vulnerable to both cold and heat stress, and females were identified as more susceptible to heat stress than males. Moreover, increased mortality risks of hypertensive disease and cerebrovascular disease were observed under cold stress, while heat stress was related to higher risks of mortality for hypertensive disease and ischemic heart disease. We also observed a stronger relationship between cold stress and ischemic heart disease mortality during the cold season, as well as a significant impact of heat stress on cerebrovascular disease mortality in the warm season when compared to the analysis of the entire year. These results confirm the significant relationship between thermal stress and cardiovascular mortality, with age and sex as potential effect modifiers of this association. Providing affordable air conditioning equipment, increasing the amount of vegetation, and establishing comprehensive early warning systems that take human thermoregulation into account could all help to safeguard the well-being of the public, particularly vulnerable populations, in the event of future extreme weather.
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Data availability
The meteorological data are openly available in the National Tibetan Plateau Data Center (DOI:10.11888/AtmosphericPhysics.tpe.249369.file). The mortality data are not publicly available due to the access agreement. Still, it can be available with reasonable request and permission from the Shenzhen Center for Disease Control and Prevention.
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Acknowledgements
We appreciate the Shenzhen Center for Disease Control and Prevention for the data collection. We also thank the National Tibetan Plateau Data Center for providing the meteorological dataset.
Funding
The work was supported by the National Natural Science Foundation of China (Grant Nos. 82173628 and 81973004).
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Maidina Jingesi: conceptualization, formal analysis, visualization, writing—original draft preparation, critical review, and editing. Shuhua Lan: data curation, validation, and visualization. Jing Hu: validation, critical review, and editing. Mengyi Dai: data curation, critical review, and editing. Suli Huang: data curation, investigation, and technical support. Siyi Chen: data curation. Ning Liu: data curation. Ziquan Lv: data curation. Jiajia Ji: data curation. Xiaoheng Li: data curation. Peng Wang: validation, supervision, reviewing, and editing. Jinquan Cheng: investigation, funding acquisition, and supervision. Ji Peng: investigation, funding acquisition, and supervision. Ping Yin: investigation, funding acquisition, supervision, reviewing, and editing.
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Maidina Jingesi and Shuhua Lan contribute equally to this paper.
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Jingesi, M., Lan, S., Hu, J. et al. Association between thermal stress and cardiovascular mortality in the subtropics. Int J Biometeorol 67, 2093–2106 (2023). https://doi.org/10.1007/s00484-023-02565-6
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DOI: https://doi.org/10.1007/s00484-023-02565-6