Cardiovascular mortality risk attributable to ambient temperature in China

Jun Yang, Peng Yin, Maigeng Zhou, Chun Quan Ou, Yuming Guo, Antonio Gasparrini, Yunning Liu, Yujuan Yue, Shaohua Gu, Shaowei Sang, Guijie Luan, Qinghua Sun, Qiyong Liu

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62 Citations (Scopus)

Abstract

Objective: To examine cardiovascular disease (CVD) mortality burden attributable to ambient temperature; to estimate effect modification of this burden by gender, age and education level. Methods: We obtained daily data on temperature and CVD mortality from 15 Chinese megacities during 2007-2013, including 1 936 116 CVD deaths. A quasi-Poisson regression combined with a distributed lag non-linear model was used to estimate the temperature-mortality association for each city. Then, a multivariate metaanalysis was used to derive the overall effect estimates of temperature at the national level. Attributable fraction of deaths were calculated for cold and heat (ie, temperature below and above minimum-mortality temperatures, MMTs), respectively. The MMT was defined as the specific temperature associated to the lowest mortality risk. Results: The MMT varied from the 70th percentile to the 99th percentile of temperature in 15 cities, centring at 78 at the national level. In total, 17.1% (95% empirical CI 14.4% to 19.1%) of CVD mortality (330 352 deaths) was attributable to ambient temperature, with substantial differences among cities, from 10.1% in Shanghai to 23.7% in Guangzhou. Most of the attributable deaths were due to cold, with a fraction of 15.8% (13.1% to 17.9%) corresponding to 305 902 deaths, compared with 1.3% (1.0% to 1.6%) and 24 450 deaths for heat. Conclusions: This study emphasises how cold weather is responsible for most part of the temperature-related CVD death burden. Our results may have important implications for the development of policies to reduce CVD mortality from extreme temperatures.

Original languageEnglish
Pages (from-to)1966-1972
Number of pages7
JournalHeart
Volume101
Issue number24
DOIs
Publication statusPublished - 1 Dec 2015
Externally publishedYes

Cite this

Yang, J., Yin, P., Zhou, M., Ou, C. Q., Guo, Y., Gasparrini, A., ... Liu, Q. (2015). Cardiovascular mortality risk attributable to ambient temperature in China. Heart, 101(24), 1966-1972. https://doi.org/10.1136/heartjnl-2015-308062
Yang, Jun ; Yin, Peng ; Zhou, Maigeng ; Ou, Chun Quan ; Guo, Yuming ; Gasparrini, Antonio ; Liu, Yunning ; Yue, Yujuan ; Gu, Shaohua ; Sang, Shaowei ; Luan, Guijie ; Sun, Qinghua ; Liu, Qiyong. / Cardiovascular mortality risk attributable to ambient temperature in China. In: Heart. 2015 ; Vol. 101, No. 24. pp. 1966-1972.
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title = "Cardiovascular mortality risk attributable to ambient temperature in China",
abstract = "Objective: To examine cardiovascular disease (CVD) mortality burden attributable to ambient temperature; to estimate effect modification of this burden by gender, age and education level. Methods: We obtained daily data on temperature and CVD mortality from 15 Chinese megacities during 2007-2013, including 1 936 116 CVD deaths. A quasi-Poisson regression combined with a distributed lag non-linear model was used to estimate the temperature-mortality association for each city. Then, a multivariate metaanalysis was used to derive the overall effect estimates of temperature at the national level. Attributable fraction of deaths were calculated for cold and heat (ie, temperature below and above minimum-mortality temperatures, MMTs), respectively. The MMT was defined as the specific temperature associated to the lowest mortality risk. Results: The MMT varied from the 70th percentile to the 99th percentile of temperature in 15 cities, centring at 78 at the national level. In total, 17.1{\%} (95{\%} empirical CI 14.4{\%} to 19.1{\%}) of CVD mortality (330 352 deaths) was attributable to ambient temperature, with substantial differences among cities, from 10.1{\%} in Shanghai to 23.7{\%} in Guangzhou. Most of the attributable deaths were due to cold, with a fraction of 15.8{\%} (13.1{\%} to 17.9{\%}) corresponding to 305 902 deaths, compared with 1.3{\%} (1.0{\%} to 1.6{\%}) and 24 450 deaths for heat. Conclusions: This study emphasises how cold weather is responsible for most part of the temperature-related CVD death burden. Our results may have important implications for the development of policies to reduce CVD mortality from extreme temperatures.",
author = "Jun Yang and Peng Yin and Maigeng Zhou and Ou, {Chun Quan} and Yuming Guo and Antonio Gasparrini and Yunning Liu and Yujuan Yue and Shaohua Gu and Shaowei Sang and Guijie Luan and Qinghua Sun and Qiyong Liu",
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Yang, J, Yin, P, Zhou, M, Ou, CQ, Guo, Y, Gasparrini, A, Liu, Y, Yue, Y, Gu, S, Sang, S, Luan, G, Sun, Q & Liu, Q 2015, 'Cardiovascular mortality risk attributable to ambient temperature in China', Heart, vol. 101, no. 24, pp. 1966-1972. https://doi.org/10.1136/heartjnl-2015-308062

Cardiovascular mortality risk attributable to ambient temperature in China. / Yang, Jun; Yin, Peng; Zhou, Maigeng; Ou, Chun Quan; Guo, Yuming; Gasparrini, Antonio; Liu, Yunning; Yue, Yujuan; Gu, Shaohua; Sang, Shaowei; Luan, Guijie; Sun, Qinghua; Liu, Qiyong.

In: Heart, Vol. 101, No. 24, 01.12.2015, p. 1966-1972.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Cardiovascular mortality risk attributable to ambient temperature in China

AU - Yang, Jun

AU - Yin, Peng

AU - Zhou, Maigeng

AU - Ou, Chun Quan

AU - Guo, Yuming

AU - Gasparrini, Antonio

AU - Liu, Yunning

AU - Yue, Yujuan

AU - Gu, Shaohua

AU - Sang, Shaowei

AU - Luan, Guijie

AU - Sun, Qinghua

AU - Liu, Qiyong

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Objective: To examine cardiovascular disease (CVD) mortality burden attributable to ambient temperature; to estimate effect modification of this burden by gender, age and education level. Methods: We obtained daily data on temperature and CVD mortality from 15 Chinese megacities during 2007-2013, including 1 936 116 CVD deaths. A quasi-Poisson regression combined with a distributed lag non-linear model was used to estimate the temperature-mortality association for each city. Then, a multivariate metaanalysis was used to derive the overall effect estimates of temperature at the national level. Attributable fraction of deaths were calculated for cold and heat (ie, temperature below and above minimum-mortality temperatures, MMTs), respectively. The MMT was defined as the specific temperature associated to the lowest mortality risk. Results: The MMT varied from the 70th percentile to the 99th percentile of temperature in 15 cities, centring at 78 at the national level. In total, 17.1% (95% empirical CI 14.4% to 19.1%) of CVD mortality (330 352 deaths) was attributable to ambient temperature, with substantial differences among cities, from 10.1% in Shanghai to 23.7% in Guangzhou. Most of the attributable deaths were due to cold, with a fraction of 15.8% (13.1% to 17.9%) corresponding to 305 902 deaths, compared with 1.3% (1.0% to 1.6%) and 24 450 deaths for heat. Conclusions: This study emphasises how cold weather is responsible for most part of the temperature-related CVD death burden. Our results may have important implications for the development of policies to reduce CVD mortality from extreme temperatures.

AB - Objective: To examine cardiovascular disease (CVD) mortality burden attributable to ambient temperature; to estimate effect modification of this burden by gender, age and education level. Methods: We obtained daily data on temperature and CVD mortality from 15 Chinese megacities during 2007-2013, including 1 936 116 CVD deaths. A quasi-Poisson regression combined with a distributed lag non-linear model was used to estimate the temperature-mortality association for each city. Then, a multivariate metaanalysis was used to derive the overall effect estimates of temperature at the national level. Attributable fraction of deaths were calculated for cold and heat (ie, temperature below and above minimum-mortality temperatures, MMTs), respectively. The MMT was defined as the specific temperature associated to the lowest mortality risk. Results: The MMT varied from the 70th percentile to the 99th percentile of temperature in 15 cities, centring at 78 at the national level. In total, 17.1% (95% empirical CI 14.4% to 19.1%) of CVD mortality (330 352 deaths) was attributable to ambient temperature, with substantial differences among cities, from 10.1% in Shanghai to 23.7% in Guangzhou. Most of the attributable deaths were due to cold, with a fraction of 15.8% (13.1% to 17.9%) corresponding to 305 902 deaths, compared with 1.3% (1.0% to 1.6%) and 24 450 deaths for heat. Conclusions: This study emphasises how cold weather is responsible for most part of the temperature-related CVD death burden. Our results may have important implications for the development of policies to reduce CVD mortality from extreme temperatures.

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U2 - 10.1136/heartjnl-2015-308062

DO - 10.1136/heartjnl-2015-308062

M3 - Article

VL - 101

SP - 1966

EP - 1972

JO - Heart

JF - Heart

SN - 1355-6037

IS - 24

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