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 language | English |
|---|---|
| Pages (from-to) | 1966-1972 |
| Number of pages | 7 |
| Journal | Heart |
| Volume | 101 |
| Issue number | 24 |
| DOIs | |
| Publication status | Published - 1 Dec 2015 |
| Externally published | Yes |
Cite this
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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 journal › Article › Research › peer-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.
UR - http://www.scopus.com/inward/record.url?scp=84949591731&partnerID=8YFLogxK
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
ER -