Air Pressure, Humidity and Stroke Occurrence: A Systematic Review and Meta-Analysis

Cao, Yongjun; Wang, Xia; Zheng, Danni; Robinson, Thompson; Hong, Daqing; Richtering, Sarah Samantha; Leong, Tzen Hugh; Salam, Abdul; Anderson, Craig S.; Hackett, Maree L.

doi:10.3390/ijerph13070675

Cited by 35 publications

(26 citation statements)

References 31 publications

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“…Fifteen million stroke events are recorded annually by the World Health Organization, leading to disability in many patients and placing a large economic burden on society. In addition to well-established major stroke risk factors, several studies have elucidated the influence of weather elements on stroke incidence [1,2]; however, the complex association of weather and stroke remains unclear. The inconsistency of the results arises from various factors: such as studying different climate zones, lacking subdivision of ischemic stroke events according to their etiology, small patient numbers, and also a selection bias of stroke centers involved in the studies [1,3,4].…”

Section: Introductionmentioning

confidence: 99%

New Insights into Weather and Stroke: Influences of Specific Air Masses and Temperature Changes on Stroke Incidence

et al. 2019

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Background/Objectives: Meteorological factors seem to influence stroke incidence, however, the complex association between weather and stroke remains unclear. Possible explanations from the literature do not categorize into subdivisions of ischemic strokes, only have small patient numbers, or refer to a selection of isolated weather elements without investigating weather changes and more. Method: In this exploratory trial, almost 18,000 stroke cases from a single stroke center in Southern Germany were analyzed from 2006 to 2015 and classified into the main subgroups of strokes and subdivisions of ischemic stroke etiologies applying the Trial of Org 10172 in Acute Stroke Treatment classification. For each stroke event, the air mass classification was determined from a subset of 7 air mass categories. Relative excess morbidities were derived for the 7 different air mass categories, taking into account the day of the event and up to 2 and 5 days preceding the stroke event. Results: Statistically significant findings (α ≤0.1) reveal that dry tropical air masses were associated with a lower/higher risk for hemorrhagic (HEM)/macroangiopathic strokes (MAS), respectively. Dry polar air masses were associated with a higher risk for intracerebral bleedings and lower risk for ischemic stroke subtypes. Moist air masses were associated with a reduced incidence of MAS. A strong temperature increase 5 days prior to the event was associated with a lower risk of HEM strokes. Temperature increases were associated with lower risks for MAS and cardio-embolic strokes. Significant temperature decreases were associated with a higher risk of MAS. Conclusions: Temperature effects were dependent on both air masses and temperature changes within 5 days prior to the event and were associated with statistically relevant changes in stroke incidence. Decisive factors such as etiology, age, sex, and risk factors were also taken into account.

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Section: Introductionmentioning

confidence: 99%

New Insights into Weather and Stroke: Influences of Specific Air Masses and Temperature Changes on Stroke Incidence

et al. 2019

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“…Numerous literatures have well explored the independent effects of temperature or humidity on human health [ 8 , 10 ]. However, there are limited studies on their joint effects, particularly in a developing country such as China [ 9 , 11 , 12 ]. Some previous studies found that the magnitude of effect estimates on mortality for cold temperatures was increased from the north to the south in China [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Humidity May Modify the Relationship between Temperature and Cardiovascular Mortality in Zhejiang Province, China

Zeng

Zhang

Yang

et al. 2017

IJERPH

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Background: The evidence of increased mortality attributable to extreme temperatures is widely characterized in climate-health studies. However, few of these studies have examined the role of humidity on temperature-mortality association. We investigated the joint effect between temperature and humidity on cardiovascular disease (CVD) mortality in Zhejiang Province, China. Methods: We collected data on daily meteorological and CVD mortality from 11 cities in Zhejiang Province during 2010–2013. We first applied time-series Poisson regression analysis within the framework of distributed lag non-linear models to estimate the city-specific effect of temperature and humidity on CVD mortality, after controlling for temporal trends and potential confounding variables. We then applied a multivariate meta-analytical model to pool the effect estimates in the 11 cities to generate an overall provincial estimate. The joint effects between them were calculated by the attributable fraction (AF). The analyses were further stratified by gender, age group, education level, and location of cities. Results: In total, 120,544 CVD deaths were recorded in this study. The mean values of temperature and humidity were 17.6 °C and 72.3%. The joint effect between low temperature and high humidity had the greatest impact on the CVD death burden over a lag of 0–21 days with a significant AF of 31.36% (95% eCI: 14.79–38.41%), while in a condition of low temperature and low humidity with a significant AF of 16.74% (95% eCI: 0.89, 24.44). The AFs were higher at low temperature and high humidity in different subgroups. When considering the levels of humidity, the AFs were significant at low temperature and high humidity for males, youth, those with a low level of education, and coastal area people. Conclusions: The combination of low temperature and high humidity had the greatest impact on the CVD death burden in Zhejiang Province. This evidence has important implications for developing CVD interventions.

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“…Higher incidences of stroke, unspecified cardiac and asthma mortalities have all been associated with a drop in minimum temperature [74][75][76][77]. Strokes have also been associated with a decrease in pressure, findings of which are supported in numerous meta-analytical studies [78,79], while asthma disease has been associated with a decrease in pressure [80]. Within the African context, diarrhoeal morbidity and mortality is associated with rainfall [81].…”

Section: Discussionmentioning

confidence: 99%

Climate Change and Healthcare Sustainability in the Agincourt Sub-District, Kruger to Canyons Biosphere Region, South Africa

et al. 2019

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As low-income communities are most vulnerable to climate-associated health concerns, access to healthcare will increase in importance as a key priority in South Africa. This study explores healthcare sustainability in the Agincourt sub-district, Kruger to Canyons Biosphere Region in Mpumalanga, South Africa. A rapid assessment and response methodology (RAR) was implemented, which includes the examination of previous studies conducted in the sub-district, the mapping of healthcare facilities in the area, and the implementation of a facility infrastructure and workforce capacity investigation by means of key informant (KI) interviews at eight healthcare facilities. Findings indicate that the greatest need across the facilities relate to access to medical doctors and pharmacists. None of the facilities factored climate associations with health into their clinical care strategies. The necessity to train healthcare facility staff on aspects related to climate change, health, and sustainability is highlighted. Environmental health practitioners should also be incorporated in grassroots community climate adaptation strategies. Outcomes further indicate the need for the advancement of integrated healthcare and climate adaptation strategies that focus on strengthening healthcare systems, which may include novel technological approaches such as telemedicine. Policy makers need to be proactive and pre-emptive in finding and improving processes and models to render healthcare services prepared for climate change.

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Air Pressure, Humidity and Stroke Occurrence: A Systematic Review and Meta-Analysis

Cited by 35 publications

References 31 publications

New Insights into Weather and Stroke: Influences of Specific Air Masses and Temperature Changes on Stroke Incidence

New Insights into Weather and Stroke: Influences of Specific Air Masses and Temperature Changes on Stroke Incidence

Humidity May Modify the Relationship between Temperature and Cardiovascular Mortality in Zhejiang Province, China

Climate Change and Healthcare Sustainability in the Agincourt Sub-District, Kruger to Canyons Biosphere Region, South Africa

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