Outdoor temperature, blood pressure, and cardiovascular disease mortality among 23 000 individuals with diagnosed cardiovascular diseases from China

Yang, Ling; Li, Liming; Lewington, Sarah; Guo, Yu; Sherliker, Paul; Zheng, Bin; Collins, Rory; Pető, Richárd; Liu, Yun; Yang, Rong; Zhang, Yongrui; Li, Guangchun; Liu, Shumei; Chen, Zhengming

doi:10.1093/eurheartj/ehv023

Cited by 150 publications

(97 citation statements)

References 32 publications

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“…There is much evidence that seasonal meteorological variables influence blood pressure in both hypertensive and normotensive individuals, [33][34][35] and decreased outdoor temperature is in some way accompanied by increased intravascular systolic pressure. 36 Changes in AP may increase transmural arterial stress by transiently lowering tissue pressure with respect to blood pressure, creating a net expansive force. 37 The alteration in AP could also affect the partial pressure of oxygen and carbon dioxide in the circulation 38 and thus activate chemoreceptors and baroreceptors leading to elevated sympathetic stimulation.…”

Section: Discussionmentioning

confidence: 99%

Onset seasons and clinical outcomes in patients with Stanford type A acute aortic dissection: an observational retrospective study

et al. 2017

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ObjectivesTo evaluate the association of onset season with clinical outcome in type A acute aortic dissection (AAD).DesignA single-centre, observational retrospective study.SettingThe study was conducted in Fuwai Hospital, the National Centre for Cardiovascular Disease, Beijing, China.ParticipantsFrom 2008 to 2010, a set of consecutive patients with type A AAD, confirmed by CT scanning, were enrolled and divided into four groups according to onset season: winter (December, January and February), spring (March, April and May), summer (June, July and August) and autumn (September, October and November). The primary end points were in-hospital death and all-cause mortality during follow-up.ResultsOf the 492 cases in this study, 129 occurred in winter (26.2%), 147 in spring (29.9%), 92 in summer (18.7%), and 124 in autumn (25.2%). After a median follow-up of 20.4 months (IQR 9.7–38.9), the in-hospital mortality in cases occurring in autumn was higher than in the other three seasons (23.4% vs 8.4%, p<0.01). Long-term mortality was comparable among the four seasonal groups (p=0.63). After adjustment for age, gender and other risk factors, onset in autumn was still an independent factor associated with increased risk of in-hospital mortality (HR 2.05; 95% CI 1.15 to 3.64, p=0.02) in addition to surgical treatment. Further analysis showed that the seasonal effect on in-hospital mortality (autumn vs other seasons: 57.4% vs 27.3%, p<0.01) was only significant in patients who did not receive surgical treatment. No seasonal effect on long-term clinical outcomes was found in this cohort.ConclusionsOnset in autumn may be a factor that increases the risk of in-hospital death from type A AAD, especially in patients who receive conservative treatment. Immediate surgery improves the short-term and long-term outcomes regardless of onset season.

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Section: Discussionmentioning

confidence: 99%

Onset seasons and clinical outcomes in patients with Stanford type A acute aortic dissection: an observational retrospective study

et al. 2017

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“…The literature generally suggests that exposures to both high and low temperatures are associated with cardiovascular events in non-pregnant populations around the world (Basu, 2009; Bhaskaran et al, 2012; Ha et al, 2014; Honda et al, 2016; Phung et al, 2016; Sartini et al, 2016; Wang et al, 2016; Yang et al, 2015) with potentially higher sensitivity among Blacks women, those with lower socioeconomic status, the elderly, and young children (Basu, 2009); but data among pregnant women are currently lacking. One large international multicenter case-control study among reproductive age women ages 15 to 49 showed that each 5°C decrease in monthly average temperature was associated with a 7% and 12% increase in hospital admission rates for stroke and acute myocardial infarction, respectively; and these effects were more prominent within one month of exposure (Chang et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have linked extreme ambient temperatures with acute cardiovascular risk in the general population as well as in susceptible subgroups including those with lower socioeconomic status, the elderly, and those with other comorbid conditions (Medina-Ramon and Schwartz, 2007; Wang et al, 2016; Yang et al, 2015). A role for temperature in the pathogenesis of cardiovascular risks is plausible given the oxidative stress and systemic inflammation induced shortly after exposure (Cai et al, 2016; Cheng et al, 2015; Halonen et al, 2010; Hong et al, 2012; Quindry et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Ambient temperature and risk of cardiovascular events at labor and delivery: A case-crossover study

Nguyen

Liu

et al. 2017

Environmental Research

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Background Extreme ambient temperatures are linked to cardiac events in the general population, but this relationship is unclear among pregnant women. We estimated the associations and attributable risk between ambient temperature and the risk of cardiovascular event at labor/delivery, and investigated whether these associations vary by maternal race/ethnicity. Methods We identified 680 women with singleton deliveries affected by cardiovascular events across 12 US sites (2002–2008). Average daily temperature during the week before, delivery day, and each of the seven days before delivery was estimated for each woman. In a case-crossover analysis, exposures during these hazard periods were compared to two control periods before and after delivery using conditional logistic regression adjusted for other environmental factors. Results During the cold season (October-April), 1°C lower during the week prior to delivery was associated with a 4% (95% CI: 1–7%) increased risk of having a labor/delivery affected by cardiovascular events including cardiac arrest and stroke. During the warm season (May–September), 1°C higher during the week prior was associated with a 7% (95% CI: 3–12%) increased risk. These risks translated to 13.4 and 23.9 excess events per 100 000 singleton deliveries during the cold and warm season, respectively. During the warm season, the risks were more pronounced on days closer to delivery and Black women appeared to be more susceptible to the same temperature increase. Conclusion Small changes in temperature appear to affect the risk of having cardiovascular events at labor/delivery. Black women had a differentially higher warm season risk. These findings merit further investigation.

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“…It is likely that winter morning surge in BP would be associated with increased cardiovascular events during winter. 23,24 We should pay attention to the onset of cardiovascular events triggered by winter morning surge in BP, especially in elderly hypertensive patients who own their homes.…”

Section: Discussionmentioning

confidence: 99%

Winter morning surge in blood pressure after the Great East Japan Earthquake

Nishizawa

Fujiwara

Hoshide

et al. 2018

J of Clinical Hypertension

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The great earthquake triggered a powerful tsunami, which provoked catastrophic damage, especially in coastal regions. Almost all buildings were completely destroyed, and thousands of residents in the affected areas were forced to move from their own homes or apartments to temporary housing. Even today, more than 7 years after the disaster, many of the displaced victims continued to live in temporary housing. The quality of life in such housing may affect the health of evacuees, since temporary housing tends to be simpler, less spacious, and less comfortable than occupant-owned housing.Blood pressure (BP), including 24-hour ambulatory BP, fluctuates with the seasons and is generally higher in winter and lower in summer. [1][2][3][4][5][6][7] Previous studies have also demonstrated that seasonal BP variations are more highly associated with indoor temperature than outdoor temperature 8,9 and that indoor temperature is mainly determined by the temperature or permanent nature of residential housing. 4,10 Therefore, housing conditions may be one of the greatest determinants of the seasonal BP variations. However, there have been no studies investigating the association between seasonal BP variations and the nature of the residential housing in areas damaged by the Great East Japan Earthquake.Elderly individuals show more highly exaggerated BP variability than younger people, mainly due to the autonomic nervous dysfunction in the former. [11][12][13][14] The elderly also show higher BP levels in the winter than in the summer, while younger individuals do not exhibit this seasonal BP difference. [15][16][17] Therefore, compared to the BP levels of young people, those of the elderly would be more likely to be changed due to differences in housing conditions; however, information is limited regarding the association between seasonal BP variations and housing conditions in the elderly.To investigate this association, we used data from the Minamisanriku study, a prospective observational study of outpatients of the Minamisanriku hospital who experienced changes in their housing status, to test our hypothesis that seasonal BP variations would be associated with housing conditions (especially This study investigated the association between winter morning surge in systolic blood pressure (SBP) as measured by ambulatory BP monitoring and the housing conditions of subjects in an area damaged by the Great East Japan Earthquake. In 2013, 2 years after disaster, hypertensives who lived in homes that they had purchased before the disaster (n = 299, 74.6 ± 8.1 years) showed significant winter morning surge in SBP (+5.0 ± 20.8 mmHg, P < 0.001), while those who lived in temporary housing (n = 113, 76.2 ± 7.6 years) did not. When we divided the winter morning surge in SBP into quintiles, the factors of age ≥75 years and occupant-owned housing were significant determinants for the highest quintile (≥20 mmHg) after adjustment for covariates. The hypertensives aged ≥75 years who lived in their own homes showed a significant risk for the hi...

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Outdoor temperature, blood pressure, and cardiovascular disease mortality among 23 000 individuals with diagnosed cardiovascular diseases from China

Cited by 150 publications

References 32 publications

Onset seasons and clinical outcomes in patients with Stanford type A acute aortic dissection: an observational retrospective study

Onset seasons and clinical outcomes in patients with Stanford type A acute aortic dissection: an observational retrospective study

Ambient temperature and risk of cardiovascular events at labor and delivery: A case-crossover study

Winter morning surge in blood pressure after the Great East Japan Earthquake

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