The Lag Effects and Vulnerabilities of Temperature Effects on Cardiovascular Disease Mortality in a Subtropical Climate  Zone in China

Huang, Jixia; Wang, Jinfeng; Yu, Weiwei

doi:10.3390/ijerph110403982

Cited by 69 publications

(53 citation statements)

References 40 publications

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“…The results showed that the heat thresholds were 29 • C, 29 • C, 29 • C, and 30 • C and the cold thresholds were 6 • C, 10 • C, 14 • C, and 15 • C for Hefei, Changsha, Nanning, and Haikou, respectively. Previous studies showed that the temperature threshold effect exhibits spatial heterogeneity [19][20][21][22][23]. We compared the results with previous studies that were conducted in East Asia.…”

Section: Discussionsupporting

confidence: 58%

“…Next, we calculated temperature thresholds for the four cities. The previous research showed that the association between temperature and CVD mortality was U shaped [19,25]; therefore, we used the double threshold-natural cubic spline DLNM from a previous study [17]. We assumed both heat-and cold-related CVD mortality were linear, and the temperature thresholds were calculated as previously described [25].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, studies of temperature-related CVD mortality in China are lacking and typically focus on northern China [17,18]. For southern China, only some large cities have been studied, such as Changsha, Kunming, Guangzhou, and Zhuhai [19][20][21][22][23]. Furthermore, these studies mainly focused on the impact of temperature on total mortality not the CVD mortality.…”

Section: Introductionmentioning

confidence: 99%

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Temperature and Cardiovascular Mortality Associations in Four Southern Chinese Cities: A Time-Series Study Using a Distributed Lag Non-Linear Model

Huang

Tan²,

2017

Sustainability

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Abstract:Few studies on population-specific health effects of extreme temperature on cardiovascular diseases (CVDs) deaths have been conducted in the subtropical and tropical climates of China. We examined the association between extreme temperature and CVD across four cities in China. We performed a two-stage analysis; we generated city-specific estimates using a distributed lag non-linear model (DLNM) and estimated the overall effects by conducting a meta-analysis. Heat thresholds of 29 • C, 29 • C, 29 • C, and 30 • C and cold thresholds of 6 • C, 10 • C, 14 • C, and 15 • C were observed in Hefei, Changsha, Nanning, and Haikou, respectively. The lag periods for heat-related CVD mortality were observed only for 0-2 days, while those of cold-related CVD mortality were observed for 10-15 days. The meta-analysis showed that a 1 • C increase above the city-specific heat threshold was associated with average overall CVD mortality increases of 4.6% (3.0%-6.2%), 6.4% (3.4%-9.4%), and 0.2% (−4.8%-5.2%) for all ages, ≥65 years, and <65 years over a lag period of 0-2 days, respectively. Similarly, a 1 • C decrease below the city-specific cold threshold was associated with average overall CVD mortality increases of 4.2% (3.0%-5.4%), 4.9% (3.5%-6.3%), and 3.1% (1.7%-4.5%), for all ages, ≥65 years, and <65 years over a lag period of 0-15 days, respectively. This work will help to take appropriate measures to reduce temperature-mortality risk in different populations in the subtropical and tropical climates of China.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Temperature and Cardiovascular Mortality Associations in Four Southern Chinese Cities: A Time-Series Study Using a Distributed Lag Non-Linear Model

Huang

Tan²,

2017

Sustainability

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“…The distributed lag nonlinear model (DLNM) is used to describe the nonlinear associations between high temperature and mortality and lag response (Gasparrini et al, 2015). Specifically, we estimated the temperature-effect with a maximum of a two-day lag, as previous studies indicated that the effects of high temperatures were generally of the short-term (Chen et al, 2013; Guo et al, 2014; Huang et al, 2014); in the cross-basis function, three internal knots were placed at the quartiles, and one internal knot was placed at equally spaced values on the log scale (Gasparrini et al, 2015). …”

Section: Methodsmentioning

confidence: 99%

The effect of high temperature on cause-specific mortality: A multi-county analysis in China

Ban

et al. 2017

Environment International

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Although existing studies have linked high temperature to mortality in a small number of regions, less evidence is available on the variation in the associations between high temperature exposure and cause-specific mortality of multiple regions in China. Our study focused on the use of time series analysis to quantify the association between high temperature and different cause-specific mortalities for susceptible populations for 43 counties in China. Two-stage analyses adopting a distributed lag non-linear model (DLNM) and a meta-analysis allowed us to obtain county-specific estimates and national-scale pooled estimates of the nonlinear temperature-mortality relationship. We also considered different populations stratified by age and sex, causes of death, absolute and relative temperature patterns, and potential confounding from air pollutants. All of the observed cause-specific mortalities are significantly associated with higher temperature. The estimated effects of high temperature on mortality varied by spatial distribution and temperature patterns. Compared with the 90th percentile temperature, the overall relative risk (RR) at the 99th percentile temperature for non-accidental mortality is 1.105 (95%CI: 1.089, 1.122), for circulatory disease is 1.107 (95%CI: 1.081, 1.133), for respiratory disease is 1.095 (95%CI: 1.050, 1.142), for coronary heart disease is 1.073 (95%CI: 1.047, 1.099), for acute myocardial infarction is 1.072 (95%CI: 1.042, 1.104), and for stroke is 1.095 (95%CI: 1.052, 1.138). Based on our findings, we believe that heat-related health effect in China is a significant issue that requires more attention and allocation of existing resources.

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“…According to previous studies, the temperature variability had delayed effect on health 18. The study conducted by Huang et al 30 showed that the effect of the cold temperatures had a long lag period of 10–25 days, while hot temperatures had a short lag period of only 1–3 days. The ageing phenomena induces some physiological changes in thermoregulation and homeostasis, along with the prevalence of chronic conditions, which cause vulnerability to cold and heat 26…”

Section: Discussionmentioning

confidence: 97%

Association between apparent temperature and acute coronary syndrome admission in Rasht, Iran

et al. 2018

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ObjectiveOur objective was to assess the relations between apparent temperature and incidence of acute coronary syndrome (ACS) in Rasht, Iran.MethodsWe used a time-series analysis to investigate the relationship between apparent temperature and hospital admission from 2005 to 2014. Distributed lag non-linear models were used to estimate the association between ACS hospitalisation and apparent temperature. To examine the high-temperature effect on ACS hospital admission, the relative risk of ACS hospital admission associated with high temperature, the 99th percentile of temperature (34.7°C) compared with the 75th percentile of temperature (26.9°C), was calculated. To assess the cold effect on ACS hospital admission, the relative risk of ACS hospital admission associated with cold temperature, the first percentile of temperature (−0.2°C) compared with the 25th percentile of temperature (8.2°C), was evaluated.ResultsThe cumulative effect of hot exposure on ACS admissions was statistically significant, with a relative risk of 2.04 (95% CI 1.06 to 4.16). The cumulative effect of cold temperature on ACS admissions was found to be non-significant. The highest risk of ACS admission in women was in 38°C (RR, 2.03, 95% CI 1.04 to 4.18). The effect of hot temperature on ACS admission occurred immediately (lag 0) (RR, 1.09, 95% CI 1.001 to 1.19).ConclusionsThe high apparent temperature is correlated with a higher ACS admission especially on the same day. These findings may have implications for developing intervention strategies to reduce and prevent temperature-related morbidity especially in the elderly.

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The Lag Effects and Vulnerabilities of Temperature Effects on Cardiovascular Disease Mortality in a Subtropical Climate Zone in China

Cited by 69 publications

References 40 publications

Temperature and Cardiovascular Mortality Associations in Four Southern Chinese Cities: A Time-Series Study Using a Distributed Lag Non-Linear Model

Temperature and Cardiovascular Mortality Associations in Four Southern Chinese Cities: A Time-Series Study Using a Distributed Lag Non-Linear Model

The effect of high temperature on cause-specific mortality: A multi-county analysis in China

Association between apparent temperature and acute coronary syndrome admission in Rasht, Iran

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