Weather-induced ischemia and arrhythmia in patients undergoing cardiac rehabilitation: another difference between men and women

Abstract

Given the accumulating evidence that people with underlying heart disease are a particularly vulnerable group for triggers like changing meteorological parameters, the objective of this longitudinal study was to analyze the influence of weather parameters on blood pressure, arrhythmia and ischemia in cardiovascular patients. A panel study with repeated measurements was conducted in a rehabilitation clinic in Timmendorfer Strand (Baltic Sea, Germany) with 872 cardiovascular patients. Heart rate, blood pressure and electrocardiography changes were measured during repeated bicycle ergometries. Generalized Estimating Equations were used for regression analyses of immediate, delayed and cumulative influences of the daily measured meteorological data. For men, a decrease in air temperature and in water vapor pressure doubled the risk of ST-segment depression during ergometry [odds ratio (OR) for 1 day delay: 1.88 (1.24; 2.83) for air temperature] with a delay of 1-2 days. For women, an increase of their heart rate before the start of the ergometry [same day: 4.36 beats/min (0.99; 7.74) for air temperature] and a 2- to 3-fold higher risk for ventricular ectopic beats [1 day delay: OR 2.43 (1.17; 5.05) for air temperature] was observed with an increase in temperature and water vapor pressure in almost all analyzed time-windows. The study indicates that meteorological parameters can induce changes in heart function which may lead to adverse cardiovascular events especially in susceptible, diseased individuals. The observed effect on ST-segment depression could be a link between the association of weather changes and cardiovascular morbidity and mortality.

Relationships between sudden weather changes in summer and mortality in the Czech Republic, 1986–2005

“…This strongly suggests that the effects of large changes in opposite directions should be differentiated and studied separately. Moreover, Schneider et al (2008) found different reactions to temperature changes for women and men; for men/women a decrease/increase of temperature was identified as a risk factor in Schneider's study, which also points out the need for studies that are specific to individual population groups. A preliminary analysis for the population of the Czech Republic reveals that the mortality effects of sudden temperature changes are more pronounced in females than males, which is in accord with heat-related mortality (e.g.…”

“…In contrast to some other biometeorological studies that examined effects of weather changes on human mortality/ health (Květoň 1991;Kyobutungi et al 2005;Schneider et al 2008), we concentrated on relationships between mortality and weather changes in a specific part of the year (summer and/or extended summer season). This is because the effects of weather on mortality depend on season and differ in winter and summer (e.g.…”

“…Ebi et al (2004) analysed temperature changes (defined as at least 3°C decrease in maximum temperature or 3°C increase in minimum temperature) associated with hospital admissions for cardiovascular diseases and stroke in three Californian regions, and found a significant increase in morbidity in northern regions of California for both decreases and increases, with a stronger association for the oldest age group. Schneider et al (2008) showed that a change in weather parameters (such as a decrease/increase in air temperature and water vapour pressure) was associated with significant changes in heart rate and electrocardiography parameters in patients in a heart rehabilitation clinic in Germany. McGregor (1999) found that ischeamic heart disease mortality in winter in the UK is related to air mass changes; the types of weather associated with increased mortality are (1) anticyclonic systems with advection of cold dry continental air, and (2) well-developed and deepening North Atlantic storm systems moving towards or over the UK with rapidly moving fronts.…”

Blood pressure and thermal responses to repeated whole body cold exposure: effect of winter clothing

“…It is well known that an increase in mortality is associated with exposure to low outdoor temperatures, primarily due to cardiovascular diseases, in particular from myocardial infarction and stroke (Marchant et al 1993;Näyhä 2002;Schneider et al 2008). Though the associations between cardiovascular diseases and temperature are well documented, the underlying mechanisms behind these associations are in general not very well understood.…”

Disentangling interactions between atmospheric pollution and weather

“…In general, morbidity8 9 and mortality10 11 associated with heat depend on age, race, sex, class, home characteristics, access to air conditioning, general health and living in an urban area versus a rural area 12. Greater susceptibility to extreme heat has been reported for: the elderly, children, impoverished populations/those with lower socioeconomic status, pregnant women, people with chronic health conditions (eg, diabetes, mobility and cognitive constraints) and outdoor workers 8 11 13–16.…”