Global and Regional Cardiovascular Mortality Attributable to Nonoptimal Temperatures Over Time

Hundessa S.; Huang W.; Zhao Q.; Wu Y.; Wen B.; Alahmad B.; Armstrong B.; Gasparrini A.; Sera F.; Tong S.; Madureira J.; Kyselý J.; Schwartz J.; Vicedo-Cabrera A.M.; Hales S.; Johnson A.; Li S.; Guo Y.; Jaakkola J.J.K.; Ryti N.; Urban A.; Tobias A.; Royé D.; Lavigne E.; Ragettli M.S.; Åström C.; Raz R.; Pascal M.; Kan H.; Goodman P.; Zeka A.; Hashizume M.; Diaz M.H.; Seposo X.; Nunes B.; Kim H.; Lee W.; Íñiguez C.; Guo Y.L.; Pan S.-C.; Zanobetti A.; Dang T.N.; Van Dung D.; Schneider A.; Entezari A.; Analitis A.; Forsberg B.; Ameling C.; Houthuijs D.; Indermitte E.; Mayvaneh F.; Acquaotta F.; de'Donato F.; Carrasco-Escobar G.; Orru H.; Katsouyanni K.; de Sousa Zanotti Stagliorio Coelho M.; Ortega N.V.; Scovronick N.; Michelozzi P.; Correa P.M.; Nascimento Saldiva P.H.; Abrutzky R.; Osorio S.; Colistro V.; Huber V.; Honda Y.; Kim Y.; Bell M.; Xu R.; Yang Z.; Roradeh H.; Félix Arellano E.E.; Rao S.; Carlos Chua P.L.; da Silva S.D.N.P.; De la Cruz Valencia C. · Journal of the American College of Cardiology (2024) · DOI: 10.1016/j.jacc.2024.03.425

Resumen

Background: The association between nonoptimal temperatures and cardiovascular mortality risk is recognized. However, a comprehensive global assessment of this burden is lacking. Objectives: The goal of this study was to assess global cardiovascular mortality burden attributable to nonoptimal temperatures and investigate spatiotemporal trends. Methods: Using daily cardiovascular deaths and temperature data from 32 countries, a 3-stage analytical approach was applied. First, location-specific temperature–mortality associations were estimated, considering nonlinearity and delayed effects. Second, a multivariate meta-regression model was developed between location-specific effect estimates and 5 meta-predictors. Third, cardiovascular deaths associated with nonoptimal, cold, and hot temperatures for each global grid (55 km × 55 km resolution) were estimated, and temporal trends from 2000 to 2019 were explored. Results: Globally, 1,801,513 (95% empirical CI: 1,526,632-2,202,831) annual cardiovascular deaths were associated with nonoptimal temperatures, constituting 8.86% (95% empirical CI: 7.51%-12.32%) of total cardiovascular mortality corresponding to 26 deaths per 100,000 population. Cold-related deaths accounted for 8.20% (95% empirical CI: 6.74%-11.57%), whereas heat-related deaths accounted for 0.66% (95% empirical CI: 0.49%-0.98%). The mortality burden varied significantly across regions, with the highest excess mortality rates observed in Central Asia and Eastern Europe. From 2000 to 2019, cold-related excess death ratios decreased, while heat-related ratios increased, resulting in an overall decline in temperature-related deaths. Southeastern Asia, Sub-Saharan Africa, and Oceania observed the greatest reduction, while Southern Asia experienced an increase. The Americas and several regions in Asia and Europe displayed fluctuating temporal patterns. Conclusions: Nonoptimal temperatures substantially contribute to cardiovascular mortality, with heterogeneous spatiotemporal patterns. Effective mitigation and adaptation strategies are crucial, especially given the increasing heat-related cardiovascular deaths amid climate change.

Instituciones: Universidad Peruana Cayetano Heredia