Autor(es):
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, AM ; Hales, S ; Johnson, A ; Li, S ; Guo, Y ; Jaakkola, JJK ; Ryti, N ; Urban, A ; Tobias, A ; Royé, D ; Lavigne, E ; Ragettli, MS ; Åström, C ; Raz, R ; Pascal, M ; Kan, H ; Goodman, P ; Zeka, A ; Hashizume, M ; Diaz, MH ; Seposo, X ; Nunes, B ; Kim, H ; Lee, W ; Íñiguez, C ; Guo, YL ; Pan, SC ; Zanobetti, A ; Dang, TN ; 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, NV ; Scovronick, N ; Michelozzi, P ; Correa, PM ; Nascimento Saldiva, PH ; Abrutzky, R ; Osorio, S ; Colistro, V ; Huber, V ; Honda, Y ; Kim, Y ; Bell, M ; Xu, R ; Yang, Z ; Roradeh, H ; Félix Arellano, EE ; Rao, S ; Carlos Chua, PL ; da Silva, SDNP ; De la Cruz Valencia, C
Data: 2024
Identificador Persistente: https://hdl.handle.net/10216/160732
Origem: Repositório Aberto da Universidade do Porto
Descrição
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. © 2024 American College of Cardiology Foundation
