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Cimmino G, Natale F, Alfieri R, Cante L, Covino S, Franzese R, Limatola M, Marotta L, Molinari R, Mollo N, Loffredo FS, Golino P. Non-Conventional Risk Factors: "Fact" or "Fake" in Cardiovascular Disease Prevention? Biomedicines 2023; 11:2353. [PMID: 37760794 PMCID: PMC10525401 DOI: 10.3390/biomedicines11092353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular diseases (CVDs), such as arterial hypertension, myocardial infarction, stroke, heart failure, atrial fibrillation, etc., still represent the main cause of morbidity and mortality worldwide. They significantly modify the patients' quality of life with a tremendous economic impact. It is well established that cardiovascular risk factors increase the probability of fatal and non-fatal cardiac events. These risk factors are classified into modifiable (smoking, arterial hypertension, hypercholesterolemia, low HDL cholesterol, diabetes, excessive alcohol consumption, high-fat and high-calorie diet, reduced physical activity) and non-modifiable (sex, age, family history, of previous cardiovascular disease). Hence, CVD prevention is based on early identification and management of modifiable risk factors whose impact on the CV outcome is now performed by the use of CV risk assessment models, such as the Framingham Risk Score, Pooled Cohort Equations, or the SCORE2. However, in recent years, emerging, non-traditional factors (metabolic and non-metabolic) seem to significantly affect this assessment. In this article, we aim at defining these emerging factors and describe the potential mechanisms by which they might contribute to the development of CVD.
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Affiliation(s)
- Giovanni Cimmino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Naples, Italy
| | - Francesco Natale
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Roberta Alfieri
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Cante
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Simona Covino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Rosa Franzese
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Mirella Limatola
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Marotta
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Riccardo Molinari
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Noemi Mollo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Francesco S Loffredo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Paolo Golino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
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Chaseling GK, Morris NB, Ravanelli N. Extreme Heat and Adverse Cardiovascular Outcomes in Australia and New Zealand: What Do We Know? Heart Lung Circ 2023; 32:43-51. [PMID: 36424263 DOI: 10.1016/j.hlc.2022.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 11/23/2022]
Abstract
Extreme heat events are a leading natural hazard risk to human health. Under all future climate change models, extreme heat events will continue to increase in frequency, duration, and intensity. Evidence from previous extreme heat events across the globe demonstrates that adverse cardiovascular events are the leading cause of morbidity and mortality, particularly amongst the elderly and those with pre-existing cardiovascular disease. However, less is understood about the adverse effects of extreme heat amongst specific cardiovascular diseases (i.e., heart failure, dysrhythmias) and demographics (sex, ethnicity, age) within Australia and New Zealand. Furthermore, although Australia has implemented regional and state heat warning systems, most personal heat-health protective advice available in public health policy documents is either insufficient, not grounded in scientific evidence, and/or does not consider clinical factors such as age or co-morbidities. Dissemination of evidence-based recommendations and enhancing community resilience to extreme heat disasters within Australia and New Zealand should be an area of critical focus to reduce the burden and negative health effects associated with extreme heat. This narrative review will focus on five key areas in relation to extreme heat events within Australia and New Zealand: 1) the potential physiological mechanisms that cause adverse cardiovascular outcomes during extreme heat events; 2) how big is the problem within Australia and New Zealand?; 3) what the heat-health response plans are; 4) research knowledge and translation; and, 5) knowledge gaps and areas for future research.
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Affiliation(s)
- Georgia K Chaseling
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; SOLVE-CHD NHMRC Synergy Grant, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Nathan B Morris
- Department of Human Physiology & Nutrition, University of Colorado, Colorado Springs, CO, USA
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Madaniyazi L, Armstrong B, Chung Y, Ng CFS, Seposo X, Kim Y, Tobias A, Guo Y, Sera F, Honda Y, Gasparrini A, Hashizume M. Seasonal variation in mortality and the role of temperature: a multi-country multi-city study. Int J Epidemiol 2022; 51:122-133. [PMID: 34468728 DOI: 10.1093/ije/dyab143] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although seasonal variations in mortality have been recognized for millennia, the role of temperature remains unclear. We aimed to assess seasonal variation in mortality and to examine the contribution of temperature. METHODS We compiled daily data on all-cause, cardiovascular and respiratory mortality, temperature and indicators on location-specific characteristics from 719 locations in tropical, dry, temperate and continental climate zones. We fitted time-series regression models to estimate the amplitude of seasonal variation in mortality on a daily basis, defined as the peak-to-trough ratio (PTR) of maximum mortality estimates to minimum mortality estimates at day of year. Meta-analysis was used to summarize location-specific estimates for each climate zone. We estimated the PTR with and without temperature adjustment, with the differences representing the seasonal effect attributable to temperature. We also evaluated the effect of location-specific characteristics on the PTR across locations by using meta-regression models. RESULTS Seasonality estimates and responses to temperature adjustment varied across locations. The unadjusted PTR for all-cause mortality was 1.05 [95% confidence interval (CI): 1.00-1.11] in the tropical zone and 1.23 (95% CI: 1.20-1.25) in the temperate zone; adjusting for temperature reduced the estimates to 1.02 (95% CI: 0.95-1.09) and 1.10 (95% CI: 1.07-1.12), respectively. Furthermore, the unadjusted PTR was positively associated with average mean temperature. CONCLUSIONS This study suggests that seasonality of mortality is importantly driven by temperature, most evidently in temperate/continental climate zones, and that warmer locations show stronger seasonal variations in mortality, which is related to a stronger effect of temperature.
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Affiliation(s)
- Lina Madaniyazi
- Department of Paediatric Infectious Disease, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Yeonseung Chung
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aurelio Tobias
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIS), Barcelona, Spain
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Department of Statistics, Computer Science and Applications 'G. Parenti', University of Florence, Florence, Italy
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Masahiro Hashizume
- Department of Paediatric Infectious Disease, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Aoyagi T, Chiba Y, Kitaoka H. Association between acute coronary syndrome onset risk and climate change. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:779-788. [PMID: 34907855 DOI: 10.1080/19338244.2021.2016567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study aimed to clarify the association between the onset of acute coronary syndrome (ACS) and weather conditions in summer and winter in the same region. At a general hospital inJapan, weather conditions during the onset of 2,381 cases diagnosed with ACS over 25 years were analyzed using a generalized additive model adopting log-quasi-Poisson distribution as the link function, with "the occurrence of ACS" as the dependent variable and "weather data" as the independent variable. In conclusion, we found that ACS occurred at about the same frequency in winter and summer, and the season did not affect the onset. The onset rate decreased 0.960-fold per 1 °C increase in the minimum temperature one day before the day of onset and decreased 0.987-fold per 1 hPa increase in the mean station pressure of the previous day.
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Affiliation(s)
- Tomokazu Aoyagi
- General Internal Medicine Nurse Practitioner, Mito Saiseikai General Hospital, Mito City, Ibaraki Prefecture, Japan
| | - Yoshiro Chiba
- Department of Cardiology, Mito Saiseikai General Hospital, Mito City, Ibaraki Prefecture, Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School, Nankoku, Kochi, Japan
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Weather Trumps Festivity? More Cardiovascular Disease Events Occur in Winter than in December Holidays in Queensland, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910158. [PMID: 34639460 PMCID: PMC8508171 DOI: 10.3390/ijerph181910158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022]
Abstract
Objective: Cardiovascular disease (CVD) is the leading cause of hospitalisations and deaths in Australia. This study estimates the excess CVD hospitalisations and deaths across seasons and during the December holidays in Queensland, Australia. Methods: The study uses retrospective, longitudinal, population-based cohort data from Queensland, Australia from January 2010 to December 2015. The outcomes were hospitalisations and deaths categorised as CVD-related. CVD events were grouped according to when they occurred in the calendar year. Excess hospitalisations and deaths were estimated using the multivariate ordinary least squares method after adjusting for confounding effects. Results: More CVD hospitalisations and deaths occurred in winter than in summer, with 7811 (CI: 1353, 14,270; p < 0.01) excess hospitalisations and 774 (CI: 35, 1513; p < 0.01) deaths compared to summer. During the coldest month (July), there was an excess of 42 hospitalisations and 7 deaths per 1000 patients. Fewer CVD hospitalisations (-20 (CI: -29, -9; p < 0.01)) occurred during the December holidays than any other period during the calendar year. Non-CVD events were mostly not statistically significant different between periods. Conclusion: Most CVD events in Queensland occurred in winter rather than during the December holidays. Potentially cost-effective initiatives should be explored such as encouraging patients with CVD conditions to wear warmer clothes during cold temperatures and/or insulating the homes of CVD patients who cannot otherwise afford to.
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Madaniyazi L, Chung Y, Kim Y, Tobias A, Ng CFS, Seposo X, Guo Y, Honda Y, Gasparrini A, Armstrong B, Hashizume M. Seasonality of mortality under a changing climate: a time-series analysis of mortality in Japan between 1972 and 2015. Environ Health Prev Med 2021; 26:69. [PMID: 34217207 PMCID: PMC8254906 DOI: 10.1186/s12199-021-00992-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Ambient temperature may contribute to seasonality of mortality; in particular, a warming climate is likely to influence the seasonality of mortality. However, few studies have investigated seasonality of mortality under a warming climate. METHODS Daily mean temperature, daily counts for all-cause, circulatory, and respiratory mortality, and annual data on prefecture-specific characteristics were collected for 47 prefectures in Japan between 1972 and 2015. A quasi-Poisson regression model was used to assess the seasonal variation of mortality with a focus on its amplitude, which was quantified as the ratio of mortality estimates between the peak and trough days (peak-to-trough ratio (PTR)). We quantified the contribution of temperature to seasonality by comparing PTR before and after temperature adjustment. Associations between annual mean temperature and annual estimates of the temperature-unadjusted PTR were examined using multilevel multivariate meta-regression models controlling for prefecture-specific characteristics. RESULTS The temperature-unadjusted PTRs for all-cause, circulatory, and respiratory mortality were 1.28 (95% confidence interval (CI): 1.27-1.30), 1.53 (95% CI: 1.50-1.55), and 1.46 (95% CI: 1.44-1.48), respectively; adjusting for temperature reduced these PTRs to 1.08 (95% CI: 1.08-1.10), 1.10 (95% CI: 1.08-1.11), and 1.35 (95% CI: 1.32-1.39), respectively. During the period of rising temperature (1.3 °C on average), decreases in the temperature-unadjusted PTRs were observed for all mortality causes except circulatory mortality. For each 1 °C increase in annual mean temperature, the temperature-unadjusted PTR for all-cause, circulatory, and respiratory mortality decreased by 0.98% (95% CI: 0.54-1.42), 1.39% (95% CI: 0.82-1.97), and 0.13% (95% CI: - 1.24 to 1.48), respectively. CONCLUSION Seasonality of mortality is driven partly by temperature, and its amplitude may be decreasing under a warming climate.
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Affiliation(s)
- Lina Madaniyazi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yeonseung Chung
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aurelio Tobias
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Masahiro Hashizume
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
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Glinge C, Engstrøm T, Midgley SE, Tanck MWT, Madsen JEH, Pedersen F, Ravn Jacobsen M, Lodder EM, Al-Hussainy NR, Kjær Stampe N, Trebbien R, Køber L, Gerds T, Torp-Pedersen C, Kølsen Fischer T, Bezzina CR, Tfelt-Hansen J, Jabbari R. Seasonality of ventricular fibrillation at first myocardial infarction and association with viral exposure. PLoS One 2020; 15:e0226936. [PMID: 32101559 PMCID: PMC7043782 DOI: 10.1371/journal.pone.0226936] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/25/2019] [Indexed: 11/19/2022] Open
Abstract
AIMS To investigate seasonality and association of increased enterovirus and influenza activity in the community with ventricular fibrillation (VF) risk during first ST-elevation myocardial infarction (STEMI). METHODS This study comprised all consecutive patients with first STEMI (n = 4,659; aged 18-80 years) admitted to the invasive catheterization laboratory between 2010-2016, at Copenhagen University Hospital, Rigshospitalet, covering eastern Denmark (2.6 million inhabitants, 45% of the Danish population). Hospital admission, prescription, and vital status data were assessed using Danish nationwide registries. We utilized monthly/weekly surveillance data for enterovirus and influenza from the Danish National Microbiology Database (2010-2016) that receives copies of laboratory tests from all Danish departments of clinical microbiology. RESULTS Of the 4,659 consecutively enrolled STEMI patients, 581 (12%) had VF before primary percutaneous coronary intervention. In a subset (n = 807), we found that VF patients experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with the patients without VF (OR 3.39, 95% CI 1.76-6.54). During the study period, 2,704 individuals were diagnosed with enterovirus and 19,742 with influenza. No significant association between enterovirus and VF (OR 1.00, 95% CI 0.99-1.02), influenza and VF (OR 1.00, 95% CI 1.00-1.00), or week number and VF (p-value 0.94 for enterovirus and 0.89 for influenza) was found. CONCLUSION We found no clear seasonality of VF during first STEMI. Even though VF patients had experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with patients without VF, no relationship was found between enterovirus or influenza exposure and occurrence of VF.
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Affiliation(s)
- Charlotte Glinge
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Thomas Engstrøm
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, University of Lund, Lund, Sweden
| | - Sofie E. Midgley
- Department of Virus and Microbiological Special Diagnostics, Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Michael W. T. Tanck
- Amsterdam UMC, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health (APH), Amsterdam, The Netherlands
| | - Jeppe Ekstrand Halkjær Madsen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Section of Biostatistics, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frants Pedersen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mia Ravn Jacobsen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Elisabeth M. Lodder
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Nour R. Al-Hussainy
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Niels Kjær Stampe
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ramona Trebbien
- Department of Virus and Microbiological Special Diagnostics, Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Lars Køber
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Gerds
- Section of Biostatistics, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Clinical Investigation and Cardiology, Nordsjaellands Hospital, Hillerød, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Thea Kølsen Fischer
- Department of Virus and Microbiological Special Diagnostics, Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Diseases and Department of Global Health, Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Connie R. Bezzina
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jacob Tfelt-Hansen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Reza Jabbari
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- International External Collaborator Sponsored Staff at Division of Preventive Medicine, Brigham & Women's Hospital, Boston, MA, United States of America
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Acute and Subacute Triggers of Cardiovascular Events. Am J Cardiol 2018; 122:2157-2165. [PMID: 30309628 DOI: 10.1016/j.amjcard.2018.08.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/24/2018] [Accepted: 08/28/2018] [Indexed: 11/23/2022]
Abstract
Inability to predict short-term cardiovascular (CV) events and take immediate preemptive actions has long been the Achilles heel of cardiology. However, certain triggers of these events have come to light. Although these triggers are nonspecific and are part of normal life, studying their temporal relationship with the onset of CV events provides an opportunity to alert high-risk atherosclerotic patients who may be most vulnerable to such triggers, the "vulnerable patient". Herein, we review the literature and shed light on the epidemiology and underlying pathophysiology of different triggers. We describe that certain adrenergic triggers can precipitate a CV event within minutes or hours; whereas triggers that elicit an immune or inflammatory response such as infections may tip an asymptomatic "vulnerable patient" to become symptomatic days and weeks later. In conclusion, healthcare providers should counsel high-risk CV patients (e.g., in secondary prevention clinics or those with coronary artery Calcium >75th percentile) on the topic, advise them to avoid such triggers, take protective measures once exposed, and seek emergency care immediately after becoming symptomatic after such triggers. Furthermore, clinical trials targeting triggers (prevention or intervention) are needed.
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Forty-year Seasonality Trends in Occurrence of Myocardial Infarction, Ischemic Stroke, and Hemorrhagic Stroke. Epidemiology 2018; 29:777-783. [DOI: 10.1097/ede.0000000000000892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Kumar N, Pandey A, Garg N, Sampene E, Lavie CJ. Seasonal and Geographic Patterns in Seeking Cardiovascular Health Information: An Analysis of the Online Search Trends. Mayo Clin Proc 2018; 93:1185-1190. [PMID: 30193672 PMCID: PMC7089782 DOI: 10.1016/j.mayocp.2018.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 07/08/2018] [Accepted: 07/27/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To ascertain whether temporal and geographic interest in seeking cardiovascular disease (CVD) information online follows seasonal and geographic patterns similar to those observed in real-world data. METHODS We searched Google Trends for popular search terms relating to CVD. Relative search volumes (RSVs) were obtained for the period January 4, 2004, to April 19, 2014, for the United States and Australia. We compared average RSVs by month and season and used cosinor analysis to test for seasonal variation in RSVs. We also assessed correlations between state-level RSVs and CVD burden using an ecological correlational design. RESULTS RSVs were 15% higher in the United States and 45% higher in Australia for winter compared with summer (P<.001 for difference for both). In the United States, RSVs were 36% higher in February compared with August, while in Australia, RSVs were 75% higher in August compared with January. On cosinor analysis, we found a significant seasonal variability in RSVs, with winter peaks and summer troughs for both the United States and Australia (P<.001 for zero amplitude test for both). We found a significant correlation between state-level RSVs and mortality from CVD (r=0.62; P<.001), heart disease (r=0.58; P<.001), coronary heart disease (r=0.48; P<.001), heart failure (r=0.51; P<.001), and stroke (r=0.60; P<.001). CONCLUSION Google search query volumes related to CVD follow strong seasonal patterns with winter peaks and summer troughs. There is moderate to strong positive correlation between state-level search query volumes and burden of CVD mortality.
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Affiliation(s)
- Nilay Kumar
- Division of Hospital Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Ambarish Pandey
- Division of Cardiovascular Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Neetika Garg
- Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Emmanuel Sampene
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Carl J Lavie
- Division of Cardiology, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA.
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Hensel M, Geppert D, Kersten JF, Stuhr M, Lorenz J, Wirtz S, Kerner T. Association between Weather-Related Factors and Cardiac Arrest of Presumed Cardiac Etiology: A Prospective Observational Study Based on Out-of-Hospital Care Data. PREHOSP EMERG CARE 2018; 22:345-352. [PMID: 29345516 DOI: 10.1080/10903127.2017.1381790] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this study was to determine the association between weather-related factors and out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology. METHODS This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period. Weather data (temperature, humidity, air pressure, wind speed) were obtained every minute and matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the above-mentioned weather-related factors and OHCA of presumed cardiac etiology. Additionally, varying measuring-ranges were defined for each weather-related factor in order to compare them with each other with regard to the probability of occurrence of OHCA. RESULTS During the observation period 1,558 OHCA with presumed cardiac etiology were registered (age: 67 ± 19 yrs; 62% male; hospital admission: 37%; survival to hospital discharge: 6.7%). Compared to moderate temperatures (5 - 25°C), probability of OHCA-occurrence increased significantly at temperatures above 25°C (p = 0.028) and below 5°C p = 0.011). Regarding air humidity, probability of OHCA-occurrence increased below a threshold-value of 75% compared to values above this cut-off (p = 0.006). Decreased probability was seen at moderate atmospheric pressure (1000 hPa - 1020 hPa), whereas increased probability was seen above 1020 hPa (p = 0.023) and below 1000 hPa (p = 0.035). Probability of OHCA-occurrence increased continuously with increasing wind speed (p < 0.001). CONCLUSIONS There are associations between several weather-related factors such as temperature, humidity, air pressure, and wind speed, and occurrence of OHCA of presumed cardiac etiology. Particularly dangerous seem to be cold weather, dry air and strong wind.
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Effects of climatic factors on plasma lipid levels: A 5-year longitudinal study in a large Chinese population. J Clin Lipidol 2016; 10:1119-28. [DOI: 10.1016/j.jacl.2016.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 06/17/2016] [Accepted: 06/18/2016] [Indexed: 11/24/2022]
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Rahman SR, Ahmed MF, Islam MA, Majibur Rahman M. Effect of risk factors on the prevalence of influenza infections among children of slums of Dhaka city. SPRINGERPLUS 2016; 5:602. [PMID: 27247898 PMCID: PMC4864765 DOI: 10.1186/s40064-016-2275-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 05/04/2016] [Indexed: 12/26/2022]
Abstract
Background Influenza viruses may cause severe acute respiratory illness among human population. People of densely populated areas, e.g., slum, are mostly affected by influenza viruses. Although potential vaccines to influenza viruses have been developed, infection rate is still high, therefore, increase the morbidity and mortality rate in slum areas. To treat these infections, slum dwellers including children and mothers do not get proper medication as well as vaccination. Hence, prevention remains to be the only mean to tackle such infections. Herein, we determined the prevalence of influenza infections among nutritionally deprived children and mothers of slum areas in Dhaka city and demonstrated the association with different risk factors like age, gender and socio-economic status. Results Nasopharyngeal swab samples and a short demography of all the participants suffering from influenza-like illness (ILI) were collected. The samples were subjected to RNA extraction and then real-time RT-PCR to detect influenza viruses. Among the ILI patients, about 87.9 % did not have knowledge about influenza infections and 80.5 % did not cover their noses during coughing as well as sneezing. Children were significantly infected by both influenza A and influenza B viruses, suggesting their vulnerability to these infections. Additionally, among the children with ILI, influenza infections were significantly associated with age below or equal to three years, very poor family incomes, practicing unhygienic habits and nutritional deficiency. Conclusions This study suggests that proper vaccination, improved sanitary conditions and nutritional diet may help reduce the risk of influenza infections in slum areas.
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Affiliation(s)
| | - Md Firoz Ahmed
- Department of Microbiology, Jahangirnagar University, Dhaka, Bangladesh
| | - Mohammad Ariful Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000 Bangladesh ; Department of Microbiology, Jagannath University, Dhaka, 1000 Bangladesh
| | - Md Majibur Rahman
- Department of Microbiology, University of Dhaka, Dhaka, 1000 Bangladesh
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Schwartz BG, Qualls C, Kloner RA, Laskey WK. Relation of Total and Cardiovascular Death Rates to Climate System, Temperature, Barometric Pressure, and Respiratory Infection. Am J Cardiol 2015; 116:1290-7. [PMID: 26297511 DOI: 10.1016/j.amjcard.2015.07.050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/03/2015] [Accepted: 07/03/2015] [Indexed: 11/28/2022]
Abstract
A distinct seasonal pattern in total and cardiovascular death rates has been reported. The factors contributing to this pattern have not been fully explored. Seven locations (average total population 71,354,000) were selected where data were available including relatively warm, cold, and moderate temperatures. Over the period 2004 to 2009, there were 2,526,123 all-cause deaths, 838,264 circulatory deaths, 255,273 coronary heart disease deaths, and 135,801 ST-elevation myocardial infarction (STEMI) deaths. We used time series and multivariate regression modeling to explore the association between death rates and climatic factors (temperature, dew point, precipitation, barometric pressure), influenza levels, air pollution levels, hours of daylight, and day of week. Average seasonal patterns for all-cause and cardiovascular deaths were very similar across the 7 locations despite differences in climate. After adjusting for multiple covariates and potential confounders, there was a 0.49% increase in all-cause death rate for every 1°C decrease. In general, all-cause, circulatory, coronary heart disease and STEMI death rates increased linearly with decreasing temperatures. The temperature effect varied by location, including temperature's linear slope, cubic fit, positional shift on the temperature axis, and the presence of circulatory death increases in locally hot temperatures. The variable effect of temperature by location suggests that people acclimatize to local temperature cycles. All-cause and circulatory death rates also demonstrated sizable associations with influenza levels, dew point temperature, and barometric pressure. A greater understanding of how climate, temperature, and barometric pressure influence cardiovascular responses would enhance our understanding of circulatory and STEMI deaths.
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Affiliation(s)
- Bryan G Schwartz
- Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico; Heart Institute, Good Samaritan Hospital, Los Angeles, California.
| | - Clifford Qualls
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico; Clinical Translational Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - Robert A Kloner
- Heart Institute, Good Samaritan Hospital, Los Angeles, California; Huntington Medical Research Institute, Pasadena, California; Division of Cardiovascular Medicine, Department of Internal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Warren K Laskey
- Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
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Park HK, Bae SR, Kim SE, Choi WS, Paick SH, Ho K, Kim HG, Lho YS. The effect of climate variability on urinary stone attacks: increased incidence associated with temperature over 18 °C: a population-based study. Urolithiasis 2014; 43:89-94. [PMID: 25407800 DOI: 10.1007/s00240-014-0741-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the effect of seasonal variation and climate parameters on urinary tract stone attack and investigate whether stone attack is increased sharply at a specific point. Nationwide data of total urinary tract stone attack numbers per month between January 2006 and December 2010 were obtained from the Korean Health Insurance Review and Assessment Service. The effects of climatic factors on monthly urinary stone attack were assessed using auto-regressive integrated moving average (ARIMA) regression method. A total of 1,702,913 stone attack cases were identified. Mean monthly and monthly average daily urinary stone attack cases were 28,382 ± 2,760 and 933 ± 85, respectively. The stone attack showed seasonal trends of sharp incline in June, a peak plateau from July to September, and a sharp decline after September. The correlation analysis showed that ambient temperature (r = 0.557, p < 0.001) and relative humidity (r = 0.513, p < 0.001) were significantly associated with urinary stone attack cases. However, after adjustment for trends and seasonality, ambient temperature was the only climate factor associated with the stone attack cases in ARIMA regression test (p = 0.04). Threshold temperature was estimated as 18.4 °C. Risk of urinary stone attack significantly increases 1.71% (1.02-2.41 %, 95% confidence intervals) with a 1 °C increase of ambient temperature above the threshold point. In conclusion, monthly urinary stone attack cases were changed according to seasonal variation. Among the climates variables, only temperature had consistent association with stone attack and when the temperature is over 18.4 °C, urinary stone attack would be increased sharply.
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Affiliation(s)
- Hyoung Keun Park
- Department of Urology, Konkuk University School of Medicine, 120-1, Neung-Dong-Ro, Gwangjin-Ku, Seoul 143-729, Korea,
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Ben Ahmed H, Allouche M, Zoghlami B, Shimi M, Razghallah R, Gloulou F, Baccar H, Hamdoun M. Mort subite d’origine cardiaque au nord de la Tunisie : variation circadienne, hebdomadaire et saisonnière. Presse Med 2014; 43:e39-45. [DOI: 10.1016/j.lpm.2013.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/02/2013] [Accepted: 09/24/2013] [Indexed: 01/09/2023] Open
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Inglis SC, Clark RA, Shakib S, Wong DT, Molaee P, Wilkinson D, Stewart S. Hot summers and heart failure: Seasonal variations in morbidity and mortality in Australian heart failure patients (1994-2005). Eur J Heart Fail 2014; 10:540-9. [DOI: 10.1016/j.ejheart.2008.03.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 02/29/2008] [Accepted: 03/26/2008] [Indexed: 10/22/2022] Open
Affiliation(s)
- Sally C. Inglis
- Schools of Medicine and Nursing; University of Queensland; Brisbane Australia
| | - Robyn A. Clark
- Department of Clinical Pharmacology; Royal Adelaide Hospital and Faculty of Health Sciences, University of South Australia; Adelaide Australia
| | - Sepehr Shakib
- Department of Clinical Pharmacology; Royal Adelaide Hospital; Adelaide Australia
| | - Denis T. Wong
- Department of Cardiology; Royal Adelaide Hospital; Adelaide Australia
| | - Payman Molaee
- Cardiovascular Research Centre, Royal Adelaide Hospital; Adelaide Australia
| | - David Wilkinson
- School of Medicine, University of Queensland; Brisbane Australia
| | - Simon Stewart
- Preventative Cardiology, Baker Heart Research Institute; Melbourne Australia
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Törő K, Väli M, Lepik D, Tuusov J, Dunay G, Marcsa B, Pauliukevicius A, Raudys R, Caplinskiene M. Characteristics of cardiovascular deaths in forensic medical cases in Budapest, Vilnius and Tallinn. J Forensic Leg Med 2013; 20:968-71. [DOI: 10.1016/j.jflm.2013.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 05/20/2013] [Accepted: 06/16/2013] [Indexed: 10/26/2022]
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Evaluation of meteorological factors on sudden cardiovascular death. J Forensic Leg Med 2010; 17:236-42. [DOI: 10.1016/j.jflm.2010.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 12/17/2009] [Accepted: 02/13/2010] [Indexed: 11/22/2022]
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Abstract
The onset of acute myocardial infarction (AMI) is a complex interplay of internal circadian factors and external physical and emotional triggers. These interactions may lead to rupture of an often nonocclusive vulnerable atherosclerotic coronary plaque with subsequent formation of an occlusive thrombus. The onset of AMI has a distinct pattern, with peak incidence within the first few hours after awakening, on certain days of the week, and in the winter months. Physical and emotional stresses are important triggers of acute cardiovascular events including AMI. Triggering events, internal changes, and external factors vary among different geographical, environmental, and ethnic regions. Life-style changes, pharmacotherapy, and psychologic interventions may potentially modify the response to, and protect against the effects of triggering events.
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Kamezaki F, Sonoda S, Tomotsune Y, Yunaka H, Otsuji Y. Seasonal Variation in Serum Lipid Levels in Japanese Workers. J Atheroscler Thromb 2010; 17:638-43. [DOI: 10.5551/jat.3566] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
BACKGROUND Several studies have described seasonal patterns of mortality, with rates higher in winter and lower in summer. Few researchers, however, have analyzed how the mortality rate in winter may influence the temperature-mortality association in the following summer. In the present paper, we addressed the question of whether the association between summer temperature and mortality among the elderly is modified by the previous winter mortality rate. METHODS We selected all deaths in Rome during 1987-2005 among persons 65 years old or older. We collected data on daily mean temperature and humidity. We estimated the effect of summer apparent temperature on mortality by using a time-series approach, and tested the effect modification based on the mortality rate during the preceding winter. RESULTS The effect of summer apparent temperature on mortality was stronger in years characterized by low mortality in the previous winter (relative risk for days at 30 degrees C vs. days at 20 degrees C = 1.73 [95% confidence interval = 1.50-2.01]), as contrasted with years with medium (1.32 [1.25-1.41]) or high winter mortality (1.34 [1.17-1.55]). The percentages of attributable risks for summer heat were 28%, 18%, and 18% for years characterized by low, medium, or high winter mortality rates respectively. CONCLUSIONS Low-mortality winters may inflate the pool of the elderly susceptible population at risk for dying from high temperature the following summer.
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Cao J, Cheng Y, Zhao N, Song W, Jiang C, Chen R, Kan H. Diurnal temperature range is a risk factor for coronary heart disease death. J Epidemiol 2009; 19:328-32. [PMID: 19749499 PMCID: PMC3924102 DOI: 10.2188/jea.je20080074] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Although the relation between day-to-day temperature change and coronary heart disease (CHD) mortality is well established, it is unknown whether temperature variation within 1 day, ie, diurnal temperature range (DTR), is an independent risk factor for acute CHD death. Methods We used time-series and case-crossover approaches to assess the relation between DTR and daily CHD mortality between 2001 and 2004 in Shanghai, China. Specifically, we used exposures averaged over periods varying from 1 to 5 days to assess the effects of DTR on CHD mortality. We estimated the percent increase in the number of daily deaths related to CHD that were associated with DTR, after adjustment for daily meteorologic conditions (temperature and relative humidity) and levels of outdoor air pollutants. Results Both time-series and case-crossover analyses showed that DTR was significantly associated with the number of daily deaths related to CHD. A 1 °C increase in 2-day lagged DTR corresponded to a 2.46% (95% CI, 1.76% to 3.16%) increase in CHD mortality on time-series analysis, a 3.21% (95% CI, 2.23% to 4.19%) increase on unidirectional case-crossover analysis, and a 2.13% (95% CI, 1.04% to 3.22%) increase on bidirectional case-crossover analysis. Conclusions Our findings suggest that DTR is an independent risk factor for acute CHD death.
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Affiliation(s)
- Jingyan Cao
- Department of Cardiology, Fourth Affiliated Hospital of Nantong University, Yancheng, China
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Chen SH, Chuang SY, Lin KC, Tsai ST, Chou P. Community-based study on summer-winter difference in insulin resistance in Kin-Chen, Kinmen, Taiwan. J Chin Med Assoc 2008; 71:619-27. [PMID: 19114326 DOI: 10.1016/s1726-4901(09)70004-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The aim of this community-based study was to explore the summer-winter difference in insulin resistance in Kin-Chen, Kinmen. METHODS A total of 2,412 residents aged 40 and over was enrolled in a mass survey in Kin-Chen, Kinmen, by the Yang-Ming Crusade, a volunteer organization of well-trained medical students from National Yang-Ming University. All participants were investigated in winter (first phase, January and February, before Chinese New Year) and summer (secondary phase, July and August) in 2002. Structured questionnaires, demographic and physical data, lifestyle, and blood chemistry parameters were collected. RESULTS Higher levels of fasting insulin, HOMA-insulin resistance and triglycerides, but lower levels of high-density lipoprotein cholesterol were found in summer than in winter. The prevalence of metabolic syndrome was higher in summer than in winter, with differences of 7.7% in both genders (p = 0.0092 in men, p = 0.0037 in women). Body mass index (BMI), age and physical activity were significantly correlated with metabolic syndrome. After controlling for BMI and other risk profiles, summer was independently and positively associated with fasting insulin and insulin resistance regardless of metabolic syndrome. CONCLUSION Fasting insulin, insulin resistance and prevalence of metabolic syndrome were higher in summer than in winter. BMI and season were 2 major determinants of the variation in fasting insulin. The contextual impacts of seasonal variation in shaping metabolic syndrome or insulin resistance in populations need to be reemphasized.
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Affiliation(s)
- Shui-Hu Chen
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, and Kin-Nin Health Center, Kinmen, Taipei, Taiwan, ROC
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Loughnan ME, Nicholls N, Tapper NJ. Demographic, seasonal, and spatial differences in acute myocardial infarction admissions to hospital in Melbourne Australia. Int J Health Geogr 2008; 7:42. [PMID: 18664293 PMCID: PMC2517067 DOI: 10.1186/1476-072x-7-42] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2008] [Accepted: 07/30/2008] [Indexed: 11/10/2022] Open
Abstract
Background Seasonal patterns in cardiac disease in the northern hemisphere are well described in the literature. More recently age and gender differences in cardiac mortality and to a lesser extent morbidity have been presented. To date spatial differences between the seasonal patterns of cardiac disease has not been presented. Literature relating to seasonal patterns in cardiac disease in the southern hemisphere and in Australia in particular is scarce. The aim of this paper is to describe the seasonal, age, gender, and spatial patterns of cardiac disease in Melbourne Australia by using acute myocardial infarction admissions to hospital as a marker of cardiac disease. Results There were 33,165 Acute Myocardial Infarction (AMI) admissions over 2186 consecutive days. There is a seasonal pattern in AMI admissions with increased rates during the colder months. The peak month is July. The admissions rate is greater for males than for females, although this difference decreases with advancing age. The maximal AMI season for males extends from April to November. The difference between months of peak and minimum admissions was 33.7%. Increased female AMI admissions occur from May to November, with a variation between peak and minimum of 23.1%. Maps of seasonal AMI admissions demonstrate spatial differences. Analysis using Global and Local Moran's I showed increased spatial clustering during the warmer months. The Bivariate Moran's I statistic indicated a weaker relationship between AMI and age during the warmer months. Conclusion There are two distinct seasons with increased admissions during the colder part of the year. Males present a stronger seasonal pattern than females. There are spatial differences in AMI admissions throughout the year that cannot be explained by the age structure of the population. The seasonal difference in AMI admissions warrants further investigation. This includes detailing the prevalence of cardiac disease in the community and examining issues of social and environmental justice.
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Affiliation(s)
- Margaret E Loughnan
- School of Geography and Environmental Science Monash University, Wellington Road Clayton, Australia.
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Goerre S, Egli C, Gerber S, Defila C, Minder C, Richner H, Meier B. Impact of weather and climate on the incidence of acute coronary syndromes. Int J Cardiol 2007; 118:36-40. [PMID: 16904213 DOI: 10.1016/j.ijcard.2006.06.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Revised: 06/17/2006] [Accepted: 06/18/2006] [Indexed: 01/03/2023]
Abstract
BACKGROUND First investigations of the interactions between weather and the incidence of acute myocardial infarctions date back to 1938. The early observation of a higher incidence of myocardial infarctions in the cold season could be confirmed in very different geographical regions and cohorts. While the influence of seasonal variations on the incidence of myocardial infarctions has been extensively documented, the impact of individual meteorological parameters on the disease has so far not been investigated systematically. Hence the present study intended to assess the impact of the essential variables of weather and climate on the incidence of myocardial infarctions. METHODS The daily incidence of myocardial infarctions was calculated from a national hospitalization survey. The hourly weather and climate data were provided by the database of the national weather forecast. The epidemiological and meteorological data were correlated by multivariate analysis based on a generalized linear model assuming a log-link-function and a Poisson distribution. RESULTS High ambient pressure, high pressure gradients, and heavy wind activity were associated with an increase in the incidence of the totally 6560 hospitalizations for myocardial infarction irrespective of the geographical region. Snow- and rainfall had inconsistent effects. Temperature, Foehn, and lightning showed no statistically significant impact. CONCLUSIONS Ambient pressure, pressure gradient, and wind activity had a statistical impact on the incidence of myocardial infarctions in Switzerland from 1990 to 1994. To establish a cause-and-effect relationship more data are needed on the interaction between the pathophysiological mechanisms of the acute coronary syndrome and weather and climate variables.
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Affiliation(s)
- Stefan Goerre
- Cardiology, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland.
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Beyerbach DM, Kovacs RJ, Dmitrienko AA, Rebhun DM, Zipes DP. Heart rate-corrected QT interval in men increases during winter months. Heart Rhythm 2006; 4:277-81. [PMID: 17341387 DOI: 10.1016/j.hrthm.2006.11.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2006] [Accepted: 11/03/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sudden cardiac death increases during winter months in both men and women. The heart rate-corrected QT (QTc) interval exhibits circadian variation. However, little is known about QTc interval variation with month of year. OBJECTIVE We sought to determine whether the QTc interval varies with month of year. METHODS We retrospectively analyzed a database of 24,370 electrocardiograms (ECGs) to determine seasonal variation in QTc intervals. The analysis data set included 7,976 baseline ECGs, one each for 3,700 men and 4,276 women. ECGs selected for analysis were normal, recorded in regions north of the equator, and taken on subjects >or=18 years old. The QT correction for heart rate (HR) was performed using QTc = QT*(HR/60)(0.4). The monthly mean QTc intervals were compared, for men and women separately, using a one-way analysis of variance with the Bonferroni correction for multiple comparisons. RESULTS Subject ages ranged from 18 to 95 years. The monthly mean QTc intervals were consistently greater for women than for men by 5.2 +/- 2.3 ms. After correction for multiple comparisons, the difference between the greatest and least monthly mean QTc interval was 6.1 +/- 1.5 ms (P <.01) for men and 3.5 ms (nonsignificant) for women. The maximum monthly mean QTc interval of 413 +/- 18 ms (n = 560; P <.05) occurred in October for men and of 417 +/- 16 ms (n = 350) in March for women, but it was not significant. CONCLUSIONS Significant seasonal variation in QTc interval exists among male subjects >or=18 years of age with normal baseline ECGs, with the QTc interval being longest in October. No significant variation was seen for women.
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Affiliation(s)
- Daniel M Beyerbach
- Krannert Institute of Cardiology, Department of Medicine, Indiana University, Indianapolis, Indiana 46202, USA
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Chen SH, Jen IA, Chuang SY, Lin KC, Chou P. Community-based study on summer-winter differences of component of metabolic syndrome in Kinmen, Taiwan. Prev Med 2006; 43:129-35. [PMID: 16624399 DOI: 10.1016/j.ypmed.2006.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2005] [Revised: 02/10/2006] [Accepted: 02/28/2006] [Indexed: 11/23/2022]
Abstract
BACKGROUND A community-based study was conducted to investigate summer-winter differences of component of metabolic syndrome in Kinmen, Taiwan. METHODS A total of 8251 residents aged 40 and over were enrolled in the mass survey in Kinmen. They were investigated while on summer (July and August) and winter vacation (January and February) during 2000-2003. Demographics, physical examination findings, lifestyle variables and biochemical data were collected. RESULTS After controlling for age, body mass index, diet, lifestyle and other risk factors for component of metabolic syndrome, there were independent and significant relationships between summer-winter difference and component of metabolic syndrome. Winter season was positively correlated with blood pressure, fasting plasma glucose level, high-density lipoprotein-cholesterol (HDL-C) and waist circumference, but was negatively associated with fasting triglycerides and metabolic syndrome. CONCLUSIONS Summer season is positively associated with hypertriglyceridemia, low HDL-C and metabolic syndrome. These findings imply that cross-sectional, experimental and cohort studies of component of metabolic syndrome or metabolic syndrome should take season into account as possible confounding effects.
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Affiliation(s)
- Shui-Hu Chen
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, 155, Li-Nong St., Sec.2, Peitou, Taipei 112, Taiwan, ROC
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Gerber Y, Jacobsen SJ, Killian JM, Weston SA, Roger VL. Seasonality and daily weather conditions in relation to myocardial infarction and sudden cardiac death in Olmsted County, Minnesota, 1979 to 2002. J Am Coll Cardiol 2006; 48:287-92. [PMID: 16843177 DOI: 10.1016/j.jacc.2006.02.065] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Revised: 02/09/2006] [Accepted: 02/14/2006] [Indexed: 01/03/2023]
Abstract
OBJECTIVES We assessed the relationship of season and weather types with myocardial infarction (MI) and sudden cardiac death (SCD) in a geographically defined population, and tested the hypothesis that the increased risk in winter was related to weather. BACKGROUND Winter peaks in coronary heart disease (CHD) have been documented. Yet, it is uncertain if seasonality exists for both incident events and deaths, and the role of weather conditions is not clear. METHODS The daily occurrence of incident MI and SCD in Olmsted County was examined with data from the National Weather Service. Poisson regression models were used to assess the relative risks (RRs) associated with season and climatic variables. Subsequent analysis stratified SCD into those with and without antecedent CHD (unexpected SCD). RESULTS Between 1979 and 2002, 2,676 MI and 2,066 SCD occurred. The age-, gender-, and year-adjusted RR of SCD, but not of MI, was increased in winter versus summer (1.17, 95% confidence interval [CI] 1.03 to 1.32) and in low temperatures (1.20, 95% CI 1.07 to 1.35, for temperatures below 0 degrees C vs. 18 degrees C to 30 degrees C). These associations were stronger for unexpected SCD than for SCD with prior CHD (p < 0.05). After adjustment for all climatic variables, low temperature was associated with a large increase in the risk of unexpected SCD (RR = 1.38, 95% CI 1.10 to 1.73), while the association with winter declined (RR = 1.06, 95% CI 0.83 to 1.35). CONCLUSIONS These data suggest that the winter peak in SCD can be accounted for by daily weather.
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Affiliation(s)
- Yariv Gerber
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA
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Abstract
There is near unanimous scientific consensus that greenhouse gas emissions generated by human activity will change Earth's climate. The recent (globally averaged) warming by 0.5 degrees C is partly attributable to such anthropogenic emissions. Climate change will affect human health in many ways-mostly adversely. Here, we summarise the epidemiological evidence of how climate variations and trends affect various health outcomes. We assess the little evidence there is that recent global warming has already affected some health outcomes. We review the published estimates of future health effects of climate change over coming decades. Research so far has mostly focused on thermal stress, extreme weather events, and infectious diseases, with some attention to estimates of future regional food yields and hunger prevalence. An emerging broader approach addresses a wider spectrum of health risks due to the social, demographic, and economic disruptions of climate change. Evidence and anticipation of adverse health effects will strengthen the case for pre-emptive policies, and will also guide priorities for planned adaptive strategies.
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Affiliation(s)
- Anthony J McMichael
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra 0200, Australia.
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Straus SMJM, Bleumink GS, Dieleman JP, van der Lei J, Stricker BHC, Sturkenboom MCJM. The incidence of sudden cardiac death in the general population. J Clin Epidemiol 2004; 57:98-102. [PMID: 15019016 DOI: 10.1016/s0895-4356(03)00210-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES To determine the incidence of sudden cardiac death in a general (Dutch) population. METHODS Cohort study in the Integrated Primary Care Information (IPCI) project, a database with all medical data from 150 general practices in The Netherlands. The study population comprised 249,126 subjects with a mean follow-up of 2.54 years. RESULTS In this period 4,892 deaths were identified, 582 of which were classified as (probable) sudden cardiac death. The overall incidence of sudden cardiac death in this population was 0.92 cases per 1,000 person-years (95%CI: 0.85-0.99). The risk was 2.3-fold higher in men than in women, and increased with age. The incidence of sudden cardiac death peaked in October and was lowest in August. CONCLUSIONS The incidence of sudden cardiac death in the general Dutch population was almost 1 per 1,000 person-years per year during the period 1 January, 1995 to 1 April, 2001. Most of the cases occurred at home.
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Affiliation(s)
- S M J M Straus
- Department of Medical Informatics, Erasmus MC, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
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