Huang Cunrui, Barnett Adrian G, Wang Xiaoming, Tong Shilu
School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Australia.
Circ Cardiovasc Qual Outcomes. 2012 Sep 1;5(5):609-14. doi: 10.1161/CIRCOUTCOMES.112.965707.
Extreme temperatures are associated with cardiovascular disease (CVD) deaths. Previous studies have investigated the relative CVD mortality risk of temperature, but this risk is heavily influenced by deaths in frail elderly people. To better estimate the burden of extreme temperatures, we estimated their effects on years of life lost due to CVD.
The data were daily observations on weather and CVD mortality for Brisbane, Australia, between 1996 and 2004. We estimated the association between daily mean temperature and years of life lost due to CVD, after adjusting for trend, season, day of the week, and humidity. To examine the nonlinear and delayed effects of temperature, a distributed lag nonlinear model was used. The model's residuals were examined to investigate whether there were any added effects due to cold spells and heat waves. The exposure-response curve between temperature and years of life lost was U-shaped, with the lowest years of life lost at 24°C. The curve had a sharper rise at extremes of heat than of cold. The effect of cold peaked 2 days after exposure, whereas the greatest effect of heat occurred on the day of exposure. There were significantly added effects of heat waves on years of life lost.
Increased years of life lost due to CVD are associated with both cold and hot temperatures. Research on specific interventions is needed to reduce temperature-related years of life lost from CVD deaths.
极端温度与心血管疾病（CVD）死亡相关。以往研究调查了温度相关的心血管疾病相对死亡风险，但这种风险受体弱老年人死亡的影响很大。为了更好地估计极端温度的负担，我们估计了其对心血管疾病导致的寿命损失年数的影响。
数据为1996年至2004年澳大利亚布里斯班天气和心血管疾病死亡率的每日观测值。在调整趋势、季节、星期几和湿度后，我们估计了日平均温度与心血管疾病导致的寿命损失年数之间的关联。为了检验温度的非线性和延迟效应，使用了分布滞后非线性模型。检查模型残差以调查寒潮和热浪是否有任何附加效应。温度与寿命损失年数之间的暴露-反应曲线呈U形，在24°C时寿命损失年数最低。曲线在极端高温时比极端低温时上升更陡。寒冷的影响在暴露后2天达到峰值，而高温的最大影响发生在暴露当天。热浪对寿命损失年数有显著的附加效应。
心血管疾病导致的寿命损失年数增加与寒冷和炎热温度均相关。需要开展关于特定干预措施的研究，以减少心血管疾病死亡导致的与温度相关的寿命损失年数。
