Helmholtz Zentrum München,German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Neuherberg, Germany.
Heart. 2014 Aug;100(16):1272-80. doi: 10.1136/heartjnl-2014-305578. Epub 2014 Jun 6.
This time series study aimed to examine the association between daily air temperature and cause-specific cardiovascular mortality in Bavaria, Southern Germany.
We obtained data from the cities Munich, Nuremberg and Augsburg and two adjacent administrative districts (Augsburg and Aichach-Friedberg), for the period 1990-2006. Data included daily cause-specific cardiovascular death counts, mean daily meteorological variables and air pollution concentrations. In the first stage, data were analysed for Munich, Nuremberg and the Augsburg region separately using Poisson regression models combined with distributed lag non-linear models adjusting for long-term trend, calendar effects and meteorological factors. In a second stage, we combined city-specific exposure-response relationships through a multivariate meta-analysis framework.
An increase in the 2-day average temperature from the 90th (20.0°C) to the 99th centiles (24.8°C) resulted in an increase of cardiovascular mortality by 10% (95% CI 5% to 15%) in the pooled analysis, while for a decrease from the 10th (-1.0°C) to the 1st centiles (-7.5°C) in the 15-day average temperature cardiovascular mortality increased by 8% (95% CI 2% to 14%). Strongest consistent risk estimates were seen for high 2-day average temperatures and mortality due to other heart diseases (including arrhythmias and heart failure) and cerebrovascular diseases, especially in the elderly.
Results indicate that, in addition to low temperatures, high temperatures increase cause-specific cardiovascular mortality in temperature climates. These findings may guide planning public health interventions to control and prevent the health effects of exposure to air temperature, especially for individuals at risk for mortality due to heart failure, arrhythmias or cerebrovascular diseases.
本时间序列研究旨在探讨德国巴伐利亚地区日平均气温与特定心血管疾病死亡原因的关系。
我们获取了慕尼黑、纽伦堡和奥格斯堡三个城市以及两个相邻行政区（奥格斯堡和艾夏赫-弗赖贝格）1990 年至 2006 年期间的每日特定心血管疾病死亡数据、日平均气象变量和空气污染浓度数据。在第一阶段，我们分别使用泊松回归模型结合分布式滞后非线性模型对慕尼黑、纽伦堡和奥格斯堡地区的数据进行分析，该模型调整了长期趋势、日历效应和气象因素。在第二阶段，我们通过多变量荟萃分析框架对各城市的暴露-反应关系进行了综合分析。
在综合分析中，2 天平均温度从第 90 百分位（20.0°C）上升到第 99 百分位（24.8°C），心血管死亡率增加了 10%（95%CI 5%至 15%），而 15 天平均温度从第 10 百分位（-1.0°C）下降到第 1 百分位（-7.5°C），心血管死亡率增加了 8%（95%CI 2%至 14%）。在高 2 天平均温度和其他心脏病（包括心律失常和心力衰竭）和脑血管疾病导致的死亡率方面，结果最为一致，特别是在老年人中。
研究结果表明，除了低温之外，高温也会增加温度气候中特定心血管疾病的死亡率。这些发现可能为规划公共卫生干预措施提供依据，以控制和预防暴露于气温对健康的影响，特别是对因心力衰竭、心律失常或脑血管疾病而面临死亡风险的个体。
