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气候危害对心血管健康和心脏重症监护带来的挑战:对缓解和适应的影响。

Challenges posed by climate hazards to cardiovascular health and cardiac intensive care: implications for mitigation and adaptation.

机构信息

University Medical Center Mainz, Department of Cardiology, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany.

Harrington Heart and Vascular Institute, University Hospitals at Case Western Reserve University, Cleveland, OH, USA.

出版信息

Eur Heart J Acute Cardiovasc Care. 2024 Oct 28;13(10):731-744. doi: 10.1093/ehjacc/zuae113.

Abstract

Global warming, driven by increased greenhouse gas emissions, has led to unprecedented extreme weather events, contributing to higher morbidity and mortality rates from a variety of health conditions, including cardiovascular disease (CVD). The disruption of multiple planetary boundaries has increased the probability of connected, cascading, and catastrophic disasters with magnified health impacts on vulnerable populations. While the impact of climate change can be manifold, non-optimal air temperatures (NOTs) pose significant health risks from cardiovascular events. Vulnerable populations, especially those with pre-existing CVD, face increased risks of acute cardiovascular events during NOT. Factors such as age, socio-economic status, minority populations, and environmental conditions (especially air pollution) amplify these risks. With rising global surface temperatures, the frequency and intensity of heatwaves and cold spells are expected to increase, emphasizing the need to address their health impacts. The World Health Organization recommends implementing heat-health action plans, which include early warning systems, public education on recognizing heat-related symptoms, and guidelines for adjusting medications during heatwaves. Additionally, intensive care units must be prepared to handle increased patient loads and the specific challenges posed by extreme heat. Comprehensive and proactive adaptation and mitigation strategies with health as a primary consideration and measures to enhance resilience are essential to protect vulnerable populations and reduce the health burden associated with NOTs. The current educational review will explore the impact on cardiovascular events, future health projections, pathophysiology, drug interactions, and intensive care challenges and recommend actions for effective patient care.

摘要

全球变暖是由温室气体排放增加引起的,导致了前所未有的极端天气事件,使包括心血管疾病(CVD)在内的多种健康状况的发病率和死亡率上升。多个行星边界的中断增加了具有放大脆弱人群健康影响的关联、级联和灾难性灾害的可能性。虽然气候变化的影响可能是多方面的,但非最佳空气温度(NOTs)会对心血管事件造成重大健康风险。脆弱人群,特别是那些患有 CVD 的人群,在 NOT 期间面临急性心血管事件风险增加的情况。年龄、社会经济地位、少数族裔和环境条件(特别是空气污染)等因素会放大这些风险。随着全球表面温度的上升,预计热浪和寒冷天气的频率和强度将会增加,这凸显了应对其健康影响的必要性。世界卫生组织建议实施热健康行动计划,其中包括早期预警系统、公众教育,以识别与热相关的症状,以及在热浪期间调整药物的指南。此外,重症监护病房必须准备好应对增加的患者负荷以及极端高温带来的具体挑战。以健康为首要考虑因素的综合和积极的适应和缓解策略以及增强弹性的措施,对于保护脆弱人群和减少与 NOT 相关的健康负担至关重要。本综述将探讨 NOT 对心血管事件的影响、未来健康预测、病理生理学、药物相互作用以及重症监护挑战,并为有效的患者护理推荐行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80df/11518858/c5398798616f/zuae113f1.jpg

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