Xu Can, Nie Xinyu, Xu Rui, Han Ge, Wang Dongjin
Department of Cardiac Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Nanjing University Medical School, Nanjing, China.
Front Public Health. 2025 Jan 3;12:1525357. doi: 10.3389/fpubh.2024.1525357. eCollection 2024.
Hypertensive heart disease (HHD) is a significant form of end-organ damage caused by hypertension, with profound impacts on global health and quality of life. Temperature anomalies driven by climate change, particularly extremes of heat and cold, are increasingly recognized as major contributors to the cardiovascular disease burden, notably impacting HHD. However, the specific spatiotemporal trends and gender-based differences in the burden of non-optimal temperatures on older adults HHD patients remain insufficiently explored. This study aims to evaluate the regional, gender-specific trends in the burden of HHD attributed to non-optimal temperatures among the older adults from 1990 to 2021, and to project future trends in HHD burden under climate-induced temperature anomalies from 2022 to 2050.
Data were sourced from the Global Burden of Disease Study (GBD 2021), which provides estimates of mortality and disability-adjusted life years (DALYs) at global, regional, and national levels. Age-standardized rates (ASR) and estimated annual percentage changes (EAPC) were analyzed. Future burden projections were modeled using age-period-cohort (APC) and Bayesian APC models to assess temperature impact by gender and age differences. Data analysis was conducted using R and STATA, examining the variations in temperature effects by gender and age.
Between 1990 and 2021, cold-related HHD burden among the older adults significantly exceeded that of heat-related burden. However, heat-related HHD burden demonstrated a marked upward trend, projected to continue rising over the next two decades, particularly in low-income and tropical regions. Gender-specific analysis revealed that cold-related HHD burden was more pronounced in women, while heat-related burden was notably higher in men. Additionally, male heat-related HHD mortality rates have shown a substantial increase over the past 30 years, whereas female rates have exhibited a comparatively modest decline.
Although cold remains the dominant non-optimal temperature factor, rising global temperatures suggest an increasing burden of heat-related HHD among the older adults. Efforts should prioritize strengthening resilience in vulnerable regions and populations, with targeted interventions to mitigate future health risks associated with temperature extremes.
高血压性心脏病（HHD）是高血压导致的一种重要的终末器官损害形式，对全球健康和生活质量有着深远影响。气候变化驱动的温度异常，尤其是极端高温和低温，越来越被认为是心血管疾病负担的主要促成因素，对高血压性心脏病有显著影响。然而，非适宜温度对老年高血压性心脏病患者负担的具体时空趋势和性别差异仍未得到充分探索。本研究旨在评估1990年至2021年期间非适宜温度导致的老年高血压性心脏病负担的区域、性别特异性趋势，并预测2022年至2050年气候引起的温度异常下高血压性心脏病负担的未来趋势。
数据来源于全球疾病负担研究（GBD 2021），该研究提供了全球、区域和国家层面的死亡率和伤残调整生命年（DALYs）估计值。分析了年龄标准化率（ASR）和估计年百分比变化（EAPC）。使用年龄-时期-队列（APC）模型和贝叶斯APC模型对未来负担进行预测，以评估性别和年龄差异对温度的影响。使用R和STATA进行数据分析，研究温度效应在性别和年龄上的差异。
1990年至2021年期间，老年人中与寒冷相关的高血压性心脏病负担显著超过与炎热相关的负担。然而，与炎热相关的高血压性心脏病负担呈明显上升趋势，预计在未来二十年将持续上升，特别是在低收入和热带地区。性别特异性分析显示，与寒冷相关的高血压性心脏病负担在女性中更为明显，而与炎热相关的负担在男性中明显更高。此外，男性与炎热相关的高血压性心脏病死亡率在过去30年中大幅上升，而女性死亡率则相对略有下降。
尽管寒冷仍然是主要的非适宜温度因素，但全球气温上升表明老年人中与炎热相关高血压性心脏病的负担在增加。应优先努力加强脆弱地区和人群的适应能力，采取有针对性的干预措施，以减轻未来与极端温度相关的健康风险。
