Vieira de Oliveira Salerno Pedro Rafael, Lewis P Grace Tee, Chen Zhuo, Dazard Jean-Eudes, Ganatra Sarju, Ahmed Eman Nayaz, Nasir Khurram, Deo Salil V, Rajagopalan Sanjay, Al-Kindi Sadeer
Department of Medicine NYC Health+Hospitals/Elmhurst, Icahn School of Medicine at Mt. Sinai Queens NY USA.
Environmental Defense Fund Houston TX USA.
J Am Heart Assoc. 2025 Jun 3;14(11):e038251. doi: 10.1161/JAHA.124.038251. Epub 2025 May 26.
There is an incomplete understanding of the impact of climate change on cardiovascular-kidney-metabolic (CKM) syndrome. Although climate change affects all Americans, certain communities and individuals may suffer a disproportionate burden. Therefore, this study's objective was to explore the relationship between the Climate Vulnerability Index domains and the prevalence of CKM components in the United States.
This cross-sectional study obtained health outcomes from Centers for Disease Control and Prevention Population Level Analysis and Community Estimates (2021) and assessed the census tract-level prevalence of coronary heart disease, chronic kidney disease, obesity, diabetes, dyslipidemia, and hypertension. ANOVA was used to assess statistically significant differences in the means of CKM components between quartiles of each climate change domain. Linear regression models assessed the association between each domain and outcome, followed by models adjusted by baseline Climate Vulnerability Index components. Fully adjusted models included all 3 climate change domains and the baseline Climate Vulnerability Index components.
Data for 70 300 census tracts, covering 299.8 million individuals, were included. Statistically significant differences (<0.001) in CKM prevalence were found between quartiles of all climate change domains. These associations persisted after adjusting for baseline domains (environment, social/economic, and infrastructure) and in the full model including all domains.
The Climate Vulnerability Index's climate change component was associated with the prevalence of CKM components (coronary heart disease, chronic kidney disease, obesity, diabetes, dyslipidemia, and hypertension). These findings suggest that populations with CKM may be associated with increased climate vulnerability, underscoring the need for a deeper understanding of climate change as a determinant of health.
气候变化对心血管-肾脏-代谢（CKM）综合征的影响尚未完全明确。尽管气候变化影响所有美国人，但某些社区和个人可能承受不成比例的负担。因此，本研究的目的是探讨气候脆弱性指数领域与美国CKM各组成部分患病率之间的关系。
这项横断面研究从疾病控制与预防中心的人口水平分析和社区估计（2021年）中获取健康结果，并评估了冠心病、慢性肾脏病、肥胖症、糖尿病、血脂异常和高血压在普查区层面的患病率。方差分析用于评估每个气候变化领域四分位数之间CKM各组成部分均值的统计学显著差异。线性回归模型评估每个领域与结果之间的关联，随后通过基线气候脆弱性指数组成部分进行调整。完全调整模型包括所有3个气候变化领域和基线气候脆弱性指数组成部分。
纳入了覆盖2.998亿人的70300个普查区的数据。在所有气候变化领域的四分位数之间发现CKM患病率存在统计学显著差异（<0.001）。在对基线领域（环境、社会/经济和基础设施）进行调整后以及在包括所有领域的完整模型中，这些关联依然存在。
气候脆弱性指数的气候变化组成部分与CKM各组成部分（冠心病、慢性肾脏病、肥胖症、糖尿病、血脂异常和高血压）的患病率相关。这些发现表明，患有CKM的人群可能与气候脆弱性增加有关，强调了深入了解气候变化作为健康决定因素的必要性。
