Research highlights:
- An analysis of more than 202,000 people who died from heart attacks in one Chinese province between 2015 and 2020 found that extreme heat, extreme cold, or high levels of fine particulate matter (PM) It turned out that there was a day when it occurred.2.5) Air pollution was significantly associated with the risk of death from heart attack, especially among women and older people.
- The risk of death from a heart attack was highest on days when extreme heat and high PM levels were combined.2.5.
- Extremely hot days were associated with an increased risk of death from heart attack in women compared with men and in older people compared with younger people.Older adults also had a higher risk of heart attack than younger adults on days with extreme cold or high levels of PM.2.5.
Embargoed until Monday, July 24, 2023 at 1:00 PM Central Time / 2:00 PM Eastern Time
DALLAS, July 24, 2023 — The combination of soaring heat and suffocating particulate pollution doubles the risk of dying from a heart attack, according to a new study of more than 202,000 heart attack deaths in China. There is a possibility that it will happen. The study was published today in the flagship journal of the American Heart Association. Circulation.
“Extreme temperature events are becoming more frequent, longer and more intense, raising concerns about their negative health effects. Another environmental problem around the world is the presence of fine particulate matter in the air. This may interact synergistically with extreme temperatures to negatively impact cardiovascular health,” said Yuewei Liu, MD, PhD, associate professor of epidemiology at the school. in Public Health from Sun Yat-sen University in Guangzhou, China. “However, it remains unclear whether and how co-exposure to extreme temperatures and particulate pollution interact to cause an increased risk of death from heart attack, and heart attack is a major threat in both acute and public health scenarios. The acute response potentially caused by the major challenges associated with “the acute response” that poses a significant disease burden worldwide. ”
To investigate the effects of extreme temperatures with and without high levels of particulate pollution, researchers conducted a study in 2015 in Jiangsu province, an area with four distinct seasons and a wide range of temperature and particulate pollution. The researchers analyzed 202,678 heart attack deaths between 2016 and 2020. level. Those who died were elderly with an average age of 77.6 years. 52% were over 80 years old. and 52% were male. Particulate exposure on each day of death and the day before death was included in the analysis.
Temperature extremes were measured according to the local daily heat index (also called apparent temperature), which captures the combined effects of both heat and humidity. Both the length and intensity of heat waves and cold waves were assessed. Heart attack deaths during these time periods, or date of onset, were compared to control days of the same month and day of the week. That is, if a death occurs on a Wednesday, all other Wednesdays of the same month are considered control days. . Days with average levels of fine particulate matter above 37.5 micrograms per cubic meter were considered to have high particle levels.
“Our findings provide evidence that reducing exposure to both extreme temperatures and particulate pollution may help prevent premature death from heart attack, especially in women and older people. ” said Liu.
Compared to control days, the risk of fatal heart attack was observed at the following levels:
- A two-day heatwave with a heat index of 90 or higher increases the rate by 18%.th The percentile (ranging from 82.6 degrees Fahrenheit to 97.9 degrees Fahrenheit) increased with temperature and duration and was 74% higher for four-day heat waves with a heat index of 97.5 degrees or higher.th Percentile (range 94.8 degrees Fahrenheit to 109.4 degrees Fahrenheit). For context, 6,417 (3.2%) of the 202,678 observed heart attack deaths occurred during heat waves with a heat index of 95 or higher.th percentile (range 91.2 degrees Fahrenheit to 104.7 degrees Fahrenheit) for at least 3 days.
- 4% increase during a two-day cold wave with temperatures below 10 degrees Celsiusth Percentiles (ranging from 33.3 degrees Fahrenheit to 40.5 degrees Fahrenheit) increased with lower temperature and duration, being 12% higher during a three-day cold wave with temperatures below 2.5 degrees Fahrenheit.th Percentile (range 27.0 degrees Fahrenheit to 37.2 degrees Fahrenheit). For context, 6,331 (3.1%) of the 202,678 observed heart attack deaths occurred during cold waves with temperatures below 5 degrees Celsius.th percentile (range 30.0 degrees Fahrenheit to 38.5 degrees Fahrenheit) for at least 3 days.
- That was twice as high during the four-day heatwave, when particulate pollution exceeded 37.5 micrograms per cubic meter. Days with high levels of particulate pollution during cold snaps did not similarly increase the risk of dying from a heart attack.
- It is generally higher in women than in men during heatwaves.
- On days with heat waves, cold waves, or high levels of particulate pollution, people aged 80 and older have higher rates than younger adults.
- From 2015 to 2020, the average age of people who died from heart attacks in Jiangsu Province was 77.6 years, including periods other than the heat wave. Of these, 52.1% were over 80 years old.
Researchers say that according to WHO targets, up to 2.8% of heart attack deaths can be caused by a combination of extreme temperatures and high levels of particulate pollution (more than 37.5 micrograms per cubic meter). It is estimated that
“Personal strategies to avoid the negative health effects of extreme temperatures include following weather forecasts, staying indoors when temperatures are extreme, using fans or air conditioners during hot weather, and responding to weather conditions. These include dressing appropriately, staying properly hydrated, and installing blinds to reduce indoor temperatures,” said Liu. “Using air purifiers inside the home, wearing masks outdoors, avoiding busy highways when walking, and choosing less strenuous outdoor activities can also reduce levels of particulate pollution. It may help reduce exposure to air pollution on high days. To improve public health, it is important to consider particulate pollution when warning the public about extreme temperatures.”
In its 2020 Scientific Statement and 2020 Policy Statement, the American Heart Association provides information on the latest science on air pollution exposure and how individuals can reduce the negative effects of poor air quality on cardiovascular health. , industry, and policy measures in detail. Reducing exposure to air pollution and reversing the negative effects of poor air quality on cardiovascular health, including heart disease and stroke, is a challenge for Black and Hispanic communities, who have historically been marginalized and under-resourced. Communities and people exposed to the highest levels of air pollution.
To confirm their results, the researchers recommended additional research into the possible mutual effects of extreme weather and particulate pollution on heart attack deaths in regions with different temperatures and pollution ranges. This study did not include adjustments for adaptive behaviors that individuals take when temperatures are extreme or pollution levels are high (such as using air conditioning or staying indoors), thereby reducing individuals’ exposure to weather. misclassification may occur and risk patterns may change. Additionally, due to potential variations in adaptive capacity and temperature distribution, these results may not be generalizable to other regions of China or other countries.
background:
- The particles are less than 2.5 microns in size and can be inhaled deep into the lungs, where they can irritate blood vessels around the lungs and heart. Most are related to the combustion of fuels, such as car exhaust, factory exhaust, and particles from wildfires.
- Previous studies have linked exposure to particulate matter, including fine particles, to heart disease, stroke, and other health problems.
- By way of background, the World Health Organization’s average annual exposure targets for particulate pollution levels are no more than 5 micrograms per cubic meter over three to four days per year, and no more than 15 micrograms per cubic meter.
- In this study, a heat wave was defined as a period of 90 degrees Celsius or higher.th,92.5th95th and 97.5th Percentile of the daily heat index (ranging from 82.6 degrees Fahrenheit to 109.4 degrees Fahrenheit across Jiangsu Province, China) for at least two, three, or four consecutive days.
- A cold wave was defined as a period of temperature below 10 degrees Celsius.th7.5th,Fiveth2.5th Percentile of the daily heat index (ranging from 27 degrees Fahrenheit to 40.5 degrees Fahrenheit) for at least two, three, or four consecutive days.
Co-author and author disclosure information is provided in the manuscript. This research was funded by the Ministry of Science and Technology of China.
Research statements and conclusions published in the scientific journals of the American Heart Association are solely the views of the study authors and do not necessarily reflect the policy or position of the association. The Association makes no representations or warranties regarding its accuracy or reliability. The association is primarily funded by individuals. Foundations and corporations (including pharmaceuticals, device manufacturers, and other companies) also make contributions, which help fund specific programs and events for the association. The Society has strict policies in place to ensure that these relationships do not influence scientific content. Revenues from pharmaceutical companies, biotech companies, device manufacturers, health insurance companies, and overall financial information for the association can be found here.
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