The mortality risk of Cardiovascular diseases attributable to temperature variability in Guangzhou City

doi:10.11817/j.issn.1673-9248.2022.04.005

Abstract

Abstract:

Objective

To evaluate the effect of temperature variation (TV) on the mortality of cardiovascular diseases (CVD), and further quantify its attributable mortality risk.

Methods

The daily CVD mortality, meteorological data，and air pollution data in Guangzhou from 1st of January 2013 to 31st of December 2017 were collected, and the generalized linear model was used to analyze the relationship between TV and CVD. The number of CVD deaths attributable to TV and the attributable fraction (AF) were calculated from their relationship.

Results

There was a nearly linear relationship between TV and CVD mortality; the mortality increased with the rise of TV, especially exposure to TV in the preceding 6 days (TV₀₆). We estimated 2.30 % (95% confidence interval [CI]: 1.42%-3.19%) increased mortality risk per 1 ℃ increase in TV₀₆, and the AF was 11.50% (95%CI: 10.54%-12.47%). In the subgroup analysis, the AF of CVD mortality in female (11.85%, 95%CI: 10.49%-13.22%) was slightly higher than that of male (11.10%, 95%CI: 9.81%-12.41%); people over 65 years (13.20%, 95%CI: 12.13%-14.28%) was higher than those of 0-64 years (2.15%, 95%CI: -0.01%-4.36%); among cause-specific CVD, hypertension had the highest AF (21.14%, 95%CI: 17.71%-24.67%).

Conclusion

In Guangzhou, the effect of TV on CVD mortality was significant. People over 65 years and patients with hypertension have a higher attributable risk of TV. Those results indicate that targeted protective measures to TV should be implemented for susceptible people.

Key words: Cardiovascular diseases, Temperature variability, Attributable mortality risk

Jianxiong Hu, Junle Wu, Weijuan Pan, Xuan Li, Lilian Zeng, Ruilin Meng, Zuhua Rong, Guanhao He, Jianpeng Xiao, Wenjun Ma, Tao Liu. The mortality risk of Cardiovascular diseases attributable to temperature variability in Guangzhou City[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(04): 241-246.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.11817/j.issn.1673-9248.2022.04.005

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Figures/Tables 7

分类	$x ¯$ ±s	最小值	P₂₅	P₅₀	P₇₅	最大值
总CVD死亡数	50.1±12.1	20	41	49	57	114
性别
男性	25.6±6.8	8	21	25	30	53
女性	24.5±7.1	8	19	24	29	63
年龄
0~64岁	7.7±2.9	1	6	7	10	20
≥65岁	42.4±11.1	14	34	41	49	100
死因类型
IHD	21.0±6.3	6	17	20	25	48
HP	4.7±2.4	0	3	4	6	16
CED	21.0±6.1	5	17	20	25	48

分类	$x ¯$ ±s	最小值	P₂₅	P₅₀	P₇₅	最大值
总CVD死亡数	50.1±12.1	20	41	49	57	114
性别
男性	25.6±6.8	8	21	25	30	53
女性	24.5±7.1	8	19	24	29	63
年龄
0~64岁	7.7±2.9	1	6	7	10	20
≥65岁	42.4±11.1	14	34	41	49	100
死因类型
IHD	21.0±6.3	6	17	20	25	48
HP	4.7±2.4	0	3	4	6	16
CED	21.0±6.1	5	17	20	25	48

指标	$x ¯$ ±s	最小值	P₂₅	P₅₀	P₇₅	最大值
气象指标
日最低气温（℃）	19.3±6.2	1.8	14.1	20.9	24.8	28.4
日平均温度（℃）	22.4±6.2	3.8	17.5	23.8	27.6	32.1
日最高气温（℃）	27.2±6.4	6.0	22.6	28.4	32.6	38.4
日相对湿度（%）	78.6±11.1	28.4	72.6	79.6	86.8	99.0
TV₀₁（℃）	4.8±1.5	1.1	3.8	4.8	5.6	10.7
TV₀₂（℃）	4.7±1.3	1.4	3.8	4.6	5.3	9.6
TV₀₃（℃）	4.7±1.2	1.5	3.9	4.6	5.3	8.6
TV₀₄（℃）	4.7±1.1	1.5	4.0	4.6	5.3	8.5
TV₀₅（℃）	4.7±1.1	1.5	4.0	4.6	5.3	8.4
TV₀₆（℃）	4.7±1.0	1.9	4.1	4.6	5.2	8.4
TV₀₇（℃）	4.7±1.0	2.0	4.1	4.6	5.2	8.3
空气污染物
PM_2.5（μg/m³）	41.4±22.9	5.4	24.2	35.7	52.7	156.3
SO₂（μg/m³）	15.0±6.4	3.7	10.6	13.6	18.1	54.0
NO₂（μg/m³）	44.9±17.3	13.7	32.5	40.9	53.3	130.6
CO（mg/m³）	0.9±0.2	0.5	0.8	0.9	1.0	3.7

指标	$x ¯$ ±s	最小值	P₂₅	P₅₀	P₇₅	最大值
气象指标
日最低气温（℃）	19.3±6.2	1.8	14.1	20.9	24.8	28.4
日平均温度（℃）	22.4±6.2	3.8	17.5	23.8	27.6	32.1
日最高气温（℃）	27.2±6.4	6.0	22.6	28.4	32.6	38.4
日相对湿度（%）	78.6±11.1	28.4	72.6	79.6	86.8	99.0
TV₀₁（℃）	4.8±1.5	1.1	3.8	4.8	5.6	10.7
TV₀₂（℃）	4.7±1.3	1.4	3.8	4.6	5.3	9.6
TV₀₃（℃）	4.7±1.2	1.5	3.9	4.6	5.3	8.6
TV₀₄（℃）	4.7±1.1	1.5	4.0	4.6	5.3	8.5
TV₀₅（℃）	4.7±1.1	1.5	4.0	4.6	5.3	8.4
TV₀₆（℃）	4.7±1.0	1.9	4.1	4.6	5.2	8.4
TV₀₇（℃）	4.7±1.0	2.0	4.1	4.6	5.2	8.3
空气污染物
PM_2.5（μg/m³）	41.4±22.9	5.4	24.2	35.7	52.7	156.3
SO₂（μg/m³）	15.0±6.4	3.7	10.6	13.6	18.1	54.0
NO₂（μg/m³）	44.9±17.3	13.7	32.5	40.9	53.3	130.6
CO（mg/m³）	0.9±0.2	0.5	0.8	0.9	1.0	3.7

分组	TV₀₁	TV₀₂	TV₀₃	TV₀₄	TV₀₅	TV₀₆	TV₀₇
总CVD死亡	1.52（0.85~2.18）	1.73（0.99~2.48）	1.92（1.14~2.70）	2.11（1.29~2.92）	2.27（1.42~3.12）	2.30（1.42~3.19）	1.93（1.02~2.86）
性别
男性	1.83（0.93~2.74）	1.79（0.79~2.80）	2.08（1.02~3.15）	2.28（1.17~3.39）	2.29（1.14~3.45）	2.23（1.03~3.43）	1.77（0.54~3.02）
女性	1.20（0.26~2.14）	1.67（0.63~2.73）	1.76（0.66~2.87）	1.94（0.80~3.09）	2.25（1.05~3.45）	2.37（1.13~3.62）	2.09（0.80~3.39）
年龄
0~64岁	2.04（0.42~3.70）	1.89（0.08~3.73）	1.74（-0.17~3.68）	1.27（-0.70~3.29）	0.76（-1.29~2.85）	0.45（-1.67~2.61）	-0.31（-2.50~1.92）
≥65岁	1.42（0.70~2.16）	1.70（0.89~2.52）	1.95（1.10~2.81）	2.25（1.36~3.15）	2.53（1.60~3.49）	2.62（1.65~3.59）	2.32（1.32~3.34)

死因	TV₀₁	TV₀₂	TV₀₃	TV₀₄	TV₀₅	TV₀₆	TV₀₇
IHD	1.53（0.53~2.54）	1.49（0.38~2.62）	1.62（0.45~2.81）	1.76（0.53~3.00）	2.20（0.91~3.49）	2.54（1.20~3.89）	2.09（0.71~3.49）
HP	3.38（1.18~5.63）	3.34（0.88~5.86）	3.72（1.12~6.40）	4.01（1.29~6.80）	4.09（1.25~7.01）	4.06（1.12~7.09）	3.09（0.06~6.21）
CED	1.52（0.85~2.18）	1.60（0.49~2.72）	1.83（0.65~3.01）	2.12（0.90~3.35）	1.98（0.71~3.27）	1.73（0.41~3.06）	1.61（0.24~2.99）

指标	AN[例， $x ¯$ （95%CI）]	AF[%， $x ¯$ （95%CI）]
总CVD死亡	10 515（9638~11 400）	11.50（10.54~12.47）
性别
男性	5185（4580~5797）	11.10（9.81~12.41）
女性	5300（4694~5913）	11.85（10.49~13.22）
年龄
0~64岁	300（-2~608）	2.15（-0.01~4.36）
≥65岁	10 227（9401~11 061）	13.20（12.13~14.28）
死因类型
IHD	4901（4340~4569）	12.81（11.35~14.30）
HP	1808（1515~2110）	21.14（17.71~24.67）
CED	3284（2746~3829）	8.58（7.18~10.00）

指标	AN[例， $x ¯$ （95%CI）]	AF[%， $x ¯$ （95%CI）]
总CVD死亡	10 515（9638~11 400）	11.50（10.54~12.47）
性别
男性	5185（4580~5797）	11.10（9.81~12.41）
女性	5300（4694~5913）	11.85（10.49~13.22）
年龄
0~64岁	300（-2~608）	2.15（-0.01~4.36）
≥65岁	10 227（9401~11 061）	13.20（12.13~14.28）
死因类型
IHD	4901（4340~4569）	12.81（11.35~14.30）
HP	1808（1515~2110）	21.14（17.71~24.67）
CED	3284（2746~3829）	8.58（7.18~10.00）

变量	ER	AF
时间变量自由度
6/年	2.15（1.29~3.01）	10.71（9.78~11.65）
8/年	2.33（1.45~3.23）	11.70（10.74~12.68）
温度最大滞后
14 d	2.31（1.42~3.20）	11.56（10.60~12.53）
28 d	2.39（1.51~3.29）	11.99（11.02~12.97）
空气污染协变量
N2O	2.23（1.33~3.13）	11.11（10.14~12.09）
CO	2.22（1.36~3.09）	11.10（10.16~12.04）
S2O	2.31（1.43~3.21）	11.60（10.63~12.57）

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