Efecto de las temperaturas extremas en la incidencia de enfermedades cardiovasculares: revisión bibliográfica 2016-2022 / Effect of extreme temperatures on the incidence of diseases cardiovascular: bibliographic review 2016-2022

Resumen: El panel intergubernamental sobre cambio climático estima que para el año 2100 74% de la población estará expuesta a olas de calor en el peor escenario (definido como 3 días consecutivos con temperaturas igual o sobre el percentil 95 de un periodo de tiempo), abarcando en Santiago hasta 40% de los días de verano con temperaturas extremas. Producto de la crisis climática también pueden ocurrir eventos de frío extremo. Ambos fenómenos constituyen un riesgo para la salud, particularmente para las enfermedades cardiovasculares. Objetivo: Estudiar la asociación entre temperaturas extremas y enfermedades cardiovasculares (mortalidad por enfermedades cardiovasculares, infarto agudo al miocardio, accidente cerebrovascular, hipertensión y paro cardíaco extra hospitalario). Métodos: Se realizó una revisión bibliográfica en los buscadores ISI-Web of Science, Scopus y Nature utilizando los términos de búsqueda heatwave, cardiovascular disease y extreme heat entre los años 2016-2021 incluyendo trabajos que presenten medidas de asociación entre temperaturas extremas (percentil 5 para temperaturas bajas y percentil 90 para temperaturas altas) y enfermedades cardiovasculares, arrojando 130 resultados de los cuales se seleccionaron 19. Resultados: Tanto las temperaturas altas como bajas aumentaron el riesgo de muerte por infarto agudo al miocardio (IAM) (RR: 2,29 [2,18-2,40] y RR: 2,3 [1,2-4,6], respectivamente) y paro cardíaco (OR 3,34 [1,90-3,58] y OR: 1,75 [1,23-2,49], respectivamente). La mortalidad por hipertensión arterial se asoció a temperaturas altas (OR 1,91 [1,2-3,1]), mientras que la mortalidad por enfermedades cardiovasculares (ECV) en general a bajas (RR: 1,79 [1,64 - 1,95]). En hospitalizaciones por ECV el riesgo por temperaturas altas (P99) fue RR: 1,74 [IC95%: 1,30-2,32]. Se identificaron diferencias por sexo y mayor riesgo en los mayores de 75 años y quienes presentaron exposiciones prolongadas. Conclusión: Hay una fuerte asociación entre hospitalizaciones y muerte por ECV y temperaturas extremas. Las mujeres y los adultos mayores son los más afectados.

Abstract: The Inter governmental panel estimates that in a worst case scenario, by 2100 74% of people will be exposed to heat waves (3 consecutive days with temperatures at or above the 95% percentile). This might be the case in up to 40% of days in Santiago. As a consequence of climate change there will also be periods with extremely low temperatures. Both conditions increase the risk of cardiovascular disease. Aim: to study the association of extreme temperatures with the incidence of cardiovascular disease (death, myocardial infarction, stroke and out of hospital sudden death). Method: The ISI-Web of Science, Scopus and Nature databases were searched using the terms "heat wave", "cardiovascular disease" and "extreme heat" for articles published between 2016 and 2021.

Research progress in mechanism and protection of high temperature environment influencing the body function / 中华创伤杂志

The thermal environment increases the risk of thermal injury for persons under high temperature environment. A full understanding of the effects and hazards of the thermal environment on the human body is of great significance to improve the awareness of persons under high temperature environment and reduce occupational heat damage during work. The authors mainly review the thermal environment from aspects of the definition, mechanism of its influence on main functional systems of the human body, influencing factors of heat stress and progress of protection, so as to provide references for the identification and protection of heat-induced diseases for workers under high temperature environment.

Effects of extreme high and low temperatures on admission risk of acute ischemic stroke and its etiology subtypes: a time series analysis in Wuhan, China / 国际脑血管病杂志

Objective@#To investigate the effects of extreme high and low temperatures on admission risk of acute ischemic stroke (AIS) and its etiology subtypes.@*Methods@#From January 1, 2016 to December 31, 2017, the data of inpatients with AIS from Zhongnan Hospital of Wuhan University and the meteorological data and air pollution data from China Meteorological Data Network in the same period were collected continuously. According to TOAST etiology criteria, the patients were divided into large artery atherosclerosis (LAA), small vessel occlusion (SVO), cardioembolism (CE), and stroke of other etiology (SOE). A time series analysis of the distributed lag model was used to investigate the effects of extreme high and low temperatures on the admission of patients with AIS and its etiology subtype, and air pollution, air pressure, humidity, and wind speed were used as confounding factors to exclude interference.@*Results@#A total of 1 413 patients with AIS were enrolled, including 906 men (64.4%), age 67.7±12.8 years. The thresholds of extreme low temperature (1%, 5% and 10% of the average temperature) were 0.7 ℃, 3.3 ℃, and 4.9 ℃. The thresholds of extreme high temperature (90%, 95% and 99% of the average temperature) were 29.2 ℃, 31.6 ℃, and 32.9 ℃. Extreme high temperature increased the risk of hospitalization in patients with AIS (lag 0 day; relative risk [RR] 1.54, 95% confidence interval [CI] 1.01-2.34). It was mainly related to the increased risk of hospitalization in patients with CE subtype (lag 0 day; RR 7.64, 95% CI 1.19-49.09). There was no significant correlation between the extreme low temperature and the risk of hospitalization of AIS (lag 2 days; RR 0.99, 95% CI 0.71-1.37), but it significantly increased the risk of hospitalization in patients with LAA subtypes (lag 2 days; RR 3.04, 95% CI 1.33-6.95), and it was still statistically significant at lag 3 days (RR 2.87, 95% CI 1.57-5.25) and lag 4 days (RR 2.19, 95% CI 1.15-4.15).@*Conclusion@#Extreme high temperature may increase the risk of hospitalization in patients with AIS and CE subtypes, while extreme low temperature may increase the risk of hospitalization in patients with LAA subtypes.

Development and Implementation of Emergency Department based Heat related Illness Active Surveillance System: Effect of Heat Index on Daily Emergency Department Visits due to Heat related Illness

PURPOSE: To evaluate the effect of heat wave on emergency department (ED) visits due to heat related illness, we developed an ED based active surveillance system. We want to identify epidemiology of ED visits due to heat related illness and determine the effect of heat index on daily ED visits due to heat related illness. METHODS: We developed an ED based active surveillance system for adults who visited the ED due to heat stroke, heat exhaustion, heat syncope, heat edema, and heat cramp. We collected demographic and clinical variables, risk factors, and heat index by standardized registry on the webpage. We operated the surveillance into 16 emergency departments in Daegu City from June to September 2011. We analyzed epidemiologic variables descriptively and assessed the effect of heat index on the number of daily ED visits by multivariate Poisson regression analysis. RESULTS: During the study period, 34 cases were registered and nine cases were heat stroke. Heat stroke patients were older, and had more unemployment status than those with other heat related illness (p<0.05). More ED visits due to heat related illness were observed during the danger period than during the cool period, classified by heat index severity (Adjusted odds ratio: 1.72, 95% CI: 1.33-2.23). Increasing heat index by one degree caused more ED visits due to heat related illness (Adjusted incident rate ratio: 1.13, 95% CI: 1.07-1.19). CONCLUSION: We developed an ED based active surveillance system and observed more elderly persons and lower educational level in patients with heat stroke. In addition, increase in heat index significantly affected more daily ED visits due to heat related illness.

The Effects of Temperature on Heat-related Illness According to the Characteristics of Patients During the Summer of 2012 in the Republic of Korea / 예방의학회지

OBJECTIVES: This study was conducted to investigate the relationship between heat-related illnesses developed in the summer of 2012 and temperature. METHODS: The study analyzed data generated by a heat wave surveillance system operated by the Korea Centers for Disease Control and Prevention during the summer of 2012. The daily maximum temperature, average temperature, and maximum heat index were compared to identify the most suitable index for this study. A piecewise linear model was used to identify the threshold temperature and the relative risk (RR) above the threshold temperature according to patient characteristics and region. RESULTS: The total number of patients during the 3 months was 975. Of the three temperature indicators, the daily maximum temperature showed the best goodness of fit with the model. The RR of the total patient incidence was 1.691 (1.641 to 1.743) per 1degrees C after 31.2degrees C. The RR above the threshold temperature of women (1.822, 1.716 to 1.934) was greater than that of men (1.643, 1.587 to 1.701). The threshold temperature was the lowest in the age group of 20 to 64 (30.4degrees C), and the RR was the highest in the > or =65 age group (1.863, 1.755 to 1.978). The threshold temperature of the provinces (30.5degrees C) was lower than that of the metropolitan cities (32.2degrees C). Metropolitan cities at higher latitudes had a greater RR than other cities at lower latitudes. CONCLUSIONS: The influences of temperature on heat-related illnesses vary according to gender, age, and region. A surveillance system and public health program should reflect these factors in their implementation.