Association Between Observed Climate Change and Cardiovascular Disease in the United States

Climate change is affecting nearly all social and environmental determinants of health. However, the extent of resulting cumulative impacts on cardiovascular and other noncommunicable diseases is not known. To address this gap and inform future research, we conducted an ecological evaluation of associations between 14 long-term climate anomaly metrics and prevalence of coronary heart disease (CHD) and stroke in the United States. We calculated long-term anomaly metrics as the difference between their respective 1970-1979 baseline mean and 2013-2022 modern mean values. With fitted random effects regression analysis, we evaluated associations between each anomaly metric, individually and collectively, and census tract-level 2020-2022 mean prevalence of CHD and stroke. In adjusted models with all noncollinear anomaly metrics, we found a net association of all metrics with 0.59% higher CHD prevalence and 0.88% higher stroke prevalence (9.8% and 27.9% relative prevalence, respectively). We found the largest significant effect for location-based annual mean air temperature anomaly, but smaller significant associations with changes in humidity, rainfall, sunlight, wind, and atmospheric pressure anomalies. We observed similar associations between mean summer and daytime heat index anomalies, which were larger than heat waves and temperature variability. While our ecological analysis cannot evaluate causal effects of climate change on cardiovascular disease, our findings align with previous research and may reflect the potential nature and extent of cumulative "slow burn" chronic health impacts of climate change among developed countries. These findings may inform precautionary policy considerations regarding the potentially large and permanent impacts of climate policies on global health.