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热浪中的心脏死亡率和过高温度之间的非线性关系:239万患者的暴露反应
Xue Yu1, Jiangdong Liu2, Peng Yin3
1Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Journal of the American College of Cardiology
|March 25, 2025
概括
热浪显著增加心脏病死亡率,特别是复合热浪. 传统的定义低估了风险,需要为心脏病患者制定量身定制的公共卫生策略.
科学领域:
- 环境流行病学环境流行病学
- 心血管健康 心血管健康
- 气候变化影响 气候变化影响
背景情况:
- 短期暴露于热浪与心脏病死亡率的增加有关.
- 传统的二进制热浪定义限制了对暴露-反应关系的理解.
研究的目的:
- 探索热浪暴露-反应曲线及其与心脏病死亡率的关联,使用热浪中的过度累积温度 (ECT-HW).
- 为了比较来自ECT-HW的死亡负担估计与传统的热浪定义.
主要方法:
- 一个全国性的病例交叉研究,对中国2,392,254例心脏病死亡 (2013-2019) 进行了研究.
- 定义了仅白天,仅夜晚和复合热浪,使用了两种方法.
- 应用条件后勤回归与分布式滞后非线性模型来分析ECT-HW和估计死亡负担.
主要成果:
- 复合热浪显示,ECT-HW的死亡风险稳步增加,缺乏明确的值.
- 只有白天和只有夜晚的热浪表现出风险值和不同的模式.
- 复合热浪带来了最高的风险 (OR:1.86),估计有41,869例心脏病死亡,远远高于传统定义.
结论:
- 热浪与心脏病的关系是非线性的,单一类型热浪的值和复合热浪的近线性模式.
- 传统的热浪定义可能低估了死亡风险和负担.
- 疾病特定的健康措施对于在气候变暖的热浪期间管理心脏风险至关重要.
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