Research involving over 2.3 million Europeans reveals that cold weather is negatively associated with fatalities from heart disease, especially in low-income areas.

The study was presented at  the ESC Congress today. Patients with heart issues had an increased risk of dying from heart disease and stroke when the temperature was high.

“Climate change,” according to Study author Professor Stefan Agewall, “is leading to a rise in the average global temperature but also extreme cold in some regions. 

“More than 70,000 excess deaths occurred across Europe during the summer of 2003 due to intense heatwaves. Cold weather also accounts for excess deaths and hospital admissions. 

According to the study author, earlier “studies on the cardiovascular effects of heat and cold mainly used aggregated data, such as daily deaths in a city.

“The EXHAUSTION project used individual data, enabling us to identify vulnerable subgroups for protective interventions, thereby increasing resilience for future weather events.”

The study analyzed data from 2.28 million adults from five cohort studies done in Italy, Germany, the United Kingdom, Norway, and Sweden between 1994 and 2010. The proportion of women varied from 36.0% to 54.5%, while the average age ranged from 49.7 to 71.7 years. Participants were included both with and without cardiovascular disease at baseline. Death and disease registries, in addition to follow-up questionnaires, were used to compile the data on rates of mortality and the emergence of new diseases. Using modeling of temperature data from weather stations, daily average air temperatures at the participants’ residences were either gathered from nearby weather stations or calculated.

Researchers looked at the links between temperature, heart conditions, and death for all of the participants and for subgroups with certain characteristics. A time-stratified case-crossover study design was used. For each person involved, the authors assessed the temperature on the day of the week an adverse event happened (for example, Monday) with the temperature on the same day of the week without an adverse event (for example, all other Mondays) in the same month. The potential confounding effects of participant characteristics and time trends were removed using within-participant comparisons between days in the same month.

The analysis revealed that cold weather was associated with increased chances of death from cardiovascular disease overall and ischemic heart disease in particular, as well as an elevated risk of new-onset ischaemic heart disease. A 10°C temperature drop from 5°C to -5°C increased the risk of cardiovascular disease mortality by 19% (relative risk [RR] 1.19; 95% confidence interval [CI] 1.04-1.36) and the risk of ischemic heart disease death by 22% (RR 1.22; 95% CI 1.07-1.38). An almost 11°C temperature drop, from 2°C to -9°C, was linked with a 4% increased risk of developing new-onset ischemic heart disease (RR 1.04; 95% CI: 1.01-1.08).

“TThe relationships between cold temperatures and deaths were more pronounced in men and people living in neighbourhoods with a low socioeconomic status,” said Professor Agewall. Among women and those over the age of 65, the correlation between the common cold and the onset of ischemic heart disease was particularly high.

In the entire study population, heat had no negative impacts. However, among those with heart disease at baseline, temperature increases from 15°C to 24°C were linked to 25% (RR 1.25; 95% CI 1.12-1.39) and 30% (RR 1.30; 95% CI 1.10-1.53) increased odds of dying from cardiovascular disease and stroke, respectively.

According to Professor Agewall, “clinicians can use this information to provide tailored advice to those most at risk of adverse health outcomes during hot and cold days.” 

Patients with cardiac issues should take their medicine as prescribed and drink plenty of water as the temperature rises.

Image Credit: Getty

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