Temperature, Myocardial Infarction, and Mortality: Effect Modification by Individual and Area-Level Characteristics

Abstract

Background-While several studies have examined associations between temperature and cardiovascular-disease-related mortality, fewer have investigated the association between temperature and the development of acute myocardial infarction (MI). Moreover, little is known about who is most susceptible to the effects of temperature. Methods-We analyzed data from the Worcester Heart Attack Study, a community-wide investigation of acute MI in residents of the Worcester (MA) metropolitan area. We used a casecrossover approach to examine the association of apparent temperature with acute MI occurrence and with all-cause in-hospital and post-discharge mortality. We examined effect modification by sociodemographic characteristics, medical history, clinical complications, and physical environment. Results-A decrease in an interquartile range (IQR) in apparent temperature was associated with an increased risk of acute MI on the same day (hazard ratio=1.15 [95% confidence interval= 1.01-1.31]). Extreme cold during the 2 days prior was associated with an increased risk of acute MI (1.36 [1.07-1.74]). Extreme heat during the two days prior was also associated with an increased risk of mortality (1.44 [1.06-1.96]). Persons living in areas with greater poverty were more susceptible to heat.

The Effect of Hurricane Sandy on Cardiovascular Events in New Jersey

“…30 Large increases and decreases in ambient temperature have also been shown to cause increases in the risk of MI. 31 During the 2 weeks following Sandy, the average temperature was around 2.5°C lower than the mean temperature from the same periods in the previous 5 years. 32 For comparison, Madrigano et al found that a 1-day decrease in temperature of 6.6°C was associated with an 8% to 15% increased risk of MI.…”

“…32 For comparison, Madrigano et al found that a 1-day decrease in temperature of 6.6°C was associated with an 8% to 15% increased risk of MI. 31 Many researchers have found an association between increases in air pollution and higher risk of MI incidence. [33][34][35] We examined the levels of ambient fine particulate pollution, PM2.5, in NJ during our study periods utilizing US Environmental Protections Agency data.…”

Effect of Weather on Back Pain: Results From a Case‐Crossover Study

“…There is, however, some evidence for other health conditions. Previous case‐crossover studies have shown that exposure to lower temperatures increases the risk of myocardial infarction (), whereas higher temperatures and lower pressures lead to an increase in risk of headaches ().…”

The Impacts of Climate Change According to the Ipcc

“…Chapter 11 writes that "the impacts on health of more frequent heat extremes greatly outweigh benefits of fewer cold days", citing two studies Mills, 2013, Kinney et al, 2012) that only consider cold deaths. Chapter 11 does not cite studies that consider both (Åström et al, 2013, Bell, 2013, Błazejczyk et al, 2013, Chen et al, 2013, El-Fadel and Ghanimeh, 2013, Guo et al, 2013, Madrigano et al, 2013, Oudin Åström et al, 2013, Shaposhnikov et al, 2013, Zanobetti et al, 2013. These studies, published while Chapter 11 was being written, show a more nuanced story (Deschenes, 2014): In some parts of the world, the reduction in cold-related mortality outweighs the increase in heat-related mortality; in other parts of the world, it is the other way around.…”