title: Diurnal temperature range is a risk factor for coronary heart disease death.
abstract: BACKGROUND
  Although the relation between day-to-day temperature change and coronary heart disease (CHD) mortality is well established, it is unknown whether temperature variation within 1 day, ie, diurnal temperature range (DTR), is an independent risk factor for acute CHD death.
  
  
  METHODS
  We used time-series and case-crossover approaches to assess the relation between DTR and daily CHD mortality between 2001 and 2004 in Shanghai, China. Specifically, we used exposures averaged over periods varying from 1 to 5 days to assess the effects of DTR on CHD mortality. We estimated the percent increase in the number of daily deaths related to CHD that were associated with DTR, after adjustment for daily meteorologic conditions (temperature and relative humidity) and levels of outdoor air pollutants.
  
  
  RESULTS
  Both time-series and case-crossover analyses showed that DTR was significantly associated with the number of daily deaths related to CHD. A 1 degrees C increase in 2-day lagged DTR corresponded to a 2.46% (95% CI, 1.76% to 3.16%) increase in CHD mortality on time-series analysis, a 3.21% (95% CI, 2.23% to 4.19%) increase on unidirectional case-crossover analysis, and a 2.13% (95% CI, 1.04% to 3.22%) increase on bidirectional case-crossover analysis.
  
  
  CONCLUSIONS
  Our findings suggest that DTR is an independent risk factor for acute CHD death.
authors.affiliation: Department of Cardiology, Fourth Affiliated Hospital of Nantong University, Yancheng, China.
authors.forename: Jingyan
authors.initials: J
authors.lastname: Cao
authors.forename: Yuexin
authors.initials: Y
authors.lastname: Cheng
authors.forename: Ni
authors.initials: N
authors.lastname: Zhao
authors.forename: Weimin
authors.initials: W
authors.lastname: Song
authors.forename: Cheng
authors.initials: C
authors.lastname: Jiang
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
mesh_terms: D002681:China; D002940:Circadian Rhythm; D003327:Coronary Disease / Q000401:mortality*; D006801:Humans; D012307:Risk Factors; D013696:Temperature