title: Relation of Total and Cardiovascular Death Rates to Climate System, Temperature, Barometric Pressure, and Respiratory Infection.
abstract: A distinct seasonal pattern in total and cardiovascular death rates has been reported. The factors contributing to this pattern have not been fully explored. Seven locations (average total population 71,354,000) were selected where data were available including relatively warm, cold, and moderate temperatures. Over the period 2004 to 2009, there were 2,526,123 all-cause deaths, 838,264 circulatory deaths, 255,273 coronary heart disease deaths, and 135,801 ST-elevation myocardial infarction (STEMI) deaths. We used time series and multivariate regression modeling to explore the association between death rates and climatic factors (temperature, dew point, precipitation, barometric pressure), influenza levels, air pollution levels, hours of daylight, and day of week. Average seasonal patterns for all-cause and cardiovascular deaths were very similar across the 7 locations despite differences in climate. After adjusting for multiple covariates and potential confounders, there was a 0.49% increase in all-cause death rate for every 1°C decrease. In general, all-cause, circulatory, coronary heart disease and STEMI death rates increased linearly with decreasing temperatures. The temperature effect varied by location, including temperature's linear slope, cubic fit, positional shift on the temperature axis, and the presence of circulatory death increases in locally hot temperatures. The variable effect of temperature by location suggests that people acclimatize to local temperature cycles. All-cause and circulatory death rates also demonstrated sizable associations with influenza levels, dew point temperature, and barometric pressure. A greater understanding of how climate, temperature, and barometric pressure influence cardiovascular responses would enhance our understanding of circulatory and STEMI deaths.
authors: Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico; Heart Institute, Good Samaritan Hospital, Los Angeles, California. Electronic address: bschwartz15@hotmail.com.
authors: Bryan G
authors: BG
authors: Schwartz
authors: Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico; Clinical Translational Sciences Center, University of New Mexico, Albuquerque, New Mexico.
authors: Clifford
authors: C
authors: Qualls
authors: Heart Institute, Good Samaritan Hospital, Los Angeles, California; Huntington Medical Research Institute, Pasadena, California; Division of Cardiovascular Medicine, Department of Internal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors: Robert A
authors: RA
authors: Kloner
authors: Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico.
authors: Warren K
authors: WK
authors: Laskey
mesh_terms: D000397:Air Pollution; D001274:Atmospheric Pressure; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002980:Climate; D006801:Humans; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012621:Seasons; D013696:Temperature; D014481:United States / Q000453:epidemiology