title: Gender, Age and Season as Modifiers of the Effects of Diurnal Temperature Range on Emergency Room Admissions for Cause-Specific Cardiovascular Disease among the Elderly in Beijing.
abstract: Diurnal temperature range (DTR) is an important index of climate change and variability. It is also a risk factor affecting human health. However, limited evidence is available to illustrate the effect of DTR modification on cause-specific cardiovascular disease among the elderly.
  
  
  
  A semi-parametric generalized additive model (GAM) was used to analyze the exposure-effect relationship between DTR and daily emergency room (ER) admissions for cause-specific cardiovascular diseases among the elderly from 2009 to 2011 in Beijing. We examined the effects of DTR for stratified groups by gender and age, and examined the effects of DTR in the warm season and cold season for cause-specific cardiovascular diseases.
  
  
  
  Significant associations were found between DTR and ER admissions for all cardiovascular and cerebrovascular disease among elderly males, while DTR was significantly associated with ER admissions for all cardiovascular disease, ischemic heart disease and cerebrovascular disease among elderly females. People aged 75 years and older were more vulnerable to DTR. DTR caused greater adverse effects on both genders in the warm season, whereas the effect estimates on females were higher in cold season than in warm season.
  
  
  
  A short-term increase of DTR was significantly associated with ER admissions for cause-specific cardiovascular disease among the elderly in Beijing. Gender, age and season may modify the acute health effect of DTR. Some prevention programs that target the high risk subgroups in the elderly for impending large temperature changes may reduce the impact of DTR on people's health.
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China. zhengsh@lzu.edu.cn.
authors.forename: Shan
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China. wangmzh@lzu.edu.cn.
authors.forename: Minzhen
authors.initials: M
authors.lastname: Wang
authors.affiliation: General Hospital of PLA, Beijng 100853, China. libei301@163.com.
authors.forename: Bei
authors.initials: B
authors.lastname: Li
authors.affiliation: College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China. wangsg@lzu.edu.cn.|School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China. wangsg@lzu.edu.cn.
authors.forename: Shigong
authors.initials: S
authors.lastname: Wang
authors.affiliation: General Hospital of PLA, Beijng 100853, China. heshilin301@163.com.
authors.forename: Shilin
authors.initials: S
authors.lastname: He
authors.affiliation: General Hospital of PLA, Beijng 100853, China. yinling301@126.com.
authors.forename: Ling
authors.initials: L
authors.lastname: Yin
authors.affiliation: College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China. shangkz@lzu.edu.cn.
authors.forename: Kezheng
authors.initials: K
authors.lastname: Shang
authors.affiliation: General Hospital of PLA, Beijng 100853, China. lts301@163.com.
authors.forename: Tanshi
authors.initials: T
authors.lastname: Li
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003080:Cold Temperature / Q000009:adverse effects*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors; D013997:Time Factors
keywords: cardiovascular disease; cerebrovascular disease; diurnal temperature range; elderly; emergency room admission; hypertensive disease; ischemic heart disease; modifiers