title: Hospitalizations from Hypertensive Diseases, Diabetes, and Arrhythmia in Relation to Low and High Temperatures: Population-Based Study.
abstract: Little is known about the extent to which ambient temperatures contribute to the burden of hospitalizations from hypertensive diseases, diabetes, and arrhythmia. To fill this knowledge gap, we conducted a time-series study comprising entire population of Ontario, Canada during 1996-2013. A distributed lag non-linear model was developed to estimate the cumulative effect of temperatures over a 21-day lag period. We computed the burden of hospitalizations attributable to cold and heat. Furthermore, we separated the burden into components related to mild and extreme temperatures. Compared to the temperature with minimum risk of morbidity, cold temperatures (1(st) percentile) were associated with a 37% (95% confidence interval: 5%, 78%) increase in hypertension-related hospitalizations whereas no significant association with hot temperatures (99(th) percentile) was observed. Cold and hot temperatures were also associated with a 12% (1%, 24%) and a 30% (6%, 58%) increase in diabetes-related hospitalizations, respectively. Arrhythmia was not linked to temperatures. These estimates translate into ~10% of hypertension-related hospitalizations attributable to total cold, and ~9% from mild cold. Similarly, ~11% of diabetes-related hospitalizations were due to total heat, virtually all of which were from mild heat. In conclusion, ambient temperatures, especially in moderate ranges, contribute to excess hospitalizations from hypertension and diabetes.
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Li
authors.initials: L
authors.lastname: Bai
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.
authors.forename: Qiongsi
authors.initials: Q
authors.lastname: Li
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Air Health Science Division, Health Canada, Ottawa, ON, Canada.|School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, ON, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Lavigne
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasparrini
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Ray
authors.initials: R
authors.lastname: Copes
authors.affiliation: Climate Change and Health Office, Health Canada, Ottawa, ON, Canada.
authors.forename: Abderrahmane
authors.initials: A
authors.lastname: Yagouti
authors.affiliation: Population Studies Division, Health Canada, Ottawa, ON, Canada.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Burnett
authors.affiliation: Department of Medicine, McGill University, Montreal, Quebec, Canada.|Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Goldberg
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|CHAIM Research Centre, Carleton University, Ottawa, ON, Canada.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Villeneuve
authors.affiliation: Population Studies Division, Health Canada, Ottawa, ON, Canada.
authors.forename: Sabit
authors.initials: S
authors.lastname: Cakmak
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D002980:Climate; D003080:Cold Temperature; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006358:Hot Temperature; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009864:Ontario