title: The association between consecutive days' heat wave and cardiovascular disease mortality in Beijing, China.
abstract: Although many studies have examined the effects of heat waves on the excess mortality risk (ER) posed by cardiovascular disease (CVD), scant attention has been paid to the effects of various combinations of differing heat wave temperatures and durations. We investigated such effects in Beijing, a city of over 20 million residents.
  
  
  
  A generalized additive model (GAM) was used to analyze the ER of consecutive days' exposure to extreme high temperatures.
  
  
  
  A key finding was that when extremely high temperatures occur continuously, at varying temperature thresholds and durations, the adverse effects on CVD mortality vary significantly. The longer the heat wave lasts, the greater the mortality risk is. When the daily maximum temperature exceeded 35 °C from the fourth day onward, the ER attributed to consecutive days' high temperature exposure saw an increase to about 10% (p < 0.05), and at the fifth day, the ER even reached 51%. For the thresholds of 32 °C, 33 °C, and 34 °C, from the fifth day onward, the ER also rose sharply (16, 29, and 31%, respectively; p < 0.05). In addition, extreme high temperatures appeared to contribute to a higher proportion of CVD deaths among elderly persons, females and outdoor workers. When the daily maximum temperature was higher than 33 °C from the tenth consecutive day onward, the ER of CVD death among these groups was 94, 104 and 149%, respectively (p < 0.05), which is considerably higher than the ER for the overall population (87%; p < 0.05).
  
  
  
  The results of this study may assist governments in setting standards for heat waves, creating more accurate heat alerts, and taking measures to prevent or reduce temperature-related deaths, especially against the backdrop of global warming.
authors.affiliation: State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, A11, Datun Road, Beijing, 100101, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Yin
authors.affiliation: State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, A11, Datun Road, Beijing, 100101, China. wangjf@lreis.ac.cn.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000068476:Beijing / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality*; D002681:China / Q000453:epidemiology; D002947:Cities; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000401:mortality*; D012621:Seasons; D012959:Socioeconomic Factors
keywords: Cardiovascular disease; Consecutive days’ high temperature; Heat wave