More heart disease deaths on very hot, very cold days

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Dec. 13, 2022 — Extremely hot and extremely cold days are linked to an increased risk of dying from heart disease, a new study suggests.

People with heart failure were most at risk when temperatures were extremely hot or cold.

According to the study’s lead author, Barrak Alahmad, MD, PhD, of the Harvard TH Chan School of Public Health in Boston, climate change, which is associated with significant swings in extremely hot and cold temperatures, is likely a key culprit.

“Studying the burden of extreme temperatures from now on will allow us to better understand what cardiovascular risks climate change might bring,” he says. “In this rapidly changing climate and unprecedented warming, it’s not the time to sleep at the wheel.”

No specific temperatures are considered extreme, Alahmad notes. “Heat and cold are context and site specific.” For example, a 104F day in Kuwait is a typical summer day, while a 104F day in London resulted in “widespread, incalculable damage.”

for study, released 12 Dec in Journal TrafficThe researchers examined more than 32 million cardiovascular deaths over 4 decades in countries around the world. They compared cardiovascular deaths on the hottest and coldest 2.5% of days in each city to cardiovascular deaths on days with optimal temperatures.

Relative risks of death increased gradually in cold temperatures, but slightly more rapidly in hot temperatures – particularly in heart failure, where the risk increased rapidly to as high as 12% in extremely hot weather, according to analysis.

Extremely cold temperatures seemed even more dangerous. They were associated with a 33% higher risk of dying from ischemic heart disease (caused by narrowed arteries); a 32% increased risk of death from ischemic stroke caused by blood clots in the brain; and a 37% greater risk of dying from heart failure.

Overall, extreme temperatures caused 2.2 extra deaths per 1,000 on hot days and 9.1 extra deaths per 1,000 on cold days.

The results were similar even after the researchers adjusted for temperature variations, heat waves, long-term trends, relative humidity, and air pollutants, including ozone, nitrogen dioxide, and particulate matter.

Protect your heart

American Heart Association volunteer expert Nieca Goldberg, MD, medical director of Atria New York and professor at New York University School of Medicine in New York City, says everyone must take action to stave off the effects of climate change.

To protect your heart on extremely hot and cold days, “avoid outdoor activities,” she advises. “If you have to go to an appointment on a very cold day, remember to get dressed, wear gloves, a hat and a scarf that covers your mouth. Keep your time outdoors to a minimum.”

“Don’t exercise outside on hot days, stay indoors as much as possible and stay hydrated,” she says.

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More heart disease deaths on very hot, very cold days
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