Effect of cold spells and their modifiers on cardiovascular disease events: evidence from two prospective studies

Claudio Sartini, Sarah J.E. Barry, S. Goya Wannamethee, Peter H. Whincup, Lucy Lennon, Ian Ford, Richard W. Morris

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To investigate effects of cold weather spells on incidence of cardiovascular disease (CVD), and potential effect modification of socio-demographic, clinical, behavioural and environmental exposures. Methods: Data from two prospective studies were analysed: the British Regional Heart Study (BRHS), a population-based study of British men aged 60?79 years, followed for CVD incidence from 1998?2000 to 2012; and the PROSPER study of men and women aged 70?82 recruited to a trial of pravastatin vs placebo from 1997 to 9 (followed until 2009). Cold spells were defined as at least three consecutive days when daily mean temperature fell below the monthly 10th percentile specific to the closest local weather station. A timestratified case-crossover approach was used to estimate associations between cold spells and CVD events. Results: 921 of 4252 men from BRHS and 760 of 2519 participants from PROSPER suffered a first CVD event during follow-up. More CVD events were registered in winter in both studies. The risk ratio (RR) associated with cold spells was statistically significant in BRHS (RR = 1.86, 95% CI 1.30?2.65, p b 0.001), and independent of temperature level: results were similar whether events were fatal or non-fatal. Increased risk was particularly marked in BRHS for ever-smokers (RR of 2.44 vs 0.99 for never-smokers), in moderate/heavy drinkers (RR 2.59 vs 1.41), and during winter months (RR 3.28 vs 1.25). No increased risk was found in PROSPER. Conclusions: Although CVD risks were higher in winter in both BRHS and PROSPER prospective studies, cold spells increased risk of CVD events, independently of cold temperature, in the BRHS only.
LanguageEnglish
Pages275-283
Number of pages9
JournalInternational Journal of Cardiology
Volume218
Early online date13 May 2016
DOIs
Publication statusPublished - 1 Sep 2016

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Weather
Incidence
Evidence
Percentile
Crossover
Heart
Consecutive
Estimate

Keywords

  • cold spell
  • outdoor temperature
  • winter deaths
  • cardiovascular disease
  • prospective study

Cite this

Sartini, Claudio ; Barry, Sarah J.E. ; Wannamethee, S. Goya ; Whincup, Peter H. ; Lennon, Lucy ; Ford, Ian ; Morris, Richard W. / Effect of cold spells and their modifiers on cardiovascular disease events : evidence from two prospective studies. In: International Journal of Cardiology. 2016 ; Vol. 218. pp. 275-283.
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abstract = "Objective: To investigate effects of cold weather spells on incidence of cardiovascular disease (CVD), and potential effect modification of socio-demographic, clinical, behavioural and environmental exposures. Methods: Data from two prospective studies were analysed: the British Regional Heart Study (BRHS), a population-based study of British men aged 60?79 years, followed for CVD incidence from 1998?2000 to 2012; and the PROSPER study of men and women aged 70?82 recruited to a trial of pravastatin vs placebo from 1997 to 9 (followed until 2009). Cold spells were defined as at least three consecutive days when daily mean temperature fell below the monthly 10th percentile specific to the closest local weather station. A timestratified case-crossover approach was used to estimate associations between cold spells and CVD events. Results: 921 of 4252 men from BRHS and 760 of 2519 participants from PROSPER suffered a first CVD event during follow-up. More CVD events were registered in winter in both studies. The risk ratio (RR) associated with cold spells was statistically significant in BRHS (RR = 1.86, 95{\%} CI 1.30?2.65, p b 0.001), and independent of temperature level: results were similar whether events were fatal or non-fatal. Increased risk was particularly marked in BRHS for ever-smokers (RR of 2.44 vs 0.99 for never-smokers), in moderate/heavy drinkers (RR 2.59 vs 1.41), and during winter months (RR 3.28 vs 1.25). No increased risk was found in PROSPER. Conclusions: Although CVD risks were higher in winter in both BRHS and PROSPER prospective studies, cold spells increased risk of CVD events, independently of cold temperature, in the BRHS only.",
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Effect of cold spells and their modifiers on cardiovascular disease events : evidence from two prospective studies. / Sartini, Claudio; Barry, Sarah J.E.; Wannamethee, S. Goya; Whincup, Peter H.; Lennon, Lucy; Ford, Ian; Morris, Richard W.

In: International Journal of Cardiology, Vol. 218, 01.09.2016, p. 275-283.

Research output: Contribution to journalArticle

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T1 - Effect of cold spells and their modifiers on cardiovascular disease events

T2 - International Journal of Cardiology

AU - Sartini, Claudio

AU - Barry, Sarah J.E.

AU - Wannamethee, S. Goya

AU - Whincup, Peter H.

AU - Lennon, Lucy

AU - Ford, Ian

AU - Morris, Richard W.

PY - 2016/9/1

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N2 - Objective: To investigate effects of cold weather spells on incidence of cardiovascular disease (CVD), and potential effect modification of socio-demographic, clinical, behavioural and environmental exposures. Methods: Data from two prospective studies were analysed: the British Regional Heart Study (BRHS), a population-based study of British men aged 60?79 years, followed for CVD incidence from 1998?2000 to 2012; and the PROSPER study of men and women aged 70?82 recruited to a trial of pravastatin vs placebo from 1997 to 9 (followed until 2009). Cold spells were defined as at least three consecutive days when daily mean temperature fell below the monthly 10th percentile specific to the closest local weather station. A timestratified case-crossover approach was used to estimate associations between cold spells and CVD events. Results: 921 of 4252 men from BRHS and 760 of 2519 participants from PROSPER suffered a first CVD event during follow-up. More CVD events were registered in winter in both studies. The risk ratio (RR) associated with cold spells was statistically significant in BRHS (RR = 1.86, 95% CI 1.30?2.65, p b 0.001), and independent of temperature level: results were similar whether events were fatal or non-fatal. Increased risk was particularly marked in BRHS for ever-smokers (RR of 2.44 vs 0.99 for never-smokers), in moderate/heavy drinkers (RR 2.59 vs 1.41), and during winter months (RR 3.28 vs 1.25). No increased risk was found in PROSPER. Conclusions: Although CVD risks were higher in winter in both BRHS and PROSPER prospective studies, cold spells increased risk of CVD events, independently of cold temperature, in the BRHS only.

AB - Objective: To investigate effects of cold weather spells on incidence of cardiovascular disease (CVD), and potential effect modification of socio-demographic, clinical, behavioural and environmental exposures. Methods: Data from two prospective studies were analysed: the British Regional Heart Study (BRHS), a population-based study of British men aged 60?79 years, followed for CVD incidence from 1998?2000 to 2012; and the PROSPER study of men and women aged 70?82 recruited to a trial of pravastatin vs placebo from 1997 to 9 (followed until 2009). Cold spells were defined as at least three consecutive days when daily mean temperature fell below the monthly 10th percentile specific to the closest local weather station. A timestratified case-crossover approach was used to estimate associations between cold spells and CVD events. Results: 921 of 4252 men from BRHS and 760 of 2519 participants from PROSPER suffered a first CVD event during follow-up. More CVD events were registered in winter in both studies. The risk ratio (RR) associated with cold spells was statistically significant in BRHS (RR = 1.86, 95% CI 1.30?2.65, p b 0.001), and independent of temperature level: results were similar whether events were fatal or non-fatal. Increased risk was particularly marked in BRHS for ever-smokers (RR of 2.44 vs 0.99 for never-smokers), in moderate/heavy drinkers (RR 2.59 vs 1.41), and during winter months (RR 3.28 vs 1.25). No increased risk was found in PROSPER. Conclusions: Although CVD risks were higher in winter in both BRHS and PROSPER prospective studies, cold spells increased risk of CVD events, independently of cold temperature, in the BRHS only.

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KW - winter deaths

KW - cardiovascular disease

KW - prospective study

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JO - International Journal of Cardiology

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