A systematic review and meta-analysis of cold exposure and cardiovascular disease outcomes
Fan JF, Xiao YC, Feng YF, Niu LY, Tan X, Sun JC, Leng YQ, Li WY, Wang WZ, Wang YK
Frontiers in cardiovascular medicine · 73 citations
How it was studied
- Design
- Meta-analysis (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- University or hospital
- U.S. Naval Academy
Based on 1 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2023-03-27 · Front Cardiovasc Med · vol. 10 · p. 1084611
- Publisher
- Frontiers Media
- Cited
- 111 citations · more than 97% of similar papers · 4.5× the field average
- Impact
- Top 10% most cited in its field
- References
- 42 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Climate Change and Health Impacts · Thermal Regulation in Medicine · Adipose Tissue and Metabolism
- Keywords
- Medicine, Relative risk, Disease, Meta-analysis, Internal medicine, Extreme Cold, Population, Coronary artery disease, Confidence interval, Cardiology, Environmental health
10 authors
From CN
- Jie‐Fu FanSecond Military Medical University
- Yuchen XiaoSecond Military Medical University
- Yifei FengSecond Military Medical University
- Lu-Yu NiuSecond Military Medical University
- Xing Lin TanSecond Military Medical University
- Jia‐Cen SunSecond Military Medical University
Abstract
Background
Cold exposure has been considered an essential risk factor for the global disease burden, while its role in cardiovascular diseases is still underappreciated. The increase in frequency and duration of extreme cold weather events like cold spells makes it an urgent task to evaluate the effects of ambient cold on different types of cardiovascular disease and to understand the factors contributing to the population's vulnerability.
Methods
In the present systematic review and meta-analysis, we searched PubMed, Scopus, and Cochrane. We included original research that explored the association between cold exposure (low temperature and cold spell) and cardiovascular disease outcomes (mortality and morbidity). We did a random-effects meta-analysis to pool the relative risk (RR) of the association between a 1°C decrease in temperature or cold spells and cardiovascular disease outcomes.
Results
In total, we included 159 studies in the meta-analysis. As a result, every 1°C decrease in temperature increased cardiovascular disease-related mortality by 1.6% (RR 1.016; [95% CI 1.015-1.018]) and morbidity by 1.2% (RR 1.012; [95% CI 1.010-1.014]). The most pronounced effects of low temperatures were observed in the mortality of coronary heart disease (RR 1.015; [95% CI 1.011-1.019]) and the morbidity of aortic aneurysm and dissection (RR 1.026; [95% CI 1.021-1.031]), while the effects were not significant in hypertensive disease outcomes. Notably, we identified climate zone, country income level and age as crucial influential factors in the impact of ambient cold exposure on cardiovascular disease. Moreover, the impact of cold spells on cardiovascular disease outcomes is significant, which increased mortality by 32.4% (RR 1.324; [95% CI 1.2341.421]) and morbidity by 13.8% (RR 1.138; [95% CI 1.015-1.276]).
Conclusion
Cold exposure could be a critical risk factor for cardiovascular diseases, and the cold effect varies between disease types and climate zones.
Systematic review registration
https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022347247.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
Community trust
Loading…
How much do you trust this study's findings?
Comments
Sign in to rate, comment on or flag this study.Sign inSomething wrong here?
Flag this study if its information, labels or funding look wrong. An editor reviews every flag.
Sign in to rate, comment on or flag this study.Sign inEducational information about published research. Not medical advice, and not a recommendation to start or stop anything.