河北省辛集市热浪与心血管疾病死亡的时间分层病例交叉研究OA

[Background]Heatwaves are a significant risk factor for cardiovascular mortality.However,quantitative evidence regarding the impact of heatwaves on cardiovascular mortality in Xinji,Hebei Province remains limited. [Objective]To quantitatively assess the association between heatwave exposure and cardiovas-cular mortality in Xinji,Hebei Province. [Methods]Data on cardiovascular mortality,meteorological factors,and air pollutants in Xinji were collected for the warm seasons(May to September)from 2016 to 2024.A time-stratified case-crossover design,combined with distributed lag non-linear model(DLNM),was adopted to assess the effects of heatwaves on overall cardiovascular mortality and its subtypes,including heart disease and cerebrovascular disease.Stratified analyses by gender and age were performed to estimate differences between subgroups. [Results]During the study period,28 heatwaves occurred.A total of 8 930 cardiovascular deaths were recorded,comprising 6 321 from heart disease,2 576 from cerebrovascular disease,and 33 from other circulatory system diseases.Heatwave exposure exhibited lagged and cumulative effects on cardiovascular mortality.On the day of heatwave exposure(lag 0),the relative risks(RRs)for overall cardiovascular(RR=1.130,95%CI:1.087,1.175),heart(RR=1.129,95%CI:1.081,1.180),and cerebrovascular(RR=1.131,95%CI:1.056,1.210)disease mortalities all reached their single-day peaks.The maximum cumulative relative risks(cumRRs)for cardiovascular and heart disease mortalities appeared at lag 010,peaking at 1.770(95%CI:1.516,2.066)and 1.852(95%CI:1.555,2.204),respectively.For cerebrovascular disease mortality,the peak cumulative effect occurred at lag 07,with a cumRR of 1.587(95%CI:1.260,1.998).The cumRR of cerebrovascular disease mortality was significantly higher among adults≥65 years compared to those under 65 years(P<0.05).The attributable fractions of heatwave exposure for cardiovascular,heart and cerebrovascular disease mortalities were 7.32%,8.29%,and 4.35%,respectively,with corresponding attributable excess mortality rates of 5.52×10-5,4.42×10-5 and 0.95×10-5,respectively. [Conclusion]Heatwave exposure significantly increases the risk of mortality from cardiovascular disease and its subtypes,with a particularly prominent impact on cerebrovascular mortality among older adults.These findings highlight the need to strengthen early warning systems and targeted intervention strategies for vulnerable populations to mitigate heatwave-related health burdens.