The Effect Of High Temperature In Summer On The Number Of Patients With Major Cardiovascular And Cerebrovascular Disease And Related Physicochemical Indexes

Objective:To explore the effect of high temperature in summer on the number of emergency and hospital admissions for hypertension,coronary heart disease and stroke,and to find the correlation between high temperature and the main physical and chemical indexes of cardiovascular and cerebrovascular disease.Methods:?1?The data on emergency visits for cardiovascular and cerebrovascular disease of three general hospitals and hospital admissions for cardiovascular diseases of four general hospitals in Jinchang City were collected from2013 to 2016.Meteorological and air pollution data in the same period were collected.The time-stratified case-cross study was used to analyze the relationship between the maximum temperature and the emergency and hospital admissions for hypertension,coronary heart disease and stroke in different high temperature ranges(T_max?31?,T_max?33?,T_max?35?,heat wave).Stratified analysis was also conducted by age,gender and heat wave duration.?2?The baseline information of Jinchang cohort were extracted and matched with the meteorological environment data in the same period.After adjusting related confounding factors,the relationships between the maximum temperature and blood pressure?SBP,DBP?and blood lipid?TC,TG,HDL-C,LDL-C?in different high temperature ranges(summer,T_max?31?,T_max?33?,T_max?35?)were analyzed.Results:?1?The maximum temperature in the ranges of T_max?31?,T_max?33?,T_max?35?and heat wave has significant effect on the emergency and hospital admissions for hypertension,coronary heart disease and stroke.The maximum temperature has the greatest impact on emergency room admissions for coronary heart disease in the range of 33?,The OR was 2.371?95%CI:2.208².547?at lag for 0d.The maximum temperature has the greatest impact on emergency room admissions for hypertension and stroke in the range of T_max?35?,The ORs were2.894?95%CI:2.027⁴.132?at lag for 5d,2.493?95%CI:1.777³.496?at lag for 01d.For the hypertensive and coronary heart disease's hospital admissions reached the biggest estimates at the lag 03d,The OR were 2.595?95%CI:1.643⁴.096?,2.520?95%CI:1.686³.767?during the heat wave.The stroke's hospital admissions in the range of T_max?33?and in the single lag 1d the effects was strongest.The OR was2.254?95%CI:1.966².585?.?2?The results of stratified analysis showed that the maximum temperature had a greater impact on the emergency room and hospital admissions for hypertension,coronary heart disease and stroke in male and the elderly over 65 years old than in female and people under 65 years old in four high temperature ranges.The effect of the maximum temperature in heat wave lasting 5 days was higher than in heat wave lasting 4 days.?3?The maximum temperature in different high temperature ranges had no significant effect on blood pressure?SBP,DBP?but had significant effect on blood lipid?TC,TG,HDL-C,LDL-C?.There was a positive correlation between TC,TG,LDL-C and the maximum temperature in different high temperature range and a negative positive correlation between HDL-C and the maximum temperature When the maximum temperature was higher than 33?,the level of TG and LDL-C were increased 0.121?95%CI:0.039⁰.202?at the lag 0d and0.026?95%CI:0.039⁰.202?at the lag 5d with a 1?increase of maximum temperature.When the maximum temperature was higher than 33?,the level of TC was increased 0.099?95%CI:0.003⁰.195?at the lag 7d with a 1?increase of maximum temperature.When the maximum temperature was higher than 31?,the level of HDL-C was decreased 0.004?95%CI:-0.007^-0.001?at the lag 7d with a 1?increase of maximum temperature.?4?In the sensitivity analysis of adjusting the maximum temperature lag effect,it was found that in the high temperature range of T_max?33?,the maximum temperature had statistical significance on SBP and reached the biggest estimates at the lag 6d,the effect value was 1.202?95%CI:0.440¹.965?;in the high temperature range of T_max?35?,the level of TG at lag 1d and LDL-C at lag 6d the maximum temperature the effect was strongest,the effect value were 1.459?95%CI:0.173².745?and 0.633?95%CI:0.111¹.155?respectively.Conclusions:?1?The maximum temperature in different high temperature ranges has a significant lag effect on the emergency room and hospital admissions for hypertension,coronary heart disease and stroke.With the increase of the maximum temperature in different high temperature ranges,the maximum temperature effect on the emergency room and hospital admissions for three cardiovascular diseases increased,but there was a difference in the temperature range for three diseases.?2?The effect of high temperature and heat wave on the emergency room and hospital admissions for three cardiovascular diseases in male and the elderly over 65 years old was greater than in female and people under 65 years old.The maximum temperature effect in 5 days heat wave was greater than in 4 days heat wave.?3?The maximum temperature in different high temperature ranges has significant influence on the level of blood lipids?TC,TG,HDL-C,LDL-C?.With the increase of temperature,the level of TC,TG,LDL-C were increased,while the level of HDL-C was opposite.