Abstract:
Ambient high temperature is a worldwide trigger for hypertension events. However, the effects of heat exposure on hypertension and years of life lost (YLL) due to heat remain largely unknown. We conducted a multicenter study in 13 cities in Jiangsu Province, China, to investigate 9727 individuals who died from hypertension during the summer months (May to September) between 2016 and 2017. Meteorological observation data (temperature and rainfall) and air pollutants (fine particulate matter and ozone) were obtained for each decedent by geocoding the residential addresses. A time-stratified case-crossover design was used to quantify the association between heat and different types of hypertension and further explore the modification effect of individual and hospital characteristics. Meanwhile, the YLL associated with heat exposure was estimated. Our results show that summer heat exposure shortens the YLL of hypertensive patients by a total of 14,74 years per month. Of these, 77.9% of YLL was mainly due to hypertensive heart disease. YLL due to heat was pronounced for essential hypertension (5.1 years (95% empirical confidence intervals (eCI): 4.1-5.8)), hypertensive heart and renal disease with heart failure (4.4 years (95% eCI: 0.9-5.9)), and hypertensive heart and renal disease (unspecified, 3.5 years (95% eCI: 1.8-4.5)). Moderate heat was associated with a larger YLL than extreme heat. The distance between hospitals and patients and the number of local first-class hospitals can significantly mitigate the adverse effect of heat exposure on longevity. Besides, unmarried people and those under 65 years of age were potentially susceptible groups, with average reduced YLL of 3.5 and 3.9 years, respectively. Our study reveals that heat exposure increases the mortality risk from many types of hypertension and YLL. In the context of climate change, if effective measures are not taken, hot weather may bring a greater burden of disease to hypertension due to premature death.
摘要:
环境高温是高血压事件的全球触发因素。然而,热暴露对高血压和热导致的寿命损失(YLL)的影响在很大程度上仍然未知.我们在江苏省13个城市进行了一项多中心研究,中国,调查在2016年至2017年夏季(5月至9月)期间因高血压死亡的9727人.通过对居住地址进行地理编码,获得了每个死者的气象观测数据(温度和降雨)和空气污染物(细颗粒物和臭氧)。采用时间分层病例交叉设计,量化热量与不同类型高血压的关联,进一步探讨个体和医院特征的修正效应。同时,估计了与热暴露相关的YLL。我们的结果表明,夏季热暴露使高血压患者的YLL每月缩短了14,74年。其中,77.9%的YLL主要是由于高血压性心脏病。由于热量导致的YLL对于原发性高血压很明显(5.1年(95%经验置信区间(eCI):4.1-5.8)),高血压性心脏和肾脏疾病伴心力衰竭(4.4年(95%eCI:0.9-5.9)),和高血压心脏和肾脏疾病(未指明,3.5年(95%eCI:1.8-4.5))。与极热相比,中热与更大的YLL相关。医院与患者之间的距离和当地一流医院的数量可以显着减轻热暴露对寿命的不利影响。此外,未婚人士和65岁以下的人是潜在的易感人群,平均减少3.5年和3.9年,分别。我们的研究表明,热暴露会增加许多类型的高血压和YLL的死亡风险。在气候变化的背景下,如果不采取有效措施,由于过早死亡,炎热的天气可能给高血压带来更大的疾病负担。