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Abstract：
BACKGROUND: Cardiovascular disease (CVD) has been found to be particularly vulnerable to climate change and temperature variability. This study aimed to assess the extent to which human-induced climate change contributes to future heat-related CVD burdens.
METHODS: Daily data on CVD mortality and temperature were collected in 161 Chinese communities from 2007 to 2013. The association between heat and CVD mortality was established using a two-stage time-series design. Under the natural forcing, human-induced, and combined scenarios, we then separately projected excess cause-/age-/region-/education-specific mortality from future high temperature in 2010-2100, assuming no adaptation and population changes.
RESULTS: Under shared socioeconomic pathway with natural forcing scenario (SSP2-4.5-nat), heat-related attributable fraction of CVD deaths decreased slightly from 3.3% [95% empirical confidence interval (eCI): 0.3, 5.8] in the 2010s to 2.8% (95% eCI: 0.1, 5.2) in the 2090s, with relative change of -0.4% (95% eCI: -0.8, 0.0). However, for combined natural and human-induced forcings, this estimate would surge to 8.9% (95% eCI: 1.5, 15.7), 14.4% (95% eCI: 1.5, 25.3), 21.3% (95% eCI: -0.6, 39.4), and 28.7% (95% eCI: -3.3, 48.0) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. When excluding the natural forcing, the number of human-induced heat-related CVD deaths would increase from approximately eight thousand (accounting for 31% of total heat-related CVD deaths) in the 2010s to 33,052 (68%), 63,283 (80%), 101,091 (87%), and 141,948 (90%) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. Individuals with stroke, females, the elderly, people living in rural areas, and those with lower education level would exhibit heightened susceptibility to future high temperature. In addition, Southern and Eastern regions of China were expected to experience a faster increase in heat-related attributable fraction of CVD deaths.
CONCLUSIONS: Human activities would significantly amplify the future burden of heat-related CVD. Our study findings suggested that active adaptation and mitigation measures towards future warming could yield substantial health benefits for the patients with CVD.
BACKGROUND: National Natural Science Foundation of China.
METHODS: Daily data on CVD mortality and temperature were collected in 161 Chinese communities from 2007 to 2013. The association between heat and CVD mortality was established using a two-stage time-series design. Under the natural forcing, human-induced, and combined scenarios, we then separately projected excess cause-/age-/region-/education-specific mortality from future high temperature in 2010-2100, assuming no adaptation and population changes.
RESULTS: Under shared socioeconomic pathway with natural forcing scenario (SSP2-4.5-nat), heat-related attributable fraction of CVD deaths decreased slightly from 3.3% [95% empirical confidence interval (eCI): 0.3, 5.8] in the 2010s to 2.8% (95% eCI: 0.1, 5.2) in the 2090s, with relative change of -0.4% (95% eCI: -0.8, 0.0). However, for combined natural and human-induced forcings, this estimate would surge to 8.9% (95% eCI: 1.5, 15.7), 14.4% (95% eCI: 1.5, 25.3), 21.3% (95% eCI: -0.6, 39.4), and 28.7% (95% eCI: -3.3, 48.0) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. When excluding the natural forcing, the number of human-induced heat-related CVD deaths would increase from approximately eight thousand (accounting for 31% of total heat-related CVD deaths) in the 2010s to 33,052 (68%), 63,283 (80%), 101,091 (87%), and 141,948 (90%) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. Individuals with stroke, females, the elderly, people living in rural areas, and those with lower education level would exhibit heightened susceptibility to future high temperature. In addition, Southern and Eastern regions of China were expected to experience a faster increase in heat-related attributable fraction of CVD deaths.
CONCLUSIONS: Human activities would significantly amplify the future burden of heat-related CVD. Our study findings suggested that active adaptation and mitigation measures towards future warming could yield substantial health benefits for the patients with CVD.
BACKGROUND: National Natural Science Foundation of China.
摘要：
背景：已经发现心血管疾病（CVD）特别容易受到气候变化和温度变化的影响。这项研究旨在评估人类引起的气候变化对未来与热相关的CVD负担的影响程度。
方法：收集了2007年至2013年161个中国社区的每日CVD死亡率和温度数据。使用两阶段时间序列设计建立了热量和CVD死亡率之间的关联。在自然强迫下,人为诱导,和组合场景，然后,我们分别预测了2010-2100年未来高温导致的额外原因/年龄/地区/教育特定死亡率,假设没有适应和人口变化.
结果：在具有自然强迫情景的共享社会经济途径（SSP2-4.5-nat）下，CVD死亡的热相关归因分数从2010年代的3.3%[95%经验置信区间(eCI)：0.3，5.8]略微下降到2030年代的2.8%(95%eCI：0.1，5.2)，相对变化为-0.4%（95%eCI：-0.8，0.0）。然而,对于自然和人为联合强迫，这一估计将飙升至8.9%(95%eCI：1.5，15.7)，14.4%（95%eCI：1.5，25.3），21.3%（95%eCI：-0.6，39.4），在SSP1-2.6、SSP2-4.5、SSP3-7.0和SSP5-8.5场景下，2090年代为28.7%(95%eCI：-3.3，48.0)，分别。当排除自然强迫时，人类引起的与热相关的CVD死亡人数将从2010年代的约八千人（占与热相关的CVD死亡总数的31％）增加到33,052人（68％），63,283（80%），101,091（87%），和141948（90%）在2090年代的SSP1-2.6，SSP2-4.5，SSP3-7.0和SSP5-8.5场景下，分别。有中风的人，女性,老年人,生活在农村地区的人们，受教育程度较低的人会表现出对未来高温的敏感性。此外,预计中国南部和东部地区的CVD死亡与热相关的部分将更快地增加。
结论：人类活动将显著放大与热相关的CVD的未来负担。我们的研究结果表明，针对未来变暖的积极适应和缓解措施可以为CVD患者带来实质性的健康益处。
背景：国家自然科学基金.
方法：收集了2007年至2013年161个中国社区的每日CVD死亡率和温度数据。使用两阶段时间序列设计建立了热量和CVD死亡率之间的关联。在自然强迫下,人为诱导,和组合场景，然后,我们分别预测了2010-2100年未来高温导致的额外原因/年龄/地区/教育特定死亡率,假设没有适应和人口变化.
结果：在具有自然强迫情景的共享社会经济途径（SSP2-4.5-nat）下，CVD死亡的热相关归因分数从2010年代的3.3%[95%经验置信区间(eCI)：0.3，5.8]略微下降到2030年代的2.8%(95%eCI：0.1，5.2)，相对变化为-0.4%（95%eCI：-0.8，0.0）。然而,对于自然和人为联合强迫，这一估计将飙升至8.9%(95%eCI：1.5，15.7)，14.4%（95%eCI：1.5，25.3），21.3%（95%eCI：-0.6，39.4），在SSP1-2.6、SSP2-4.5、SSP3-7.0和SSP5-8.5场景下，2090年代为28.7%(95%eCI：-3.3，48.0)，分别。当排除自然强迫时，人类引起的与热相关的CVD死亡人数将从2010年代的约八千人（占与热相关的CVD死亡总数的31％）增加到33,052人（68％），63,283（80%），101,091（87%），和141948（90%）在2090年代的SSP1-2.6，SSP2-4.5，SSP3-7.0和SSP5-8.5场景下，分别。有中风的人，女性,老年人,生活在农村地区的人们，受教育程度较低的人会表现出对未来高温的敏感性。此外,预计中国南部和东部地区的CVD死亡与热相关的部分将更快地增加。
结论：人类活动将显著放大与热相关的CVD的未来负担。我们的研究结果表明，针对未来变暖的积极适应和缓解措施可以为CVD患者带来实质性的健康益处。
背景：国家自然科学基金.
