Sartini, C;
Barry, SJE;
Wannamethee, SG;
Whincup, PH;
Lennon, L;
Ford, I;
Morris, RW;
(2016)
Effect of cold spells and their modifiers on cardiovascular disease events: evidence from two prospective studies.
International Journal of Cardiology
, 218
pp. 275-283.
10.1016/j.ijcard.2016.05.012.
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Abstract
Objective: To investigate effects of cold weather spells on incidence of cardiovascular disease (CVD), and potential effect modification of socio-demographic, clinical, behavioural and environmental exposures. / Methods: Data from two prospective studies were analysed: the British Regional Heart Study (BRHS), a population-based study of British men aged 60–79 years, followed for CVD incidence from 1998–2000 to 2012; and the PROSPER study of men and women aged 70–82 recruited to a trial of pravastatin vs placebo from 1997 to 9 (followed until 2009). Cold spells were defined as at least three consecutive days when daily mean temperature fell below the monthly 10th percentile specific to the closest local weather station. A time-stratified case-crossover approach was used to estimate associations between cold spells and CVD events. / Results: 921 of 4252 men from BRHS and 760 of 2519 participants from PROSPER suffered a first CVD event during follow-up. More CVD events were registered in winter in both studies. The risk ratio (RR) associated with cold spells was statistically significant in BRHS (RR = 1.86, 95% CI 1.30–2.65, p < 0.001), and independent of temperature level: results were similar whether events were fatal or non-fatal. Increased risk was particularly marked in BRHS for ever-smokers (RR of 2.44 vs 0.99 for never-smokers), in moderate/heavy drinkers (RR 2.59 vs 1.41), and during winter months (RR 3.28 vs 1.25). No increased risk was found in PROSPER. / Conclusions: Although CVD risks were higher in winter in both BRHS and PROSPER prospective studies, cold spells increased risk of CVD events, independently of cold temperature, in the BRHS only.
| Type: | Article |
|---|---|
| Title: | Effect of cold spells and their modifiers on cardiovascular disease events: evidence from two prospective studies |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ijcard.2016.05.012 |
| Publisher version: | http://dx.doi.org/10.1016/j.ijcard.2016.05.012 |
| Language: | English |
| Additional information: | Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Cold spell; Outdoor temperature; Winter deaths; Cardiovascular disease; Prospective study; Older people |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1493448 |
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