Ismael Henrique Silveira1, Beatriz Fátima Alves Oliveira2, Taísa Rodrigues Cortes2, Washington Leite Junger2. 1. Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil. Electronic address: ismaelhsilveira@gmail.com. 2. Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil.
Abstract
BACKGROUND: There is limited evidence on the relationship between temperature and cardiovascular mortality in middle and low-income countries, particularly in Latin America. In this study, we investigated the total effect of temperature on cardiovascular mortality in 27 Brazilian cities, and the effect modification by geographic, socioeconomic, demographic and infrastructure characteristics within cities. METHODS: In the city-specific analysis, we used time-series analyses to estimate the relationship between mean temperature and daily cardiovascular mortality using quasi-Poisson generalized linear models combined with distributed lag non-linear models. In the second stage, a meta-analysis was used to pool the effects of temperature on cardiovascular mortality for Brazil and its five regions (Central-West, North, Northeast, South, and Southeast). We used a meta-regression to examine the effect modification of city-specific geographic, socioeconomic, demographic and infrastructure-related variables. RESULTS: The risks associated with temperature varied across the locations. Higher cardiovascular mortality was associated with low and high temperatures in most of the cities, Brazil and the Central-West, North, South, and Southeast regions. The overall relative risk (RR) for Brazil was 1.26 (95% confidence interval [CI]: 1.17-1.35) for the 1st percentile of temperature and 1.07 (95% CI: 1.01-1.13) for the 99th percentile of temperature versus the 79th percentile (27.7 °C), where RR was lowest. The temperature range was the variable that best explained the variation in effects among the cities, with greater effects in locations having a broader range. CONCLUSIONS: The results indicate effects of low and high temperatures on the risk of cardiovascular mortality in most of Brazil's capital cities, besides a pooled effect for Brazil and the Central-West, North, South, and Southeast regions. These findings can help inform public policies addressing the health impact of temperature extremes, especially in the context of climate change.
BACKGROUND: There is limited evidence on the relationship between temperature and cardiovascular mortality in middle and low-income countries, particularly in Latin America. In this study, we investigated the total effect of temperature on cardiovascular mortality in 27 Brazilian cities, and the effect modification by geographic, socioeconomic, demographic and infrastructure characteristics within cities. METHODS: In the city-specific analysis, we used time-series analyses to estimate the relationship between mean temperature and daily cardiovascular mortality using quasi-Poisson generalized linear models combined with distributed lag non-linear models. In the second stage, a meta-analysis was used to pool the effects of temperature on cardiovascular mortality for Brazil and its five regions (Central-West, North, Northeast, South, and Southeast). We used a meta-regression to examine the effect modification of city-specific geographic, socioeconomic, demographic and infrastructure-related variables. RESULTS: The risks associated with temperature varied across the locations. Higher cardiovascular mortality was associated with low and high temperatures in most of the cities, Brazil and the Central-West, North, South, and Southeast regions. The overall relative risk (RR) for Brazil was 1.26 (95% confidence interval [CI]: 1.17-1.35) for the 1st percentile of temperature and 1.07 (95% CI: 1.01-1.13) for the 99th percentile of temperature versus the 79th percentile (27.7 °C), where RR was lowest. The temperature range was the variable that best explained the variation in effects among the cities, with greater effects in locations having a broader range. CONCLUSIONS: The results indicate effects of low and high temperatures on the risk of cardiovascular mortality in most of Brazil's capital cities, besides a pooled effect for Brazil and the Central-West, North, South, and Southeast regions. These findings can help inform public policies addressing the health impact of temperature extremes, especially in the context of climate change.
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Deborah Carvalho Malta; Andreia Biolo; Bruno Ramos Nascimento; Maria de Fatima Marinho de Souza; Andrea Rocha De Lorenzo; Antonio Aurélio de Paiva Fagundes Júnior; Beatriz D Schaan; Fábio Morato de Castilho; Fernando Henpin Yue Cesena; Gabriel Porto Soares; Gesner Francisco Xavier Junior; Jose Augusto Soares Barreto Filho; Luiz Guilherme Passaglia; Marcelo Martins Pinto Filho; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Paolo Blanco Villela; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Pablo Perel; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2022-01 Impact factor: 2.000
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Andreia Biolo; Bruno Ramos Nascimento; Deborah Carvalho Malta; Maria de Fatima Marinho de Souza; Gabriel Porto Soares; Gesner Francisco Xavier Junior; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Odilson Marcos Silvestre; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2020-09 Impact factor: 2.667
Authors: Ludmilla da Silva Viana Jacobson; Beatriz Fátima Alves de Oliveira; Rochelle Schneider; Antonio Gasparrini; Sandra de Souza Hacon Journal: Int J Environ Res Public Health Date: 2021-05-22 Impact factor: 3.390
Authors: Raphael Romano Bruno; Bernhard Wernly; Maryna Masyuk; Johanna M Muessig; Rene Schiffner; Laura Bäz; Christian Schulze; Marcus Franz; Malte Kelm; Christian Jung Journal: Wien Med Wochenschr Date: 2021-03-18