Stroke risk associated with cold spells occurring during the warm season

IF 10.3 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environment International Pub Date : 2025-05-01 DOI:10.1016/j.envint.2025.109514

Cheng He , Susanne Breitner , Siqi Zhang , Markus Naumann , Claudia Traidl-Hoffmann , Gertrud Hammel , Annette Peters , Michael Ertl , Alexandra Schneider

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引用次数: 0

Abstract

Background

Recent climate changes have resulted in a rising frequency of extreme cold events that take place during the warm season. Few studies have investigated the impact of these warm-season cold spells on cardiovascular health. Here, we aimed to investigate the potential relationship between exposure to relatively low temperature exposure during the warm season and stroke risk.

Methods

We conducted a time-stratified case-crossover study using a validated, complete, and detailed registration of all stroke cases in the city of Augsburg, Germany, from 2006 to 2020 to assess the association between the occurrence of stroke and exposure to cold spell events during the warm season (May–October). Six cold spell definitions were created using different relative temperature thresholds (1st, 2.5th, and 5th percentiles) and durations (more than 1–2 consecutive days). Conditional logistic regression with distributed lag models was then applied to assess the accumulated effects of these warm-season cold spells on stroke risk over a lag period of 0–6 days, with adjustments for daily mean temperature.

Results

Results confirmed that warm-season cold spells were significantly linked to an elevated risk of stroke with effects that could persist three days after exposure. The cumulative odds ratio (OR) estimates for the cold spells using the 2.5th percentile as air temperature threshold reached 1.29 (95% confidence interval (CI): 1.09–1.53) and 1.23 (95%CI: 1.05–1.44) for durations more than one and two days, respectively. Warm-season cold spells also had significant associations with both transient ischemic attacks and ischemic strokes. The stratified analysis showed that the elderly population (aged ≥ 65 years), females, and stroke cases characterized by minor symptoms demonstrated a significantly increased stroke risk of the effects of warm season cold spells.

Conclusions

This study presents strong evidence for an overlooked association between warm-season cold spells and an increased risk of stroke occurrence. These findings further highlight the multifaceted ways in which climate change can affect human health.

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在温暖的季节，中风的风险与感冒有关

最近的气候变化导致在暖季发生的极端寒冷事件频率上升。很少有研究调查这些暖季寒冷期对心血管健康的影响。在这里，我们的目的是调查在温暖季节暴露于相对低温与中风风险之间的潜在关系。方法：我们对2006年至2020年德国奥格斯堡市的所有中风病例进行了一项时间分层病例交叉研究，对这些病例进行了验证、完整和详细的登记，以评估在温暖季节（5 - 10月）中风发生与暴露于寒潮事件之间的关系。使用不同的相对温度阈值（第1、第2.5和第5百分位）和持续时间（超过连续1-2天）创建了6个冷期定义。然后应用分布滞后模型的条件逻辑回归来评估这些暖季寒冷天气在0-6 天的滞后期内对中风风险的累积影响，并对日平均温度进行调整。结果证实，温暖季节的寒潮与中风风险的增加有显著联系，其影响可能在暴露后三天持续。使用第2.5百分位作为气温阈值的累积优势比（OR）估计，持续时间超过一天和两天的寒流分别达到1.29（95%置信区间（CI）： 1.09-1.53）和1.23 （95%CI: 1.05-1.44）。暖季寒潮也与短暂性脑缺血发作和缺血性中风有显著关联。分层分析显示，老年人（ ≥ 65 岁）、女性和症状轻微的脑卒中患者受暖季寒潮影响的卒中风险显著增加。结论：这项研究提供了强有力的证据，证明暖季寒流与中风发生风险增加之间存在被忽视的联系。这些发现进一步强调了气候变化可以以多方面的方式影响人类健康。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Environment International 环境科学-环境科学

CiteScore

21.90

自引率

3.40%

发文量

734

审稿时长

2.8 months

期刊介绍： Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review. It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.