The effects of Increased temperature(Heat waves) on cardiovascular health among adults in Atlanta. GA Pubblico

Abstract

Background: In the coming years, average temperatures will increase as climate change continues. These temperature changes can have a direct effect on human health, including in people with cardiovascular diseases; numerous studies in the United States have reported a link between high ambient temperatures and increased emergency department (ED) visits due to cardiovascular diseases. In this study, we assessed the association between summer temperature (May and September, 2016-2018) and hypertension using ED data for adults in Atlanta Georgia.

 

Methods: We examined the association between ambient temperature and daily ED visits for hypertensive diagnoses among adults who visited four of Emory University’s hospitals. We also explored the impact of having a history of hypertension. We analyzed the data using a time-stratified case-crossover study design, with conditional logistic regression, at up to three days of lag. The case-crossover study design controls for time trends and individual-level confounders, as each individual serves as their own control. We estimated odds ratios (ORs) and 95% confidence intervals (CI) for maximum temperature changes  for each degree celsius. We also investigated potential non-linearity in the temperature-morbidity relationship, by evaluating the association within each temperature quartile.

 

Results: During the 3 year study period from 2016 – 2018, there were 220,210 adult ED visits. Of these, 33,565 (15.2%) were patients with a previous history of hypertension. The reason for the visit was hypertension in twelve percent of cases. Those who presented with hypertension and had a hypertensive history were 15,159 (6.8%) of total visits. About a quarter of all visits were in the elderly. We observed significant (p<0.05) associations between heat and all ED visits at lags 0, 1 and 2 days. We observed no significant associations with visits for hypertensions or in visits where the cases had a history of hypertension.  There was no evidence of non linearity.

 

Conclusion: We found that that increased temperatures increased the rate of visits to the ED but not for hypertensive visits in particular or visits in patients with a history of hypertension.

Table of Contents

i.              Introduction……………………………………………………………………………1

ii.             Methods ………………………………………………………………………………..4

a.    Study area………………………………………………………………………….....4

b.    Health dataset…………………………………………………………………….....4

c.    Temperature dataset………………………………………………………………..5

d.    Statistical analysis…………………………………………………………………..5

iii.           Results…………………………………………………………………………............6

iv.           Discussion……………………………………………………………………………...10

a.    Strengths and limitation ………………………………………………………….13

v.             Conclusion……………………………………………………………………………..14

vi.           Acknowledgement…………………………………………………………………….15

vii.          References……………………………………………………………………………...16

viii.        Abbreviation…………………………………………………………………………....26

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Environmental Sciences Environmental Health Health Sciences, Medicine and Surgery
Parola chiave	Hypertension Cardiovascular disease Climate change Temperature Heat Waves
Committee Chair / Thesis Advisor	Noah Scovronick , Emory University

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