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Health

Extreme heat expected to increase cardiovascular deaths


Press release

Monday October 30, 2023

An NIH-funded study predicts that older, black adults will suffer the most.

Cardiovascular deaths from extreme heat are expected to increase between 2036 and 2065 in the United States, according to a study supported by the National Institutes of Health. Researchers, whose work is published in Trafficpredict that adults ages 65 and older and Black adults will likely be disproportionately affected.

While extreme heat currently accounts for less than 1% of cardiovascular disease-related deaths, modeling analysis predicts that will change due to a projected increase in summer days that reach at least 90 degrees. This heat index, which takes into account the sensation of temperature with humidity, measures extreme temperatures. Older adults and Black adults will be most vulnerable because many have underlying health conditions or face socioeconomic barriers that can influence their health – such as not having air conditioning or living in places that can absorb and trap heat, called “heat islands”.

“The health burden from extreme heat will continue to grow over the coming decades,” said study author Sameed A. Khatana, MD, MPH, a cardiologist and assistant professor of medicine at the University of Pennsylvania in Philadelphia. . “Because of the unequal impact of extreme heat on different populations, it is also a health equity issue and could exacerbate already existing health disparities. »

To generate these predictions, researchers evaluated county-level data from the contiguous 48 states between May and September 2008-2019. More than 12 million deaths related to cardiovascular disease occurred during this period. Using environmental modeling estimates, they also found that the heat index reached at least 90 degrees about 54 times each summer. Researchers linked extreme temperatures occurring during each summer period to a national average of 1,651 cardiovascular deaths per year. Some areas, such as the South and the South-West, were more affected than others, such as the North-West and the North-East.

Using modeling analyzes to predict environmental and demographic changes, the researchers looked at the period 2036-2065 and estimated that each summer, approximately 71 to 80 days will be characterized by a temperature of 90 degrees or higher. Based on these changes, they predicted that the annual number of heat-related cardiovascular deaths would increase 2.6 times for the general population, from 1,651 to 4,320. This estimate is based on the assumption that emissions greenhouse gases, which capture heat from the sun, are kept to a minimum. If emissions increase significantly, the number of deaths could more than triple, to 5,491.

For older adults and black adults, the projections were more pronounced. Among people aged 65 and over, the number of deaths could almost triple, from 1,340 to 3,842 if greenhouse gas emissions remain stable – or to 4,894 otherwise. Among black adults, deaths could more than triple, from 325 to 1,512 or 2,063.

When comparing current and future populations, researchers considered several factors, including age, underlying health conditions and where the person lived.

Most people adapt to extreme heat because the body finds ways to cool itself, such as by sweating. However, people with underlying health conditions, including diabetes and heart disease, may have different reactions and face increased risks of heart attack, cardiac arrhythmia or stroke.

“The number of heat-related cardiovascular events affects a small proportion of adults, but this research shows how important it is for those with underlying risks to take additional steps to avoid extreme temperatures,” said Lawrence J. Fine, MD, senior advisor. in the Clinical Applications and Prevention Branch, in the Division of Cardiovascular Sciences of the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH.

The authors described cooling approaches used by some cities: planting trees to create shade, adding cooling centers equipped with air conditioning, and using heat-reflecting materials to pave streets or paint roofs. However, more research is needed to understand how these approaches may impact population health.

“In addition to reflecting on the impact of extreme temperatures in the United States, this type of modeling forecast also foreshadows the impact that extreme heat could have around the world, particularly in regions with warmer climates and which are disproportionately affected by health disparities,” said Flora N. Katz, Ph.D., director of the Division of International Training and Research at the NIH Fogarty International Center.

The research was partially supported by NHLBI grant K23 HL153772.

To learn more about the NIH Climate Change and Health Initiative, visit https://www.nih.gov/climateandhealth.

About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research into heart, lung and blood diseases and sleep disorders that advances scientific knowledge, improves public health and saves lives. For more information, visit https://www.nhlbi.nih.gov/.

About the National Institutes of Health (NIH):The NIH, the nation’s medical research agency, consists of 27 institutes and centers and is part of the U.S. Department of Health and Human Services. The NIH is the primary federal agency that conducts and supports basic, clinical, and translational medical research, and studies the causes, treatments, and cures for common and rare diseases. For more information about the NIH and its programs, visit www.nih.gov.

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Study

Khatana SE, Eberly LA, Nathan AS, et al. Projected change in the burden of excess cardiovascular deaths associated with extreme heat by mid-century (2036-2065) in the contiguous United States. Traffic. 2023; doi: 10.1161/CIRCULATIONAHA.123.066017.

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