Heat-related first cardiovascular event incidence in the city of Madrid (Spain): Vulnerability assessment by demographic, socioeconomic, and health indicators.

Salvador, Coral; Gullón, Pedro; Franco, Manuel; Vicedo-Cabrera, Ana M (2023). Heat-related first cardiovascular event incidence in the city of Madrid (Spain): Vulnerability assessment by demographic, socioeconomic, and health indicators. Environmental research, 226, p. 115698. Elsevier 10.1016/j.envres.2023.115698

[img]
Preview
Text
1-s2.0-S0013935123004905-main.pdf - Accepted Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (1MB) | Preview
[img] Text
Salvador_EnvironRes_2023.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (2MB)

While climate change and population ageing are expected to increase the exposure and vulnerability to extreme heat events, there is emerging evidence suggesting that social inequalities would additionally magnify the projected health impacts. However, limited evidence exists on how social determinants modify heat-related cardiovascular morbidity. This study aims to explore the association between heat and the incidence of first acute cardiovascular event (CVE) in adults in Madrid between 2015 and 2018, and to assess how social context and other individual characteristics modify the estimated association. We performed a case-crossover study using the individual information collected from electronic medical records of 6514 adults aged 40-75 living in Madrid city that suffered a first CVE during summer (June-September) between 2015 and 2018. We applied conditional logistic regression with a distributed lag non-linear model to analyse the heat-CVE association. Estimates were expressed as Odds Ratio (OR) for extreme heat (at 97.5th percentile of daily maximum temperature distribution), compared to the minimum risk temperature. We performed stratified analyses by specific diagnosis, sex, age (40-64, 65-75), country of origin, area-level deprivation, and presence of comorbidities. Overall, the risk of suffering CVE increased by 15.3% (OR: 1.153 [95%CI 1.010-1.317]) during extreme heat. Males were particularly more affected (1.248, [1.059-1.471]), vs 1.039 [0.810-1.331] in females), and non-Spanish population (1.869 [1.28-2.728]), vs 1.084 [0.940-1.250] in Spanish). Similar estimates were found by age groups. We observed a dose-response pattern across deprivation levels, with larger risks in populations with higher deprivation (1.228 [1.031-1.462]) and almost null association in the lowest deprivation group (1.062 [0.836-1.349]). No clear patterns of larger vulnerability were found by presence of comorbidity. We found that heat unequally increased the risk of suffering CVE in adults in Madrid, affecting mainly males and deprived populations. Local measures should pay special attention to vulnerable populations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
10 Strategic Research Centers > Oeschger Centre for Climate Change Research (OCCR)

UniBE Contributor:

Salvador Gimeno, Coral, Vicedo Cabrera, Ana Maria

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0013-9351

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

20 Mar 2023 11:56

Last Modified:

18 Mar 2024 00:25

Publisher DOI:

10.1016/j.envres.2023.115698

PubMed ID:

36931379

Uncontrolled Keywords:

Cardiovascular events Case-crossover Gender assessment Neighbourhood deprivation Social inequalities Urban heat

BORIS DOI:

10.48350/180309

URI:

https://boris.unibe.ch/id/eprint/180309

Actions (login required)

Edit item Edit item
Provide Feedback