Vulnerability to the Cardiovascular Effects of Ambient Heat in Six U.S. Cities: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)

Details

• Alternative Title:
  Epidemiology
• Personal Author:
  Gronlund, Carina J. ; Sheppard, Lianne ; Adar, Sara D. ; O’Neill, Marie S. ; Auchincloss, Amy ; Madrigano, Jaime ; Kaufman, Joel ; Diez Roux, Ana V.
• Description:
  Background:
  
  With climate change, temperatures are increasing. Heat-associated health events disproportionately affect certain subpopulations. However, prior research has often lacked information on individual-level health and air conditioning and neighborhood stressors/protections.
  
  Objectives:
  
  To assess whether 1) heat (2-day mean temperature above local 75th percentiles) is associated with increased heart rate and decreased blood pressure, controlling for age, time, season, daily ozone, and daily particulate matter (PM2.5), and 2) associations differ by anti-hypertensive-medication use, renal function, fasting glucose, emotional support, air conditioning ownership and use, normalized difference vegetation index, neighborhood safety, and residence-specific oxides of nitrogen and PM2.5.
  
  Methods:
  
  Health and behavioral characteristics were obtained repeatedly on participants of the Multi-Ethnic Study of Atherosclerosis in six U.S. sites (2000–2010). These were linked with airport temperature, air quality, and satellite- and survey-derived neighborhood characteristics. We used a fixed-effects design, regressing health outcomes on linear temperature splines with knots at the 75th percentiles, interaction terms for each characteristic, and adjustment for month-of-year, age, PM2.5, and ozone.
  
  Results:
  
  Overall, heat was not associated with heart rate. However, for a 2 degree-Celsius increase in heat, systolic blood pressure (SBP) decreased by 1.1 mmHg (95% CI: −1.6, −0.6) and diastolic by 0.3 mmHg (95% CI: −0.6, −0.1). Among non-users of anti-hypertensive medications, heat-associated decreases in SBP were 2.1 mmHg greater among individuals with central air conditioning vs. without. Confidence intervals around the remaining modifiers were wide after multiple-comparisons corrections or sensitivity analyses.
  
  Conclusions:
  
  Outdoor heat is associated with decreasing blood pressure, and cardiovascular vulnerability may vary primarily by ownership of central air conditioning.
  
  
• Keywords:
  Aged Aged, 80 And Over Air Conditioning Atherosclerosis Baltimore Blood Pressure Chicago Cities Ethnicity Female Heart Rate Hot Temperature Humans Los Angeles Male Middle Aged New York City Risk Factors Temperature United States Vulnerability

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• Source:
  Epidemiology. 29(6):756-764
• Pubmed ID:
  30113342
• Pubmed Central ID:
  PMC6233295
• Document Type:
  Journal Article
• Funding:
  UL1 TR000433/TR/NCATS NIH HHSUnited States/ ; T42 OH008455/OH/NIOSH CDC HHSUnited States/ ; N01HC95160/HL/NHLBI NIH HHSUnited States/ ; N01HC95163/HL/NHLBI NIH HHSUnited States/ ; UL1 TR001079/TR/NCATS NIH HHSUnited States/ ; N01HC95169/HL/NHLBI NIH HHSUnited States/ ; N01HC95164/HL/NHLBI NIH HHSUnited States/ ; N01HC95162/HL/NHLBI NIH HHSUnited States/ ; N01HC95165/HL/NHLBI NIH HHSUnited States/ ; N01HC95159/HL/NHLBI NIH HHSUnited States/ ; P30 ES017885/ES/NIEHS NIH HHSUnited States/ ; HHSN268201500003I/HL/NHLBI NIH HHSUnited States/ ; N01HC95167/HL/NHLBI NIH HHSUnited States/ ; UL1 TR002240/TR/NCATS NIH HHSUnited States/ ; UL1 TR000040/TR/NCATS NIH HHSUnited States/ ; N01HC95166/HL/NHLBI NIH HHSUnited States/ ; T42 OH008433/OH/NIOSH CDC HHSUnited States/ ; HHSN268201500003C/HL/NHLBI NIH HHSUnited States/ ; K99 ES026198/ES/NIEHS NIH HHSUnited States/ ; N01HC95168/HL/NHLBI NIH HHSUnited States/ ; R00 ES026198/ES/NIEHS NIH HHSUnited States/ ; N01HC95161/HL/NHLBI NIH HHSUnited States/ ; UL1 TR001420/TR/NCATS NIH HHSUnited States/
• Volume:
  29
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:64f5726fa43754dfe0ba9be18626579e0c8fa642d11f4147d603fc7601cb04bb
• Download URL:
  https://stacks.cdc.gov/view/cdc/60611/cdc_60611_DS1.pdf
• File Type:
  [PDF - 440.58 KB ]