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Stroke risk associated with cold spells occurring during the warm season.
Environ. Int. 199, 9:109514 (2025)
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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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Cause-specific Mortality; Myocardial-infarction; Extreme Temperatures; Hospital Admissions; Air-temperature; Exposure; Thermoregulation; Augsburg; Increase
ISSN (print) / ISBN
0160-4120
e-ISSN
1873-6750
Journal
Environment International
Quellenangaben
Volume: 199,
Pages: 9,
Article Number: 109514
Publisher
Elsevier
Publishing Place
The Boulevard, Langford Lane, Kidlington, Oxford Ox5 1gb, England
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)
Institute of Environmental Medicine (IEM)
Institute of Environmental Medicine (IEM)
Grants
Alexander von Humboldt Foundation