![]() A study was conducted in Italy in which cold-spell episodes (happened in February 2012) were defined as days when mean temperatures were below the 10th percentile of February's normal distribution for greater than 3 days. Cold spells were associated with positive mean excess CVD mortality in all age groups (25–59, 60–69, 70–79, and 80+ yr) in both men and women ( 44). ![]() The association between cardiovascular mortality and winter cold spells was evaluated in the population of the Czech Republic over a 21-year period from 1986 to 2006. In the Czech Republic, a study was conducted in which cold spells were defined as periods of days during which air temperature does not exceed −3.5☌. Various definitions of cold spell have appeared in the literature as a descriptor of extreme cold events ( 44, 61, 92). In this review, the recent evidence on the impact of temperature change on cardiovascular diseases (CVDs) and the relevant mechanisms were summarized. Undeniably, these endeavor is vital for planning before the occurrence of extreme heat or cold event to effectively reduce the mortality/morbidity induced by the climate variation. ![]() Recently, special attention has been drawn by the temperature effects on cardiovascular response. The mortality or morbidity induced by the extreme climates is not necessarily caused directly by hypothermia or hyperthermia, but by other indirect causes such as respiratory diseases and cardiovascular disorders that are triggered when human body attempts to adapt to the excessive environment ( 44). Furthermore, global average surface temperature has risen at an average rate of 0.15☏ per decade since 1901 in response to the increased concentrations of heat-trapping greenhouse gases in the Earth's atmosphere, with the United States having warmed faster than the global rate ( 79b). In view of the global climate change, there has been a violent change in the frequency, intensity, and duration of extreme climate events such as heat waves and cold spells. Studies on the underlying mechanism by which temperature challenge induces pathophysiological response and CVD await profound and lasting investigation. Future research should focus on multidisciplinary adaptation strategies that incorporate epidemiology, climatology, indoor/building environments, energy usage, labor legislative perfection, and human thermal comfort models. Temperature-induced damage is thought to be related to enhanced sympathetic reactivity followed by activation of the sympathetic nervous system, renin-angiotensin system, as well as dehydration and a systemic inflammatory response. Vulnerability to temperature-related mortality was associated with some characteristics of the populations, including sex, age, location, socioeconomic condition, and comorbidities such as cardiac diseases, kidney diseases, diabetes, and hypertension. Cause-specific study of CVD morbidity/mortality indicated that the sensitivity to temperature was disease-specific, with different patterns for acute and chronic ischemic heart disease. Although the relative risk of morbidity/mortality associated with extreme temperature varied greatly across different studies, both cold and hot temperatures were associated with a positive mean excess of cardiovascular deaths or hospital admissions. With a rapidly growing amount of literature on this issue, we aim to review the recent publications regarding the impact of cold and heat on human populations with regard to cardiovascular disease (CVD) mortality/morbidity while also examining lag effects, vulnerable subgroups, and relevant mechanisms. It has been shown that ambient temperature challenges have a direct and highly varied impact on cardiovascular health. A growing number of extreme climate events are occurring in the setting of ongoing climate change, with an increase in both the intensity and frequency. ![]()
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