March 26, 2026Circulation
Nonoptimal Temperature and Cardiovascular Health: A Scientific Statement From the American Heart Association
Why the study?
With rising global temperatures and increasing extreme temperature events, synthesizing current knowledge on the cardiovascular impacts of nonoptimal temperature, inequalities, and actionable strategies is urgently needed.
Key Points
- The statement aims to synthesize the relationship between nonoptimal temperature and cardiovascular health, highlighting urgent risks and inequalities.
- Literature synthesis on temperature impacts on cardiovascular health
- Evaluation of biological mechanisms mediating risks
- Identification of contextual factors affecting cardiovascular outcomes
- Short-term exposure to extreme temperatures increases risk of cardiac events such as myocardial infarction and stroke.
- Contextual factors like socioeconomic status and geographic location exacerbate cardiovascular risks.
- Health systems face challenges from nonoptimal temperatures, increasing emergency care demand and operational disruptions.
PICO
P
Population
Cardiovascular disease
I
Intervention / Comparator
Nonoptimal temperature exposure (heat and cold)
This AHA scientific statement highlights the increasing cardiovascular risks associated with nonoptimal temperatures and climate change, calling for coordinated action in research, clinical practice, and policy.
Limitations
- Need for improved exposure assessment
- Need for better understanding and measurement of the impact of long-term exposures
- Need to understand interactions with medications and coexposures
- Need for identification of risk modifiers
Discussion
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
PRPedro Rafael Vieira De Oliveira SalernoResident physician, Icahn School of Medicine at Mt. Sinai
“This is the first time we have actual numbers for most of the United States, and we found the burden of excess deaths associated with cold is quite substantial.”
SASadeer Al-KindiCardiologist, UH Harrington Heart & Vascular Institute
“Our study provides the first comprehensive assessment of the global temperature-related CVD burden. The findings are alarming and underscore the significant impact of temperature on global public health. It is crucial that policymakers and public health officials take these findings into account when designing strategies to mitigate the impact of climate change on public health.”
Sanjay RajagopalanChief, Division of Cardiovascular Medicine, UH Harrington Heart & Vascular Institute“These study findings are particularly concerning for individuals living in low socioeconomic regions who are more vulnerable to the effects of non-optimal temperature on CVD. It is imperative that we take a multi-faceted approach to tackle the health impacts of climate change, including improving access to healthcare, increasing public awareness, and reducing greenhouse gas emissions.”
Implication
Clinicians should counsel vulnerable patients on avoiding temperature extremes; reinforces consensus on environmental CV triggers and extends to policy action on disparities.
Abstract
Ambient temperature is a key environmental driver of cardiovascular health. With rising global temperatures and increasing frequency, intensity, and duration of extreme temperature events, understanding the cardiovascular impacts of nonoptimal temperature is more urgent than ever. Short-term exposures to both heat and cold increase the risk of cardiovascular events, including myocardial infarction, stroke, heart failure decompensation, arrhythmias, and sudden cardiac death. Climate, built environment, socioeconomic variables, physiological vulnerability, and systemic inequities exacerbate these risks. There is also a growing appreciation of the importance of contextual factors such as geographic location, housing, occupation, and individual-level exposure. A range of biological mechanisms, including autonomic and neurohormonal activation, endothelial dysfunction, inflammation, hemoconcentration, and impaired thermoregulation, mediate temperature-related cardiovascular risk. Nonoptimal temperatures affect not only the incidence of cardiovascular disease but also health care access and delivery. They can increase demand for emergency care, disrupt operations, and pose challenges to the resilience and sustainability of health systems. Meanwhile, cardiovascular care contributes significantly to health care-related greenhouse gas emissions, highlighting a paradox in which efforts to protect cardiovascular health can indirectly contribute to climate-driven risks. This scientific statement synthesizes current knowledge of the relationship between nonoptimal temperature and cardiovascular health, highlights inequalities in exposure and outcomes, and identifies actionable strategies at the individual, community, health system, and public policy levels. Last, this scientific statement outlines significant research gaps and future priorities, including the need for improved exposure assessment, better understanding and measurement of the impact of long-term exposures, interactions with medications and coexposures, and identification of risk modifiers. Coordinated action is needed in research, clinical practice, and policy to mitigate the rising risks of nonoptimal temperatures on cardiovascular health in a changing climate.
Cite This Study
Hanneman et al. (2026) conducted a review in Cardiovascular disease. Nonoptimal temperature exposure (heat and cold) was evaluated. Short-term exposures to both heat and cold increase the risk of cardiovascular events, including myocardial infarction, stroke, heart failure decompensation, arrhythmias, and sudden cardiac death.