Abstract Introduction Climate change has driven temperature rise and extreme weather events, yet temperate climates remain understudied. Recently, unprecedented heatwaves (HW) have emerged alongside existing coldwaves (CW) in this region. Aim To evaluate the impact of extreme HW and CW on cardiovascular disease (CVD) hospital admissions and premature mortality. Methods We analyzed 8 million residents in Eastern Poland (2011–20). Individual exposure was linked to residential location for personalized exposome estimates. The primary endpoint was Major Adverse CV and Cerebrovascular Events (MACCE), comprised of CVD mortality, STEMI and ischemic stroke (IS). Secondary endpoints included total mortality and hospitalizations due to NSTEMI, STEMI, IS, hemorrhagic stroke (HS), atrial fibrillation (AF), and kidney disease. Extreme weather events were indexed using the Excess Heat and Cold Factor, defined at the local administrative unit (LAU-2) level (N=655), based on temperature deviations beyond the 95th percentile of a 30-day moving average. The analysis employed negative binomial regression with random effects. The final model adjusted for air pollution exposure, weather conditions (as natural spline function), day of the week, public holidays, and long-term trend indicators. The results are presented as increases in the risk of admission (IR %). Results We recorded a total of 2, 056, 743 cases. The median (Me) age ranged from 67 years (y. ) (59–77) for STEMI to 82 y. (72–88) for CVD mortality. The proportion of males was highest in the NSTEMI group (60%) and lowest among CVD deaths (46. 2%). For MACCE (N=573, 538), Me age was 78 y. (68–86), 48. 5% male. Over time, the average temperature increased, accompanied by more HW and fewer CW (see FIG1A). Both HW and CW were associated with a higher risk of MACCE (IRHW=2. 7% / IRCW=4. 3%), total mortality (IRHW=7% / IRCW=2. 6%), and CVD (IRHW=6. 7% / IRCW=5. 5%). Age-based differences were observed across all outcomes, with a more pronounced effect in individuals younger than 65 y. (P0. 001). No significant differences were found based on sex, residence, or socioeconomic status. Exposure to air pollution further amplified the effects of extreme temperatures, with PM2. 5 and NO2 exacerbating the impact of CW and O3 intensifying the effects of HW. HW were linked to a decrease in hospital admissions for STEMI and NSTEMI (IRHW=-9. 1%, IRHW=-8. 1%). Extreme temperatures influenced the incidence of HS (IRHW=-7. 9%, IRCW=11%), while no association was found for IS. Detailed results see FIG1B. Conlusions: Extreme temperatures increased the risk of MACCE, particularly in individuals under 65 years. Air pollution exposure further amplified these effects. Reduced hospital admissions for myocardial infarctions, with no impact on IS, suggest a rise in pre-hospital mortality. These findings highlight the need for targeted public health measures to mitigate climate-related CVD risks.
Kuzma et al. (Sat,) studied this question.