Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2005 Jul;59(7):551–557. doi: 10.1136/jech.2004.028514

Cold periods and coronary events: an analysis of populations worldwide

A Barnett 1, A Dobson 1, P McElduff 1, V Salomaa 1, K Kuulasmaa 1, S Sans 1, t for 1
PMCID: PMC1757082  PMID: 15965137

Abstract

Study objective: To investigate the association between cold periods and coronary events, and the extent to which climate, sex, age, and previous cardiac history increase risk during cold weather.

Design: A hierarchical analyses of populations from the World Health Organisation's MONICA project.

Setting: Twenty four populations from the WHO's MONICA project, a 21 country register made between 1980 and 1995.

Patients: People aged 35–64 years who had a coronary event.

Main results: Daily rates of coronary events were correlated with the average temperature over the current and previous three days. In cold periods, coronary event rates increased more in populations living in warm climates than in populations living in cold climates, where the increases were slight. The increase was greater in women than in men, especially in warm climates. On average, the odds for women having an event in the cold periods were 1.07 higher than the odds for men (95% posterior interval: 1.03 to 1.11). The effects of cold periods were similar in those with and without a history of a previous myocardial infarction.

Conclusions: Rates of coronary events increased during comparatively cold periods, especially in warm climates. The smaller increases in colder climates suggest that some events in warmer climates are preventable. It is suggested that people living in warm climates, particularly women, should keep warm on cold days.

Full Text

The Full Text of this article is available as a PDF (126.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson T. W., Le Riche W. H. Cold weather and myocardial infarction. Lancet. 1970 Feb 7;1(7641):291–296. doi: 10.1016/s0140-6736(70)90651-3. [DOI] [PubMed] [Google Scholar]
  2. Ballester F., Corella D., Pérez-Hoyos S., Sáez M., Hervás A. Mortality as a function of temperature. A study in Valencia, Spain, 1991-1993. Int J Epidemiol. 1997 Jun;26(3):551–561. doi: 10.1093/ije/26.3.551. [DOI] [PubMed] [Google Scholar]
  3. Barnett Adrian G., Dobson Annette J., WHO MONICA Project Is the increase in coronary events on Mondays an artifact? Epidemiology. 2004 Sep;15(5):583–588. doi: 10.1097/01.ede.0000129521.22687.c0. [DOI] [PubMed] [Google Scholar]
  4. Braga A. L., Zanobetti A., Schwartz J. The time course of weather-related deaths. Epidemiology. 2001 Nov;12(6):662–667. doi: 10.1097/00001648-200111000-00014. [DOI] [PubMed] [Google Scholar]
  5. Braga Alfésio L. F., Zanobetti Antonella, Schwartz Joel. The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. Environ Health Perspect. 2002 Sep;110(9):859–863. doi: 10.1289/ehp.02110859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. De Lorenzo F., Sharma V., Scully M., Kakkar V. V. Cold adaptation and the seasonal distribution of acute myocardial infarction. QJM. 1999 Dec;92(12):747–751. doi: 10.1093/qjmed/92.12.747. [DOI] [PubMed] [Google Scholar]
  7. Donaldson G. C., Ermakov S. P., Komarov Y. M., McDonald C. P., Keatinge W. R. Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study. BMJ. 1998 Oct 10;317(7164):978–982. doi: 10.1136/bmj.317.7164.978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Donaldson G. C., Keatinge W. R. Early increases in ischaemic heart disease mortality dissociated from and later changes associated with respiratory mortality after cold weather in south east England. J Epidemiol Community Health. 1997 Dec;51(6):643–648. doi: 10.1136/jech.51.6.643. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Donaldson G. C., Robinson D., Allaway S. L. An analysis of arterial disease mortality and BUPA health screening data in men, in relation to outdoor temperature. Clin Sci (Lond) 1997 Mar;92(3):261–268. doi: 10.1042/cs0920261. [DOI] [PubMed] [Google Scholar]
  10. Hajat S., Kovats R. S., Atkinson R. W., Haines A. Impact of hot temperatures on death in London: a time series approach. J Epidemiol Community Health. 2002 May;56(5):367–372. doi: 10.1136/jech.56.5.367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Huynen M. M., Martens P., Schram D., Weijenberg M. P., Kunst A. E. The impact of heat waves and cold spells on mortality rates in the Dutch population. Environ Health Perspect. 2001 May;109(5):463–470. doi: 10.1289/ehp.01109463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Keatinge William R. Death in heat waves. BMJ. 2003 Sep 6;327(7414):512–513. doi: 10.1136/bmj.327.7414.512. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kloner R. A., Poole W. K., Perritt R. L. When throughout the year is coronary death most likely to occur? A 12-year population-based analysis of more than 220 000 cases. Circulation. 1999 Oct 12;100(15):1630–1634. doi: 10.1161/01.cir.100.15.1630. [DOI] [PubMed] [Google Scholar]
  14. Kunst A. E., Groenhof F., Mackenbach J. P. The association between two windchill indices and daily mortality variation in The Netherlands. Am J Public Health. 1994 Nov;84(11):1738–1742. doi: 10.2105/ajph.84.11.1738. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Kunst A. E., Looman C. W., Mackenbach J. P. Outdoor air temperature and mortality in The Netherlands: a time-series analysis. Am J Epidemiol. 1993 Feb 1;137(3):331–341. doi: 10.1093/oxfordjournals.aje.a116680. [DOI] [PubMed] [Google Scholar]
  16. Lawlor D. A., Maxwell R., Wheeler B. W. Rurality, deprivation, and excess winter mortality: an ecological study. J Epidemiol Community Health. 2002 May;56(5):373–374. doi: 10.1136/jech.56.5.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lawlor D. A. The health consequences of fuel poverty: what should the role of primary care be? Br J Gen Pract. 2001 Jun;51(467):435–436. [PMC free article] [PubMed] [Google Scholar]
  18. Marchand I., Johnson D., Montgomery D., Brisson G. R., Perrault H. Gender differences in temperature and vascular characteristics during exercise recovery. Can J Appl Physiol. 2001 Oct;26(5):425–441. doi: 10.1139/h01-026. [DOI] [PubMed] [Google Scholar]
  19. Mercer James B. Cold--an underrated risk factor for health. Environ Res. 2003 May;92(1):8–13. doi: 10.1016/s0013-9351(02)00009-9. [DOI] [PubMed] [Google Scholar]
  20. Näyhä Simo. Cold and the risk of cardiovascular diseases. A review. Int J Circumpolar Health. 2002 Nov;61(4):373–380. doi: 10.3402/ijch.v61i4.17495. [DOI] [PubMed] [Google Scholar]
  21. Ockene Ira S., Chiriboga David E., Stanek Edward J., 3rd, Harmatz Morton G., Nicolosi Robert, Saperia Gordon, Well Arnold D., Freedson Patty, Merriam Philip A., Reed George. Seasonal variation in serum cholesterol levels: treatment implications and possible mechanisms. Arch Intern Med. 2004 Apr 26;164(8):863–870. doi: 10.1001/archinte.164.8.863. [DOI] [PubMed] [Google Scholar]
  22. Pell J. P., Sirel J., Marsden A. K., Cobbe S. M. Seasonal variations in out of hospital cardiopulmonary arrest. Heart. 1999 Dec;82(6):680–683. doi: 10.1136/hrt.82.6.680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Poloniecki J. D., Atkinson R. W., de Leon A. P., Anderson H. R. Daily time series for cardiovascular hospital admissions and previous day's air pollution in London, UK. Occup Environ Med. 1997 Aug;54(8):535–540. doi: 10.1136/oem.54.8.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rogot E., Padgett S. J. Associations of coronary and stroke mortality with temperature and snowfall in selected areas of the United States, 1962-1966. Am J Epidemiol. 1976 Jun;103(6):565–575. doi: 10.1093/oxfordjournals.aje.a112261. [DOI] [PubMed] [Google Scholar]
  25. Saez M., Sunyer J., Castellsagué J., Murillo C., Antó J. M. Relationship between weather temperature and mortality: a time series analysis approach in Barcelona. Int J Epidemiol. 1995 Jun;24(3):576–582. doi: 10.1093/ije/24.3.576. [DOI] [PubMed] [Google Scholar]
  26. Schwartz J. Air pollution and hospital admissions for cardiovascular disease in Tucson. Epidemiology. 1997 Jul;8(4):371–377. doi: 10.1097/00001648-199707000-00004. [DOI] [PubMed] [Google Scholar]
  27. Schwartz Joel, Samet Jonathan M., Patz Jonathan A. Hospital admissions for heart disease: the effects of temperature and humidity. Epidemiology. 2004 Nov;15(6):755–761. doi: 10.1097/01.ede.0000134875.15919.0f. [DOI] [PubMed] [Google Scholar]
  28. Tunstall-Pedoe H., Kuulasmaa K., Amouyel P., Arveiler D., Rajakangas A. M., Pajak A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation. 1994 Jul;90(1):583–612. doi: 10.1161/01.cir.90.1.583. [DOI] [PubMed] [Google Scholar]
  29. Wilkinson Paul, Pattenden Sam, Armstrong Ben, Fletcher Astrid, Kovats R. Sari, Mangtani Punam, McMichael Anthony J. Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ. 2004 Aug 17;329(7467):647–647. doi: 10.1136/bmj.38167.589907.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Woodhouse P. R., Khaw K. T., Plummer M., Foley A., Meade T. W. Seasonal variations of plasma fibrinogen and factor VII activity in the elderly: winter infections and death from cardiovascular disease. Lancet. 1994 Feb 19;343(8895):435–439. doi: 10.1016/s0140-6736(94)92689-1. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

[Web-only appendix]
jepicomh_59_7_551__index.html (1.1KB, html)
jepicomh_59_7_551__1.pdf (67.3KB, pdf)

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES