Projecting heat-related cardiovascular mortality burden attributable to human-induced climate change in China

Qiongyu Zhu; Maigeng Zhou; Mohammad Javad Zare Sakhvidi; Siru Yang; Sujuan Chen; Puyu Feng; Zhaoyue Chen; Zhiwei Xu; Qiyong Liu; Jun Yang

doi:10.1016/j.ebiom.2024.105119

Projecting heat-related cardiovascular mortality burden attributable to human-induced climate change in China

EBioMedicine. 2024 Apr 16:103:105119. doi: 10.1016/j.ebiom.2024.105119. Online ahead of print.

Authors

Qiongyu Zhu¹, Maigeng Zhou², Mohammad Javad Zare Sakhvidi³, Siru Yang⁴, Sujuan Chen⁴, Puyu Feng⁵, Zhaoyue Chen⁶, Zhiwei Xu⁷, Qiyong Liu⁸, Jun Yang⁹

Affiliations

¹ The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China.
² National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China.
³ Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁴ School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China.
⁵ College of Land Science and Technology, China Agricultural University, Beijing, 100193, China.
⁶ ISGLOBAL, Barcelona, Spain.
⁷ School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
⁸ National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: liuqiyong@icdc.cn.
⁹ The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China. Electronic address: yangjun_eci@jnu.edu.cn.

Abstract

Background: Cardiovascular disease (CVD) has been found to be particularly vulnerable to climate change and temperature variability. This study aimed to assess the extent to which human-induced climate change contributes to future heat-related CVD burdens.

Methods: Daily data on CVD mortality and temperature were collected in 161 Chinese communities from 2007 to 2013. The association between heat and CVD mortality was established using a two-stage time-series design. Under the natural forcing, human-induced, and combined scenarios, we then separately projected excess cause-/age-/region-/education-specific mortality from future high temperature in 2010-2100, assuming no adaptation and population changes.

Findings: Under shared socioeconomic pathway with natural forcing scenario (SSP2-4.5-nat), heat-related attributable fraction of CVD deaths decreased slightly from 3.3% [95% empirical confidence interval (eCI): 0.3, 5.8] in the 2010s to 2.8% (95% eCI: 0.1, 5.2) in the 2090s, with relative change of -0.4% (95% eCI: -0.8, 0.0). However, for combined natural and human-induced forcings, this estimate would surge to 8.9% (95% eCI: 1.5, 15.7), 14.4% (95% eCI: 1.5, 25.3), 21.3% (95% eCI: -0.6, 39.4), and 28.7% (95% eCI: -3.3, 48.0) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. When excluding the natural forcing, the number of human-induced heat-related CVD deaths would increase from approximately eight thousand (accounting for 31% of total heat-related CVD deaths) in the 2010s to 33,052 (68%), 63,283 (80%), 101,091 (87%), and 141,948 (90%) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. Individuals with stroke, females, the elderly, people living in rural areas, and those with lower education level would exhibit heightened susceptibility to future high temperature. In addition, Southern and Eastern regions of China were expected to experience a faster increase in heat-related attributable fraction of CVD deaths.

Interpretation: Human activities would significantly amplify the future burden of heat-related CVD. Our study findings suggested that active adaptation and mitigation measures towards future warming could yield substantial health benefits for the patients with CVD.

Funding: National Natural Science Foundation of China.

Keywords: Cardiovascular mortality; Health benefit; Heat; Human-induced climate change.