Trends in temperature-related age-specific and sex-specific mortality from cardiovascular diseases in Spain: a national time-series analysis

Description

Between 1980 and 2016, more than 4.5 Million cardiovascular deaths were recorded. For warm temperatures, the increase in relative risk (RR) of death from cardiovascular diseases was higher for women than men and higher for older individuals (aged ≥90 years) than younger individuals (aged 60–74 years), whereas for cold temperatures, RRs were higher for men than women, with no clear pattern by age group.

The heat-attributable fraction of cardiovascular deaths was higher for women in all age groups, and the cold-attributable fraction was larger in men.

The heat-attributable fraction increased with age for both sexes, whereas the cold-attributable fraction increased with age for men and decreased for women. Overall minimum mortality temperature increased from 19.5°C between 1980 and 1994 to 20.2°C between 2002 and 2016, which is similar in magnitude to, and occurred in parallel with, the observed mean increase of 0.77°C that occurred in Spain between these two time periods.

In general, between 1980 and 2016, the risk and attributable fraction of cardiovascular deaths due to warm and cold temperatures decreased for men and women across all age groups. 

In Spain, the observed warming of the climate has occurred in parallel with substantial adaptation to both high and low temperatures. The reduction in the RR and the attributable fraction associated with heat would be compatible with an adaptive response specifically addressing the negative consequences of climate change. Nevertheless, the simultaneous reduction in the RR and attributable fraction of cold temperatures also highlights the importance of more general factors such as socioeconomic development, increased life expectancy and quality, and improved health-care services in the country.

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