Identifying patients' cardiovascular vulnerability against atmospheric parameters and air pollution

Abstract

Abstract Background Atmospheric parameters are direct environmental factors on the human body. There is a growing concern that atmospheric parameters might have a potential cardiovascular (CV) effect and increase morbidity and mortality. The health effects of climate change and air pollution are already major public health issues. In the future, the growing concern about unfavorable atmospheric situations and air pollution can further increase this problem. Despite the importance of different atmospheric parameters’ CV risks, there are few studies about identifying vulnerable populations against atmospheric parameters and air pollution. Purpose We aimed to explore vulnerable populations against atmospheric parameters. Methods The study comprised 7230 hospitalized patients with acute CV diseases (ACVDs). Demographic and individual CV risk factor data were collected for each patient. We examined the relationship between demographic characteristics (age, sex) and CV risk factors (hypertension, hyperlipidemia, diabetes, previous CV diseases) and meteorological and air pollution parameters on a day-to-day basis in a 5-year time period (2017-2021) using a General Additive Model with cubic splines of covariates, regularized by a ridge penalty, and employing generalized cross-validation. Results Patients with diabetes were detected as the most vulnerable group against atmospheric parameters. The interaction between temperature change (5°C≤) and elevated ozone concentration (90 µg/m³≤) showed a positive association with daily diabetic patients’ hospitalization counts (p<0.001). The relative strength of the association with demographic characteristics was the largest between daily temperature variation (5°C≤) and patients with age 55 or more (p=0.002). The effect of temperature change (5°C≤) and elevated ozone concentration (90 µg/m³≤) was positively associated with the daily hospitalization counts of male patients (p<0.001). Conclusions In our study, we can identify vulnerable subpopulations that have increased CV risk during specific atmospheric conditions. The importance of our findings is growing in the context that extreme atmospheric conditions and air pollution are likely to become more common in the future. In conclusion, a better understanding of vulnerability could help establish new CV prevention strategies.