WEI Xing-fu, ZHENG Shan, WENG Jun, NIE Yong-hong, WANG Min-zhen, MI Xiu-ying, MENG Xiang-yan, LI Hai-yan, BAI Ya-na. Effects of temperature change on outpatient and emergency room visits for hypertension in Jinchang of Gansu Province: A time-series analysis[J]. Journal of Environmental and Occupational Medicine, 2019, 36(5): 452-458. DOI: 10.13213/j.cnki.jeom.2019.18759
Citation: WEI Xing-fu, ZHENG Shan, WENG Jun, NIE Yong-hong, WANG Min-zhen, MI Xiu-ying, MENG Xiang-yan, LI Hai-yan, BAI Ya-na. Effects of temperature change on outpatient and emergency room visits for hypertension in Jinchang of Gansu Province: A time-series analysis[J]. Journal of Environmental and Occupational Medicine, 2019, 36(5): 452-458. DOI: 10.13213/j.cnki.jeom.2019.18759

Effects of temperature change on outpatient and emergency room visits for hypertension in Jinchang of Gansu Province: A time-series analysis

  • Background At present, hypertension is an important disease threatening residents' health in China, but its potential risk factors have not been fully identified.

    Objective The study aims to evaluate the relationship between temperature changes and visits to outpatient and emergency room for hypertension, and explore the potential meteorological factors of outpatient and emergency room visits for hypertension.

    Methods Daily counts of outpatient and emergency room visits for hypertension (ICD-10:I10-I15) from three general hospitals, meteorological parameters (including daily average temperature, relative humidity, air pressure, and wind speed), and air pollution data (PM10, NO2, SO2) in Jinchang of Gansu Province were collected from January 1, 2012 to December 31, 2015. A generalized additive model with quasi-Poisson regression was employed to establish the exposure-response relationship between 24-hour and 48-hour temperature changes and outpatient and emergency room visits for hypertension after controlling long-term trend, day-of-the-week effect, holiday effect, selected meteorological factors, and selected air pollutants. Based on the model, the effects of temperature change were estimated and exposure-response curves were fitted. Stratification analyses were conducted by gender and age.

    Results During the study period, a total of 61 438 diagnosed hypertensive patients were included in the study. At the same time, the mean values of 24-hour negative temperature change, 24-hour positive temperature change, 48-hour negative temperature change, and 48-hour positive temperature change in Jinchang were (-2.18±1.91)℃, (1.80±1.26)℃, (-2.98±2.56)℃, and (2.66±1.98)℃, respectively. The results of generalized additive model showed a U-shaped relationship between the 24-hour and 48-hour temperature changes and outpatient and emergency room visits for hypertension. Both 24-hour and 48-hour temperature changes had significant lag effects on outpatient and emergency room visits for hypertension, and the largest excess risks were -1.25% (95%CI:-1.93%——0.57%) for 24-hour negative temperature change at lag 1 day, 2.77% (95%CI:1.86%-3.69%) for 24-hour positive temperature change at lag 5 day, -0.67% (95%CI:-1.14%——0.21%) for 48-hour negative temperature change at lag 3 day, and 1.53% (95%CI:0.94%-2.13%) for 48-hour positive temperature change at lag 1 day. The effects of 24-hour and 48-hour positive temperature changes on outpatient and emergency room visits were larger than the effects of negative temperature changes. The stratification analysis results showed that the effects of temperature changes in females and those aged 65-74 years were larger than the effects in males and those of other age groups.

    Conclusion There is a U-shaped exposure-response curve between 24-hour and 48-hour temperature changes and visits to outpatient and emergency room for hypertension, and both positive and negative temperature changes have significant impacts on outpatient and emergency room visits due to hypertension. The effects of positive temperature change are larger than the effects of negative temperature change. Females and the elderly are more sensitive to temperature change than other groups.

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