Heatwave warnings mitigate long-term cardiovascular diseases risk from heat-related illness: a real-world prospective cohort study

作者：Qi Huang, Limei Ke, Linfeng Liu, Yuyang Liu, Yanjun Li, Guoqing Feng, Bo Yin, Wenxin Xiang, Jiarun Li, Keyi Lyu, Miao Wang, Qiannan Tian, Liqun Wu, Xiaofeng He, Wannian Liang, Huatang Zeng, Jiming Zhu, Kuiying Gu, Qian Di · 发表于：The Lancet Regional Health - Western Pacific · 年份：2025 · DOI：10.1016/j.lanwpc.2025.101468 · 被引用次数：9 · 研究领域：Climate Change and Health Impacts、Thermoregulation and physiological responses、Circadian rhythm and melatonin

Background: Global warming is intensifying, exacerbating associated health issues. Heat-related illness, a critical risk during heatwaves, significantly impacts public health, yet its long-term health effects remain poorly understood. We established a cohort to investigate these health impact and explore the mitigative role of heatwave warnings. Methods: Our cohort study enrolled 9,658,745 participants free of cardiovascular disease (CVD) at baseline from 1332 hospitals and 922 primary care centres in Shenzhen, China. The cohort was observed and followed up from January 1, 2017, to July 31, 2023. We utilized Cox proportional hazards model to analyse CVD incidence among participants who had heat-related illness versus those who did not, and further assessed causal relationship using instrumental variable approach. We employed stratified logistic regression to explore the protective effects of heatwave warning policies. Findings: Among 9,658,745 participants followed up to 6 years, 238,278 (2.47%) developed CVD. People who developed CVD were generally older, male, with a higher degree of education, and with more hospital admissions before baseline. Heat-related illness was associated with CVD, with a hazard ratio of CVD 2.526 (95% CI = 2.301-2.773) among patients with heat-related illness compared with those without heat-related illness, and instrumental variable approach analysis suggested causation. Issuing heatwave warnings reduced hospital admissions for heat-related illnes...