Relationship between Temperature and Ischemic Heart Disease in Bogota 2009 - 2014

摘要

Temperature changes has been associated with a variety of cardiovascular, respiratory and neurological effects. Evidence that accounts for health effects of temperature in tropical countries as Colombia is scarce. Temperature in Bogota has risen from 1 to 2℃ since 1997 and the adverse health effects of such changes are uncertain. In this ecological time series analysis study, we explored the temporal patterns of emergency room daily admissions of ischemic heart diseases (IHD) in relation to temperature, relative humidity, ground level ozone and particulate matter (PM10 and PM2.5) from 2009 to 2014 in Bogota. Statistical analysis included Spearman rank correlation, Poisson regression models and distributed lag non-linear models (DNLM). Admissions for angina pectoris increased by 4.1% for each 1℃ rise in maximum temperature; admissions for myocardial infarction dropped by 15.7% as average temperature increased in 1℃ and decreased by 2.5% for each unit increase in relative humidity. Regarding DNLM models, the relationship between IHD and temperature was stronger and evident at lower (8 and 11℃) and higher temperatures (>19℃); the effects were mostly immediate, particularly with minimum temperature, but there were some delayed effects with maximum temperature which reached a peak in lags 2 and 3 when was adjusted by PM10 and PM2.5. A significant association was also found between the number of events and a wide thermal variation (>12℃) on the same day. This study is the first approach on the patterns of IHD morbidity because of temperature changes in Bogota, a high-altitude low-latitude city. These findings suggest a non-linear exposure response curve between temperature and IHD. Higher temperatures were associated with angina while lower one were to myocardial infarction. Thermal amplitude and effect modification by PM10 and RH were also factors that triggered the number of daily admissions of IHD. Further studies should assess those findings at individual level.