The effect of apparent temperature on hospital admissions for cardiovascular diseases in rural areas of Pingliang, China
More details
Hide details
School of Economics and Management, Lanzhou University of Technology, Lanzhou 730050, China
School of Management, Lanzhou University, Lanzhou 730000, China
Corresponding author
Yiwen Tian   

School of Economics and Management, University of Technology, Lanzhou, China
Ann Agric Environ Med. 2022;29(2):281-286
Introduction and objective:
There is a well-reported association between temperature and the relative risk (RR) of cardiovascular disease (CVD) in urban areas in China. However, insufficient research has been performed in rural areas. The aim of the study was to analyze the association between apparent temperature (AT) and the RR of CVD hospital admissions in rural areas of Pingliang, northwest China.

Material and methods:
Daily data and weather conditions were collected in Pingliang from 2014–2015. The median value of AT was selected to estimate the RR of CVD, and the distributed lag nonlinear model (DLNM) used to examine the relationship between AT and the RR of CVD admissions for up to 21 days.

The results showed a nonlinear relationship between AT and the RR of CVD admissions. Regarding the heat effect, there was a protective effect. Meanwhile, the cold effect on the RR of CVD admissions appeared at day 0 and persisted until day 21, resulting in a cumulative RR of 2.304 (95%CI: 1.809–2.936) compared with the median value of AT, and the maximum RR appeared at about -5 °.The cumulative RR values of CVD on men and adults were more sensitive than those on women and elders in the cold effect.

AT is associated with the hospitalization of CVD patients. Both gender and age factors were associated with the increase in RR of CVD admissions. More preventive measures should be taken to avoid this adverse effect.

RR – relative risk; CVD – cardiovascular disease; AT – apparent temperature; DLNM – distributed lag nonlinear model; DTR – diurnal temperature range; NRCMS – New Rural Cooperative Medical Scheme; AIC – Akaike’s information criterion; CI – confidence Interval
The authors express their thanks to the National Natural Science Foundation of China [71861026], Gansu Natural Science Project ‘Knowledge-driven Meteorological Environment for Public Health Economic Loss Evaluation’ [20JR5RA474] and China Postdoctoral Science Foundation [2016M600827], who provided funds for the research.
Ponjoan A, Blanch J, Alves-Cabratosa L, et al. Extreme diurnal temperature range and cardiovascular emergency hospitalisations in a Mediterranean region. Occup Environ Med. 2021; 78(1): 62–68.
Wichmann J. Heat effects of ambient apparent temperature on all-cause mortality in Cape Town, Durban and Johannesburg, South Africa: 2006–2010. Sci Total Environ. 2017; 587: 266–272.
Luo Y, Zhang Y, Liu T, et al. Lagged effect of diurnal temperature range on mortality in a subtropical megacity of China. Plos One. 2013; 8(2): e55280.
Lim YH, Hong YC, Kim H. Effects of diurnal temperature range on cardiovascular and respiratory hospital admissions in Korea. Sci Total Environ. 2012; 417: 55–60.
Phosri A, Sihabut T, Jaikanlaya C. Short-term effects of diurnal temperature range on hospital admission in Bangkok, Thailand. Sci Total Environ. 2020; 717: 137202.
Zheng S, Zhu W, Wang M, et al. The effect of diurnal temperature range on blood pressure among 46,609 people in Northwestern China. Sci Total Environ. 2020; 730: 138987.
Zheng S, Wang M, Li B, et al. Gender, age and season as modifiers of the effects of diurnal temperature range on emergency room admissions for cause-specific cardiovascular disease among the elderly in Beijing. Int J Env Res Pub Health. 2016; 13(5): 447.
Davis R E, Markle E S, Windoloski S, et al. A comparison of the effect of weather and climate on emergency department visitation in Roanoke and Charlottesville, Virginia. Environ Res. 2020; 191: 110065.
Kim J, Shin J, Lim Y H, et al. Comprehensive approach to understand the association between diurnal temperature range and mortality in East Asia. Sci Total Environ. 2016; 539: 313–321.
Wang Z, Hu S. Interpretation of Report on Cardiovascular Health and Diseases in China 2020. Chin J Cardiovasc Med. 2021; 26(3): 209–218. doi:10.3969/j.issn.1007-5410.2021.03. 001.
Mohammad KN, Chan EYY, Wong MCS, et al. Ambient temperature, seasonal influenza and risk of cardiovascular disease in a subtropical area in Southern China. Environ Res. 2020; 186: 109546.
Lu P, Xia G, Zhao Q, et al. Temporal trends of the association between ambient temperature and hospitalisations for cardiovascular diseases in Queensland, Australia from 1995 to 2016: A time-stratified case-crossover study. Plos Med. 2020; 17(7): e1003176.
Cui L, Geng X, Ding T, et al. Impact of ambient temperature on hospital admissions for cardiovascular disease in Hefei City, China. Int J Biometeorol. 2019; 63(6): 723–734.
Kouis P, Kakkoura M, Ziogas K, et al. The effect of ambient air temperature on cardiovascular and respiratory mortality in Thessaloniki, Greece. Sci Total Environ. 2019; 647: 1351–1358.
Almeida S P, Casimiro E, Calheiros J. Effects of apparent temperature on daily mortality in Lisbon and Oporto, Portugal. Environ Health-Glob. 2010; 9(1): 1–7.
Yi W, Zhang X, Gao J, et al. Examining the association between apparent temperature and admissions for schizophrenia in Hefei, China, 2005–2014: a time-series analysis. Sci Total Environ. 2019; 672: 1–6.
Zhang Y, Fan X, Zhang X, et al. Moderately cold temperature associates with high cardiovascular disease mortality in China. Air Qual Atmos Hlth. 2019; 12, 1225–1235.
Shi Q, Wei X, Liu Y, et al. An effect of 24-hour temperature change on outpatient and emergency and inpatient visits for cardiovascular diseases in northwest China. Environ Sci Pollut R. 2021: 1–12.
Tian L, Qiu H, Sun S, et al. Emergency cardiovascular hospitalization risk attributable to cold temperatures in Hong Kong. Circ-Cardiovasc Qual. 2016; 9(2): 135–142.
Ding Z, Guo P, Xie F, et al. Impact of diurnal temperature range on mortality in a high plateau area in southwest China: a time series analysis. Sci Total Environ. 2015; 526: 358–365.
Dang B, Wang S, Shang K. Evaluation of Tourism Climate Comfort Level in Pingliang of Gansu Province. J Arid Meteorol. 2013; 31(4), 684–689. doi: 10.11755/j.issn.1006-7639 2013)-04-0684.
Dang B, Zhang B, Li J, et al. Analysis of Kongtong mountain tourist climate and human comfort in Pingliang, Gansu province. J Lanzhou University (Natural Sciences). 2012; 48(2): 75–79. doi:10.13885/j.issn.0455-2059.2012.02.008.
Cao R, Wang Y, Huang J, et al. The mortality effect of apparent temperature: a multi-city study in Asia. Int J Env Res Pub Health. 2021; 18(9): 4675.
Wiru K, Oppong FB, Agyei O, et al. The influence of apparent temperature on mortality in the Kintampo Health and Demographic Surveillance area in the Middle Belt of Ghana: a retrospective time-series analysis. J Environ Public Health. 2020; 2020: 1–9.
Moghadamnia MT, Ardalan A, Mesdaghinia A, et al. The effects of apparent temperature on cardiovascular mortality using a distributed lag nonlinear model analysis: 2005 to 2014. Asia-Pac J Public Health. 2018; 30(4): 361–368.
Ren C, O'Neill MS, Park SK, et al. Ambient temperature, air pollution, and heart rate variability in an aging population. Am J Epidemiol. 2011; 173(9): 1013–1021.
Wang B, Chai G, Sha Y, et al. Impact of ambient temperature on cardiovascular disease hospital admissions in farmers in China's Western suburbs. Sci Total Environ. 2021; 761: 143254.
Lee W, Chung Y, Choi H M, et al. Interactive effect of diurnal temperature range and temperature on mortality, northeast Asia. Epidemiology. 2019; 30: S99-S106. doi: 10.1097/EDE.0000000000000997.
Zhao Q, Zhao Y, Li S, et al. Impact of ambient temperature on clinical visits for cardio-respiratory diseases in rural villages in northwest China. Sci Total Environ. 2018; 612: 379–385.
Liu X, Kong D, Fu J, et al. Association between extreme temperature and acute myocardial infarction hospital admissions in Beijing, China: 2013–2016. Plos One. 2018; 13(10): e0204706.
Mohammadi R, Soori H, Alipour A, et al. The impact of ambient temperature on acute myocardial infarction admissions in Tehran, Iran. J Therm Biol. 2018, 73: 24–31.
Wu C, Zhang Y, Chen Z, et al. The prevention and treatment of hypertension and cardiovascular risk factors in rural China is not optimistic. Chinese J Molecular Cardiol. 2016; 6(02): 1625. doi: 10. 16563/j.cnki. 1671-6272.2016.10.017.
Zhou X, Zhao A, Meng X, et al. Acute effects of diurnal temperature range on mortality in 8 Chinese cities. Sci Total Environ. 2014; 493: 92–97.
Phung D, Guo Y, Thai P, et al. The effects of high temperature on cardiovascular admissions in the most populous tropical city in Vietnam. Environ Pollut. 2016; 208: 33–39.
Shen Y, Zhang X, Chen C, et al. The relationship between ambient temperature and acute respiratory and cardiovascular diseases in Shenyang, China. Environ Sci Pollut R. 2021; 28(16): 20058–20071.
Li Y, Wang DD, Ley SH, et al. Potential impact of time trend of life-style factors on cardiovascular disease burden in China. J Am Coll Cardiol. 2016; 68(8): 818–833.
Luan G, Yin P, Li T, et al. The years of life lost on cardiovascular disease attributable to ambient temperature in China. Sci Rep-UK. 2017; 7(1): 1–8.
Wu X, Liu X, Liao W, et al. Association of night sleep duration and ideal cardiovascular health in rural China: The Henan Rural Cohort Study. Front Public Health. 2021; 8: 606458.
TANG D. Study on the Relationship between the Air Quality and the Development of Socioeconomics in Gansu Province from 2015 to 2018. doi:10.27204/d.cnki.glzhu.2020.000744.
Journals System - logo
Scroll to top