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(Circulation. 1999;100:E1-E7.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

Unhealthy Effects of Atmospheric Temperature and Pressure on the Occurrence of Myocardial Infarction and Coronary Deaths

A 10-Year Survey: The Lille-World Health Organization MONICA Project (Monitoring Trends and Determinants in Cardiovascular Disease)

Sandrine Danet, MD; Florence Richard, MD; Michèle Montaye, MD; Stephanette Beauchant, MD; Brigitte Lemaire, MD; Catherine Graux, MD; Dominique Cottel, MD; Nadine Marécaux, RD; Philippe Amouyel, MD, PhD

From Service d'Epidémiologie et de Santé Publique. INSERM U508, Centre Hospitalier et Universitaire, et Institut Pasteur de Lille, Lille, France.

Correspondence to Philippe Amouyel, MD, PhD, INSERM U508, Institut Pasteur de Lille, 1, Rue Calmette, 59019 Lille Cedex, France. E-mail philippe.amouyel{at}pasteur-lille.fr

Background—Associations between an increase in coronary heart disease occurrence and low atmospheric temperatures have been reported from mortality data and hospital admission registries. However, concomitant increases in noncardiovascular case fatality rates and selection bias of hospital cases may weaken this observation. In this study, we addressed the question of the relationships between fatal and nonfatal coronary diseases and meteorological variables in 10-year data (1985 to 1994) collected in a morbidity registry (Lille-WHO MONICA Project) monitoring 257 000 men from 25 to 64 years of age.

Methods and Results—The impacts of atmospheric temperature (in Celsius) and pressure (in millibars) on daily rates of myocardial infarction (MI) and coronary deaths were studied. Percentages of variation of event rates according to meteorological variations were derived from the relative risks estimated with a Poisson regression model. During the 10-year longitudinal survey, 3616 events occurred. Rates of events decreased linearly with increasing atmospheric temperature. For atmospheric pressure, we detected a V-shaped relationship, with a minimum of daily event rates at 1016 mbar. A 10°C decrease was associated with a 13% increase in event rates (P<0.0001); a 10-mbar decrease <1016 mbar and a 10-mbar increase >1016 mbar were associated with a 12% increase (P=0.001) and an 11% increase (P=0.01) in event rates, respectively. These effects were independent and influenced both coronary morbidity and mortality rates, with stronger effects in older age groups and for recurrent events.

Conclusions—This longitudinal study is the first to estimate the attributable effect of meteorological variables on MI morbidity in population and strongly argues for a systematic fight against cold in cardiovascular disease prevention, particularly in older ages and after a first MI.

Key Words: registries • myocardial infarction • temperature, atmospheric • pressure, atmospheric • prevention

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