Projections for temperature-related years of life lost from cardiovascular diseases in the elderly in a Chinese city with typical subtropical climate

Objective: Extreme temperature is an important risk factor for cardiovascular diseases, and the elderly are particularly vulnerable to temperature variation. Global warming and the increasingly aging population are two major global challenges for human health; thus, an urgent need exists to project the temperature-related cardiovascular disease burden regarding both of the aforementioned factors. We aimed to the project temperature related burden of cardiovascular diseases using years of life lost (YLL) in the elderly in a Chinese city with typical subtropical climate. Methods: A retrospective time-series study was first conducted to estimate cardiovascular disease burden associated with temperature in the elderly from 2008 to 2015 in Ningbo, China. Then, future projections considering demographic change and adaptation under 19 global-scale climate models (GCMs) and 3 different Representative Concentration Pathways (RCPs) scenarios for the 2050s and 2070s were estimated. Results: The exposure-response curve for temperature on YLL from cardiovascular diseases was U-shaped, with increased YLL for both higher- and lower- than optimal temperature. The projected annual increase in heat related YLL was outweighed by the decrease in cold-related YLL. However, monthly analysis demonstrated that temperature-related YLL will increase significantly in August. Additionally, heat-related YLL is projected to increase 3.1-11.5 times for the 2050s and 2070s relative to baseline, when considering demographic changes, even with 30% adaptation taken into consideration. Conclusions: Although annual YLL from cardiovascular diseases in the elderly associated with temperature will decrease in the future, heat-related YLL will increase tremendously, which indicates that more adaptation strategies and greenhouse emission control measures should be undertaken to reduce the future heat-related burden of cardiovascular diseases in the elderly.