Association Between the Incidence of Hospitalizations for Acute Cardiovascular Events, Weather, and Air Pollution

Julie K.K. Vishram-Nielsen, Brigitte Mueller, Heather J. Ross, Chun Po Fan, Barry Rubin, Ana Carolina Alba, Cedric Manlhiot

Research output: Contribution to journalArticlepeer-review


Background: The incidence of hospitalizations for cardiovascular events has been associated with specific weather conditions and air pollution. A comprehensive model including the interactions between various environmental factors remains to be developed. Objectives: The purpose of this study was to develop a comprehensive model of the association between weather patterns and the incidence of cardiovascular events and use this model to forecast near-term spatiotemporal risk. Methods: We present a spatiotemporal analysis of the association between atmospheric data and the incidence rate of hospital admissions related to heart failure (922,132 episodes), myocardial infarction (521,988 episodes), and ischemic stroke (263,529 episodes) in ∼24 million people in Canada between 2007 and 2017. Our hierarchical Bayesian model captured the spatiotemporal distribution of hospitalizations and identified weather and air pollution–related factors that could partially explain fluctuations in incidence. Results: Models that included weather and air pollution variables outperformed models without those covariates for most event types. Our results suggest that environmental factors may interact in complex ways on human physiology. The impact of environmental factors was magnified with increasing age. The weather and air pollution variables included in our models were predictive of the future incidence of heart failure, myocardial infarction, and ischemic strokes. Conclusions: The increasing importance of environmental factors on cardiovascular events with increasing age raises the need for the development of educational materials for older patients to recognize environmental conditions where exacerbations are more likely. This model could be the basis of a forecasting system used for local, short-term clinical resource planning based on the anticipated incidence of events.

Original languageEnglish (US)
Article number100334
JournalJACC: Advances
Issue number4
StatePublished - Jun 2023


  • acute cardiac events
  • heart failure
  • hospital admissions
  • pollution
  • spatiotemporal patterns
  • weather

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Dentistry (miscellaneous)


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