ArticleBMJ open2020
Influenza-associated cardiovascular mortality in older adults in Beijing, China: a population-based time-series study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- High Clinical Burden of Influenza Disease in Adults Aged ≥ 65 Years: Can We Do Better? A Systematic Literature Review.Advances in therapy · 2023Pooled it
- Cardiovascular Complications of Seasonal Influenza in the Pre- and Post-COVID-19 Era: Epidemiology, Mechanisms, and Clinical Implications.Medical sciences (Basel, Switzerland) · 2026Review
- Chronic Diseases and Influenza Vaccines.Vaccines · 2025Review
- Influenza Activity and Preterm Birth in the Atlanta Metropolitan Area: A Time-Series Analysis from 2010 to 2017.Epidemiology (Cambridge, Mass.) · 2025Article
- Diabetes mortality burden attributable to influenza in China: A population-based time-series analysis.Heliyon · 2025Article
- Observational
- Geographic Variation in Mortality of Acute Myocardial Infarction and Association With Health Care Accessibility in Beijing, 2007 to 2018.Journal of the American Heart Association · 2023Article
- Driving Time to the Nearest Percutaneous Coronary Intervention-Capable Hospital and the Risk of Case Fatality in Patients with Acute Myocardial Infarction in Beijing.International journal of environmental research and public health · 2023Article
- What if flu vaccination is the most responsible thing to do for cardiovascular health in the upcoming season?European heart journal supplements : journal of the European Society of Cardiology · 2023Article
- Global, regional and national estimates of influenza-attributable ischemic heart disease mortality.EClinicalMedicine · 2023Article
- HIPEC as a risk factor for postoperative coagulopathy after cytoreductive surgery for peritoneal metastases.Updates in surgery · 2022Article
- Article
- Article
- Trends and Inequalities in the Incidence of Acute Myocardial Infarction among Beijing Townships, 2007-2018.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study comprehensively estimated the excess cardiovascular disease (CVD) mortality attributable to influenza in an older (age ≥65 years) population.
designEcological study.
settingAggregated data from administrative systems on CVD mortality, influenza surveillance and meteorological data in Beijing, China.
main outcome measureExcess overall CVD, and separately for ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke mortality attributable to influenza, adjusting for influenza activity, time trend, seasonality and ambient temperature.
resultsCVD (risk ratio (RR) 1.02, 95% CI 1.01, 1.02), IHD (RR 1.01, 95% CI 1.01, 1.02), ischaemic stroke (RR=1.03, 95% CI 1.02, 1.04), but not haemorrhagic stroke (RR=1.00, 95% CI 0.99, 1.01) mortality, were significantly associated with every 10% increase in influenza activity. An increase in circulating A(H1N1)09pdm, A(H3N2) and B type virus were all significantly associated with CVD and ischaemic stroke mortality, but only A(H3N2) and B type virus with IHD mortality. The strongest increase in disease mortality was in the same week as the increase in influenza activity. Annual excess CVD mortality rate attributable to influenza ranged from 54 to 96 per 100 000 population. The 3%-6% CVD mortality attributable to influenza activity was related to an annual excess of 916-1640 CVD deaths in Beijing, China.
conclusionsInfluenza activity has moderate to strong associations with CVD, IHD and ischaemic stroke mortality in older adults in China. Promoting influenza vaccination could have major health benefit in this population.
backgroundInfluenza may trigger serious CVD events. An estimation of excess CVD mortality attributable to influenza has particular relevance in China where vaccination is low and CVD burden is high.
methodsThis study analysed data at the population level (age ≥65 years) using linked aggregated data from administrative systems on CVD mortality, influenza surveillance and meteorological data during 2011 to 2018. Quasi-Poisson regression models were used to estimate the excess overall CVD, and separately for IHD, ischaemic stroke, haemorrhagic stroke mortality attributable to influenza, adjusting for influenza activity, time trend, seasonality and ambient temperature. Analyses were also undertaken for influenza subtypes (A(H1N1)09pdm, A(H3N2) and B viruses), and mortality risk with time lags of 1-5 weeks following influenza activity in the current week.
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