Evidence map›Paper›PMID 37901952›Full record

ArticleCirculation2023

Projected Change in the Burden of Excess Cardiovascular Deaths Associated With Extreme Heat by Midcentury (2036-2065) in the Contiguous United States.

Sameed Ahmed M Khatana, Lauren A Eberly, Ashwin S Nathan, Peter W Groeneveld

Abstract read
In one paragraph

Article in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Journal of the American Heart Association · 2026
    Article
  6. Article
  7. Observational
  8. Cardiovascular challenges of aging in a hotter environment: a narrative review.Journal of applied physiology (Bethesda, Md. : 1985) · 2025
    Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Causal effect of PMFrontiers in big data · 2025
    Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Biological sex impacts oxidative stress in skeletal muscle in a porcine heat stress model.American journal of physiology. Regulatory, integrative and comparative physiology · 2024
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sameed Ahmed M KhatanaFrom the Division of Cardiovascular Medicine (S.A.M.K, L.A.E., A.S.N.), University of Pennsylvania, Philadelphia.ORCID 0000-0002-1345-3004
Lauren A EberlyFrom the Division of Cardiovascular Medicine (S.A.M.K, L.A.E., A.S.N.), University of Pennsylvania, Philadelphia.ORCID 0000-0003-0879-7694
Ashwin S NathanFrom the Division of Cardiovascular Medicine (S.A.M.K, L.A.E., A.S.N.), University of Pennsylvania, Philadelphia.ORCID 0000-0002-7227-6423
Peter W GroeneveldPenn Cardiovascular Outcomes, Quality, and Evaluative Research Center (S.A.M.K., L.A.E., A.S.N., P.W.G.), University of Pennsylvania, Philadelphia.ORCID 0000-0002-7374-4292

Funding

Association of Health Insurance with Access to Cardiovascular CareK23HL153772 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KHATANA, SAMEED AHMED MUSTAFA · 2020 to 2024
$981k
NHLBI NIH HHS K23 HL153772
6 · The paper itself

Abstract

backgroundClimate change is causing an increase in extreme heat. Individuals with cardiovascular disease are at high risk of heat-related adverse health effects. How the burden of extreme heat-associated cardiovascular deaths in the United States will change with the projected rise in extreme heat is unknown.

methodsWe obtained data on cardiovascular deaths among adults and the number of extreme heat days (maximum heat index ≥90 °F [32.2 °C]) in each county in the contiguous United States from 2008 to 2019. Based on representative concentration pathway trajectories that model greenhouse gas emissions and shared socioeconomic pathways (SSP) that model future socioeconomic scenarios and demographic projections, we obtained county-level projected numbers of extreme heat days and populations under 2 scenarios for the midcentury period 2036 to 2065: SSP2-4.5 (representing demographic projections from a "middle-of-the-road" socioeconomic scenario and an intermediate increase in emissions) and SSP5-8.5 (demographic projections in an economy based on "fossil-fueled development" and a large increase in emissions). The association of cardiovascular mortality with extreme heat was estimated with a Poisson fixed-effects model. Using estimates from this model, the projected number of excess cardiovascular deaths associated with extreme heat was calculated.

resultsExtreme heat was associated with 1651 (95% CI, 921-2381) excess cardiovascular deaths per year from 2008 to 2019. By midcentury, extreme heat is projected to be associated with 4320 (95% CI, 2369-6272) excess deaths annually, which is an increase of 162% (95% CI, 142-182) under SSP2-4.5, and 5491 (95% CI, 3011-7972) annual excess deaths, which is an increase of 233% (95% CI, 206-259) under SSP5-8.5. Elderly adults are projected to have a 3.5 (95% CI, 3.2-3.8) times greater increase in deaths in the SSP2-4.5 scenario compared with nonelderly adults. Non-Hispanic Black adults are projected to have a 4.6 (95% CI, 2.8-6.4) times greater increase compared with non-Hispanic White adults. The projected change in deaths was not statistically significantly different for other race and ethnicity groups or between men and women.

conclusionsBy midcentury, extreme heat is projected to be associated with a significantly greater burden of excess cardiovascular deaths in the contiguous United States.

Indexed as

Cardiovascular DiseasesExtreme HeatAdultAgedFemaleForecastingHot TemperatureHumansMaleUnited Statesclimate changeextreme heathealth status disparitiespopulation health

Identifiers

PMID37901952
PMCPMC10840949

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.