Dirty air, heat, cold may all trigger heart attacks

By Anne Harding

NEW YORK (Reuters Health) - Extreme temperatures and heavy air pollution boost heart attack risk, according to a major new study.

And on days when the air is extra dirty and the temperature is unusually hot or cold, the effects are likely to be particularly bad, given that temperature and pollution seem to harm the body in different ways, Dr. Krishnan Bhaskaran of the London School of Hygiene and Tropical Medicine in the UK, the lead author of the research, told Reuters Health.

Several studies have linked changes in temperature to increases in deaths due to any cause, as well as heart disease mortality, Bhaskaran and his team note in their reports. But looking at heart attacks-not just deaths from heart disease-could offer a more accurate picture of the overall health risks of temperature changes and air pollution, they say, and might also offer clues to why they may trigger heart attack in high-risk people.

In two separate reports, the researchers reviewed 19 studies on temperature and heart attack and 26 examining air pollution and heart attack.

In the 12 temperature studies that collected winter data, eight showed short-term increases in heart attack risk with colder temperatures. Seven of the 13 studies that looked at the effects of warmer temperatures found increased heart attack risk in hotter weather.

Cold temperatures seemed to have a greater effect on heart attack risk in areas that were warmer, on average, Bhaskaran and colleagues note, suggesting that people living in colder areas may be better adapted to dips in temperature. But hot days boosted heart attack risk whether they happened in Sweden or Brazil.

In a city that normally sees 10 heart attacks a day, Bhaskaran explained, the findings show there might be an extra one to four heart attacks on the hottest or coldest days.

"There was a lot of variation in the methods and quality of the studies we reviewed, so more work is needed in this area, but we thought the results were consistent enough to suggest that these effects are real," he added.