Seasonal variation in cardiovascular mortality and hospitalisations and its implications for public health planning: a prospective cohort study
- 1BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- 2Human Performance Lab, Education, Physical Activity, and Health Research Unit, Universidad Católica del Maule, Talca, Chile
- 3High-Altitude Medicine Research Centre (CEIMA), Universidad Arturo Prat, Iquique, Chile
Abstract
Background: We characterised seasonal patterns in cardiovascular (CV) mortality and hospitalisations to understand how CV health might be affected by climate change.
Methods: We analysed the UK Biobank cohort recruited from 22 centres between 2006 and 2010. Seasonal mortality rates and hospitalisation rates were determined for death (all cause, CV and non-CV death) and first recorded of CV hospitalisations (heart failure (HF), myocardial infarction (MI), stroke and peripheral vascular disease (PVD)). Seasonal trends were evaluated using a cosinor model with a binomial family and by sex, age, ethnicity and socioeconomic deprivation. Multivariable models were adjusted for demographic, socioeconomic, lifestyle and clinical covariates, and assessment centre was subsequently included as a random intercept to account for clustering within centres.
Results: Data from 453 597 participants were included, 56% were women, with a mean age of 56 years (SD 8). There were 33 857 deaths (10 807 (31.9%) were CV and 23 050 (68.1%) non-CV deaths). All-cause mortality showed evidence of seasonal variation, and CV and non-CV deaths had significant seasonal variation (p<0.001), with the highest rates in winter. The maximum and minimum of all-cause mortality rates were 62.2 and 51.5 per 10 000 person-years in winter and summer respectively. There were 12 273, 9520, 7137, 14 492 hospitalisations for HF, MI, stroke and PVD. MI and stroke showed clear winter peaks (p<0.001), HF and PVD also displayed seasonal variation (p<0.001) with the highest hospitalisation rate in spring.
Conclusions: Rates of deaths, MI and stroke hospitalisations were highest during winter months. The findings imply that colder temperatures rather than warmer temperatures are a more significant driver of adverse outcomes.
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BibTeX
@article{talebi2026seasonal,
title = {{Seasonal variation in cardiovascular mortality and hospitalisations and its implications for public health planning: a prospective cohort study}},
author = {Atefeh Talebi and Paul Welsh and Alasdair D Henderson and Carlos A Celis-Morales and Pardeep S Jhund},
journal = {Open Heart},
year = {2026},
month = oct,
doi = {10.1136/openhrt-2026-004422},
url = {https://doi.org/10.1136/openhrt-2026-004422},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Seasonal variation in cardiovascular mortality and hospitalisations and its implications for public health planning: a prospective cohort study
AU - Atefeh Talebi
AU - Paul Welsh
AU - Alasdair D Henderson
AU - Carlos A Celis-Morales
AU - Pardeep S Jhund
PY - 2026
DA - 2026/10/28
JO - Open Heart
DO - 10.1136/openhrt-2026-004422
UR - https://doi.org/10.1136/openhrt-2026-004422
AB - Background: We characterised seasonal patterns in cardiovascular (CV) mortality and hospitalisations to understand how CV health might be affected by climate change. Methods: We analysed the UK Biobank cohort recruited from 22 centres between 2006 and 2010. Seasonal mortality rates and hospitalisation rates were determined for death (all cause, CV and non-CV death) and first recorded of CV hospitalisations (heart failure (HF), myocardial infarction (MI), stroke and peripheral vascular disease (PVD)). Seasonal trends were evaluated using a cosinor model with a binomial family and by sex, age, ethnicity and socioeconomic deprivation. Multivariable models were adjusted for demographic, socioeconomic, lifestyle and clinical covariates, and assessment centre was subsequently included as a random intercept to account for clustering within centres. Results: Data from 453 597 participants were included, 56% were women, with a mean age of 56 years (SD 8). There were 33 857 deaths (10 807 (31.9%) were CV and 23 050 (68.1%) non-CV deaths). All-cause mortality showed evidence of seasonal variation, and CV and non-CV deaths had significant seasonal variation (p<0.001), with the highest rates in winter. The maximum and minimum of all-cause mortality rates were 62.2 and 51.5 per 10 000 person-years in winter and summer respectively. There were 12 273, 9520, 7137, 14 492 hospitalisations for HF, MI, stroke and PVD. MI and stroke showed clear winter peaks (p<0.001), HF and PVD also displayed seasonal variation (p<0.001) with the highest hospitalisation rate in spring. Conclusions: Rates of deaths, MI and stroke hospitalisations were highest during winter months. The findings imply that colder temperatures rather than warmer temperatures are a more significant driver of adverse outcomes.
SN - 2053-3624
ER -