Dataset Information

Influenza-associated cardiovascular mortality in older adults in Beijing, China: a population-based time-series study.

ABSTRACT:

Objective

This study comprehensively estimated the excess cardiovascular disease (CVD) mortality attributable to influenza in an older (age ?65 years) population.

Design

Ecological study.

Setting

Aggregated data from administrative systems on CVD mortality, influenza surveillance and meteorological data in Beijing, China.

Main outcome measure

Excess 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.

Results

CVD (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.

Conclusions

Influenza 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.

Background

Influenza 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.

Methods

This 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.

SUBMITTER: Liu R

PROVIDER: S-EPMC7678395 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Influenza-associated cardiovascular mortality in older adults in Beijing, China: a population-based time-series study.

Liu Rong R Liu Xiaoshuang X Yang Peng P Du Xin X He Liu L Chen Tiange T Li Xiang X Xie Guotong G Wu Shuangsheng S Su Jianting J Xia Shijun S Jiang Chao C Huffman Mark D MD MacIntyre Chandini Raina CR Wei Zaihua Z Wang Quanyi Q Dong Jianzeng J Anderson Craig C

BMJ open 20201119 11

<h4>Objective</h4>This study comprehensively estimated the excess cardiovascular disease (CVD) mortality attributable to influenza in an older (age ≥65 years) population.<h4>Design</h4>Ecological study.<h4>Setting</h4>Aggregated data from administrative systems on CVD mortality, influenza surveillance and meteorological data in Beijing, China.<h4>Main outcome measure</h4>Excess overall CVD, and separately for ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke mortality attribut ...[more]

PMID: 33444216

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Project description:ObjectivesThe present study aimed to estimate the influenza vaccination coverage rate in Beijing, China, and identify its determinants in older and younger adults.MethodsA survey was conducted among Chinese adults using a self-administered, anonymous questionnaire in May-June 2015. The main outcome was seasonal influenza vaccination uptake. Multivariate logistic regression models were performed to identify factors associated with uptake.ResultsA total of 7106 participants completed the questionnaire. The overall coverage rate was 20.6% (95% CI 19.7% to 21.5%) in the 2014/2015 influenza season. Lower education (older adults: OR 1.6; 95% CI 1.2 to 2.1; younger adults: OR 1.9; 95% CI 1.4 to 2.6), having a chronic illness (older adults: OR 1.9; 95% CI 1.5 to 2.4; younger adults: OR 1.4; 95% CI 1.2 to 1.7) and recommendations from healthcare workers (older adults: OR 5.4; 95% CI 3.9 to 7.4; younger adults: OR 4.5; 95% CI 3.7 to 5.4) were positively associated with uptake; perceived side effects of vaccination had a negative impact (older adults: OR 0.6; 95% CI 0.4 to 0.7; younger adults: OR 0.8; 95% CI 0.7 to 1.0). Perceived susceptibility to influenza (OR 1.5; 95% CI 1.2 to 2.0) and awareness of the free influenza vaccine policy (OR 1.9; 95% CI 1.2 to 2.9) were only associated with vaccine uptake in older adults, while perceived effectiveness of vaccination (OR 2.2; 95% CI 1.7 to 2.8) was only a predictor for younger adults. Older adults were more likely to receive recommendations from healthcare professionals and perceive the severity of seasonal influenza, and less likely to worry about side effects of vaccination.ConclusionThe influenza vaccination coverage rate was relatively low in Beijing. Apart from free vaccinations for older adults, age disparity in the rate between older and younger adults (48.7% vs 16.0%) may be explained by differing professional recommendations and public perceptions. Vaccination campaigns targeting increasing professional recommendations and public perceptions should be implemented in the coming years.

Project description:BackgroundAssociations between air temperature and mortality have been consistently observed in Europe and the United States; however, there is a lack of studies for Asian countries. Our study investigated the association between air temperature and cardio-respiratory mortality in the urban area of Beijing, China.MethodsDeath counts for cardiovascular and respiratory diseases for adult residents (?15 years), meteorological parameters and concentrations of particulate air pollution were obtained from January 2003 to August 2005. The effects of two-day and 15-day average temperatures were estimated by Poisson regression models, controlling for time trend, relative humidity and other confounders if necessary. Effects were explored for warm (April to September) and cold periods (October to March) separately. The lagged effects of daily temperature were investigated by polynomial distributed lag (PDL) models.ResultsWe observed a J-shaped exposure-response function only for 15-day average temperature and respiratory mortality in the warm period, with 21.3°C as the threshold temperature. All other exposure-response functions could be considered as linear. In the warm period, a 5°C increase of two-day average temperature was associated with a RR of 1.098 (95% confidence interval (95%CI): 1.057-1.140) for cardiovascular and 1.134 (95%CI: 1.050-1.224) for respiratory mortality; a 5°C decrease of 15-day average temperature was associated with a RR of 1.040 (95%CI: 0.990-1.093) for cardiovascular mortality. In the cold period, a 5°C increase of two-day average temperature was associated with a RR of 1.149 (95%CI: 1.078-1.224) for respiratory mortality; a 5°C decrease of 15-day average temperature was associated with a RR of 1.057 (95%CI: 1.022-1.094) for cardiovascular mortality. The effects remained robust after considering particles as additional confounders.ConclusionsBoth increases and decreases in air temperature are associated with an increased risk of cardiovascular mortality. The effects of heat were immediate while the ones of cold became predominant with longer time lags. Increases in air temperature are also associated with an immediate increased risk of respiratory mortality.

Dataset Information

Influenza-associated cardiovascular mortality in older adults in Beijing, China: a population-based time-series study.

Objective

Design

Setting

Main outcome measure

Results

Conclusions

Background

Methods

Publications

Influenza-associated cardiovascular mortality in older adults in Beijing, China: a population-based time-series study.

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