Poisson regression models were used to evaluate associations between temperature, precipitation, days of extreme heat, and other weather changes (lagged 7 days), as well as El Nino events, with hospitalizations for acute myocardial infarction, angina pectoris, congestive heart failure, and stroke in three California regions. Temperature changes were defined as a 3 degreesC decrease in maximum temperature or a 3 degreesC increase in minimum temperature. Temperature and precipitation were analyzed separately for normal weather periods and El Nino events, and for both weather periods combined. Associations varied by region, age, and gender. In Los Angeles, temperature changes resulted in small changes in hospitalizations. Among San Francisco residents 70+ years of age, temperature changes increased hospitalizations for nearly all outcomes from 6% to 13%. Associations among Sacramento residents were similar to those in San Francisco: among men 70+ years of age, temperature changes increased hospitalizations by 6%-11% for acute myocardial infarction and congestive heart failure, and 10%-18% for stroke. El Nino events were consistently and significantly associated with hospitalizations only in San Francisco and Sacramento, and then only for angina pectoris (increasing hospitalizations during El Nino events). These exploratory analyses merit further confirmation to improve our understanding of how admissions to hospitals for cardiovascular disease and stroke change with changing weather. Such an understanding is useful for developing current public health responses, for evaluating population vulnerability, and for designing future adaptation measures.
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