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Q J Med 1999; 92: 747-751
© 1999 Association of Physicians

Commentary

Cold adaptation and the seasonal distribution of acute myocardial infarction

F. De Lorenzo, V. Sharma, M. Scully and V.V. Kakkar

From the Thrombosis Research Institute, London, UK

Dr F. De Lorenzo, Department of Clinical Trials, Thrombosis Research Institute, Manresa Road, London SW3 6LR. e-mail: dlorenzo@tri-london.ac.uk


   Introduction
 
Numerous studies have reported an increased mortality from coronary heart disease (CHD) during the winter.1–5 Observational epidemiological data in England and Wales have shown that mortality from cardiovascular disease (CVD) increases linearly with decrease in diurnal minimum from 17 °C, accounting for about half of all excess cold-related mortality,1,2 which is approximately 50 000 per year in Britain alone.3 This effect is particularly pronounced in the elderly, in whom there is a 30% increase in deaths from this cause. Mortality increases more with a given fall of temperature in regions with `warm' winters.6 These deaths may therefore represent a graded effect of mild to severe environmental cold, rather than a specific effect of severe cold stress. The short temporal relation between temperature drop and mortality observed in Taiwan, where ambient temperature fluctuates greatly, supports the hypothesis that temperature effect may be a major factor which contributes to the increased mortality . . . [Full Text of this Article]


   Seasonal variations in coagulation factors and plasma lipids
 

   Haemodynamic and hormonal response to cold
 

   Mechanisms and effects of adaptation to cold
 

   Conclusions
 

   References
 

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