European Journal of Epidemiology

, Volume 20, Issue 5, pp 407–410 | Cite as

Endothelial function and outdoor temperature

  • Tim S. Nawrot
  • Jan A. Staessen
  • Robert H. Fagard
  • Luc M. Van Bortel
  • Harry A. Struijker-Boudier
Cardiovascular Epidemiology


Studies within populations consistently showed that cardiovascular mortality increases with hot weather. However, the biological mechanisms underlying this association remain largely unknown. Endothelial function plays a pivotal role in the pathogenesis of cardiovascular disease. Therefore, we investigated the association between endothelial function and outdoor temperature. We measured flow-mediated vasodilatation (FMD) as index of endothelial function in 274 randomly recruited subjects (50% women, mean age 40.6 year). Both before (partial r = −0.14, p = 0.017) and after adjustment (partial r = −0.17, p = 0.006) for sex, age, body mass index, brachial artery diameter and current smoking, FMD was negatively associated with mean daily temperature. The odds of endothelial dysfunction increased by 58% (95% CI: 4–141%; p = 0.03) for each 10 °C increment in mean daily temperature during the week before the examination. Our findings suggest that endothelial dysfunction might contribute to the increase in cardiovascular morbidity and mortality associated with hot weather.


Cardiovascular mortality Endothelium Epidemiology Heat waves Outdoor temperature Vasodilation 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Huynen, MM, Martens, P, Schram, D, Weijenberg, MP, Kunst, AE 2001The impact of heat waves and cold spells on mortality rates in the Dutch populationEnviron Health Perspect109463470PubMedGoogle Scholar
  2. 2.
    Keatinge, WR, Donaldson, GC, Cordioli, E,  et al. 2000Heat related mortality in warm and cold regions of Europe: Observational studyBr Med J321670673Google Scholar
  3. 3.
    Alberdi, JC, Diaz, J, Montero, JC, Miron, I 1998Daily mortality in Madrid community 1986–1992: Relationship with meteorological variablesEur J Epidemiol14571578PubMedGoogle Scholar
  4. 4.
    Mackenbach, JP, Borst, V, Schols, JM 1997Heat-related mortality among nursing-home patientsLancet34912971298Google Scholar
  5. 5.
    McGeehin, MA, Mirabelli, M 2001The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United StatesEnviron Health Perspect109185189PubMedGoogle Scholar
  6. 6.
    Nawrot, T, Den Hond, E, Thijs, L, Staessen, JA 2003Isolated systolic hypertension and the risk of vascular diseaseCurr Hypertens Rep5372379PubMedGoogle Scholar
  7. 7.
    Vita, JA, Keaney, JF 2002Endothelial function – A barometer for cardiovascular risk?Circulation106640642PubMedGoogle Scholar
  8. 8.
    Faulx, MD, Wright, AT, Hoit, BD 2003Detection of endothelial dysfunction with brachial artery ultrasound scanningAm Heart J145943951PubMedGoogle Scholar
  9. 9.
    Gokce, N, Keaney, JF,Jr, Hunter, LM,  et al. 2003Predictive value of noninvasively determined endothelial dysfunction for long-term cardiovascular events in patients with peripheral vascular diseaseJ Am Coll Cardiol4117691775PubMedGoogle Scholar
  10. 10.
    Gokce, N, Holbrook, M, Duffy, SJ,  et al. 2001Effects of race and hypertension on flow-mediated and nitroglycerin-mediated dilation of the brachial arteryHypertension3813491354PubMedGoogle Scholar
  11. 11.
    Tounian, P, Aggoun, Y, Dubern, B,  et al. 2001Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: A prospective studyLancet35814001404PubMedGoogle Scholar
  12. 12.
    Oftedal, B, Nafstad, P, Magnus, P, Bjorkly, S, Skrondal, A 2003Traffic related air pollution and acute hospital admission for respiratory diseases in Drammen, Norway 1995–2000Eur J Epidemiol18671675PubMedGoogle Scholar
  13. 13.
    Staessen, JA, Nawrot, T, Den Hond, E,  et al. 2001Renal function, cytogenetic measurements and sexual development in adolescents in relation to environmental pollutants: A feasibility study of biomarkersLancet35716601669PubMedGoogle Scholar
  14. 14.
    Nemmar, A, Hoet, PH, Vanquickenborne, B,  et al. 2002Passage of inhaled particles into the blood circulation in humansCirculation105411414PubMedGoogle Scholar
  15. 15.
    Nemmar, A, Hoet, PH, Dinsdale, D, Vermylen, J, Hoylaerts, MF, Nemery, B 2003Diesel exhaust particles in lung acutely enhance experimental peripheral thrombosisCirculation10712021208PubMedGoogle Scholar
  16. 16.
    Pan, WH, Li, LA, Tsai, MJ 1995Temperature extremes and mortality from coronary heart disease and cerebral infarction in elderly ChineseLancet345353355PubMedGoogle Scholar
  17. 17.
    Donaldson, GC, Robinson, D, Allaway, SL 1997An analysis of arterial disease mortality and BUPA health screening data in men, in relation to outdoor temperatureClin Sci92261268PubMedGoogle Scholar
  18. 18.
    Neild, PJ, Syndercombe-Court, D, Keatinge, WR, Donaldson, GC, Mattock, M, Caunce, M 1994Cold-induced increases in erythrocyte count, plasma cholesterol and plasma fibrinogen of elderly people without a comparable rise in protein C or factor XClin Sci864348PubMedGoogle Scholar
  19. 19.
    Mudge, GH,Jr, Grossman, W, Mills, RM,Jr, Lesch, M, Braunwald, E 1976Reflex increase in coronary vascular resistance in patients with ischemic heart diseaseN Engl J Med29513331337PubMedGoogle Scholar
  20. 20.
    Modena, MG, Bonetti, L, Coppi, F, Bursi, F, Rossi, R 2002Prognostic role of reversible endothelial dysfunction in hypertensive postmenopausal womenJ Am Coll Cardiol40505510PubMedGoogle Scholar
  21. 21.
    Celermajer, DS, Sorensen, KE, Bull, C, Robinson, J, Deanfield, JE 1994Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interactionJ Am Coll Cardiol2414681174PubMedGoogle Scholar
  22. 22.
    Benjamin, EJ, Larson, MG, Keyes, MJ,  et al. 2004Clinical correlates and heritability of flow-mediated dilation in the community: The Framingham Heart StudyCirculation109613619PubMedGoogle Scholar
  23. 23.
    Herrington, DM, Fan, L, Drum, M,  et al. 2001Brachial flow-mediated vasodilator responses in population-based research: Methods, reproducibility and effects of age, gender and baseline diameterJ Cardiovasc Risk8319328PubMedGoogle Scholar
  24. 24.
    Nawrot, T, Staessen, J, Gardner, J, Aviv, A 2004Telomere length and possible link to X chromosomeLancet363507510PubMedGoogle Scholar
  25. 25.
    Minamino, T, Komuro, I 2002Role of telomere in endothelial dysfunction in atherosclerosisCurr Opin Lipidol13537543PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Tim S. Nawrot
    • 1
    • 4
  • Jan A. Staessen
    • 1
  • Robert H. Fagard
    • 1
  • Luc M. Van Bortel
    • 2
  • Harry A. Struijker-Boudier
    • 3
  1. 1.Study Coordinating Centre, Laboratory of Hypertension, Department of Molecular and Cardiovascular ResearchUniversity of LeuvenLeuven
  2. 2.Heymans Institute of PharmacologyGhent UniversityGentBelgium
  3. 3.Department of Pharmacology and Toxicology, Cardiovascular Research Institute MaastrichtUniversity of MaastrichtThe Netherlands
  4. 4.StudiecoördinatiecentrumLaboratorium HypertensieLeuvenBelgium

Personalised recommendations