Future temperature-related hospitalizations from cardiovascular diseases among rural residents in southeastern China considering population aging

Future climate changes are projected to adversely affect mortality risk of cardiovascular disease (CVD) in urbanized regions. However, future temperature-related excess CVD hospitalizations in rural residents with poorer socioeconomic status is not well understood. Moreover, influence of aging and declining rural population are rarely considered. Using CVD hospitalizations in rural residents during 2010–2016 in eight regions in southeastern China, the region-specific temperature-CVD associations were estimated by generalized additive models, which were combined by a meta-regression. We projected excess CVD hospitalizations due to temperature using regional associations for 27 climate models under scenarios of climate change for 2010–2099. To reveal the influences of aging and declining rural population, age-specific associations and future population change ratio were used to estimate age-specific number of temperature-related hospitalizations. We found that heat-related hospitalizations in rural residents from ischemic stroke, ischemic heart disease and cerebrovascular disease are projected to increase in the 2090 s, although the excess CVD hospitalizations associated with future temperature in rural residents will reduce in the 2090 s. Rural population aging amplifies temperature-related CVD burden by >2.34-fold under SSPs in the 2050 s compared to scenarios with only population declining, although rural population reduction will reduce the temperature-related CVD hospitalizations in the 2090 s. The elderly, male and those lived in Longyan and Sanming could be more affected. These findings suggest that future heat is projected to increase hospitalizations of some CVD subcategories. Policies are needed to mitigate increasing temperature and baseline hospitalization rate. The impact of population aging is noteworthy.