ESC Congress 2026 Abstract · Oct 26, 2026

Mortality patterns in the context of climate change: a 14-year nationwide analysis of extreme weather events

By Kurasz A, Lip GYH, Dobrzycki S et al.

Background: Climate change is increasingly recognized as a major threat to global health. Beyond gradual global warming, climate change manifests through more frequent and intense heat (HW) and cold waves (CW), which can trigger health events. Purpose: This study aims to assess the impact of extreme weather events on cause-specific cardiovascular (CV) mortality in the population of Poland in the context of environmental exposure. Methods: A geospatial analysis was conducted for the years 2011-23 on the Polish population (Fig 1). Primary endpoints were CV mortality and secondary: case-specific mortality [heart failure (HF), acute coronary syndrome, all-cause and external]. All analyses were conducted using individual-level mortality data. We operationalised temperature extremes at the municipality-day level using the Excess Heat and Cold Factor. Daily air pollutant exposure data at municipality level was obtained using the GEM-AQ model. Individual exposure was assigned based on the place of residence. A Poisson pseudo–maximum likelihood regression with high-dimensional fixed effects was used. Models were adjusted for long-term temporal trends, day of the week, COVID-19, influenza activity, holidays,weather conditions. Results are reported as incidence rate ratios (IRRs) with 95% confidence intervals (95%CI). Results: Total recorded deaths were 5,386,726 (51.9% male), including 2,084,773 CV deaths (45.9% male). HW exposure was consistently associated with increased mortality across all examined outcomes, with the strongest effects observed at lag 0-2 and a gradual attenuation over the following days. For CV mortality, the risk increased by 9% on the day of exposure (lag 0:1.09; 95%CI: 1.08-1.10) and peaked on lag 1 (1.10; 95%CI:1.09-1.11). Conversely, CW were associated with elevated CV mortality, with effects persisting across multiple lag days and showing a more prolonged temporal pattern (p<0.001) – Fig. 2. The observed associations remained robust in models that accounted for both temperature extremes and air pollution exposure. HW-related mortality was more pronounced among women and older individuals, particularly for CV and HF deaths, whereas CW exerted stronger effects in men (p<0.001). For external-cause mortality, significant associations (more pronounced among men aged <65 years old) were observed only during HW. HW affected mortality more in urban than rural areas, while no significant effect modification was observed based on socioeconomic status. The attributable burden was substantially greater for HW (513,997 years of life lost) than for CW (169,128), which translates into 28,501 and 11,297 deaths, respectively. Conclusions: Both heat and cold waves significantly increased CV mortality, with heat effects being more acute and cold effects more prolonged. These findings identify vulnerable subgroups and support the integration of climate-sensitive risk stratification into public health and CV prevention policies.Fig 1.Flow chart of the study design

doi.org/10.1093/eurheartj/ehag785.3523Open accessPopulations