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Seasonality of cardiovascular risk factors: an analysis including over 230 000 participants in 15 countries
Open accessAbstract
Objective: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. Methods: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist circumference; systolic (SBP) and diastolic (DBP) blood pressure; total, high (HDL) and low (LDL) density lipoprotein cholesterol; triglycerides and glucose levels. Within each study, all data were adjusted for age, gender and current smoking. For blood pressure, lipids and glucose levels, further adjustments on BMI and drug treatment were performed. Results: In the Northern and Southern Hemispheres, CVRFs levels tended to be higher in winter and lower in summer months. These patterns were observed for most studies. In the Northern Hemisphere, the estimated seasonal variations were 0.26 kg/m 2 for BMI, 0.6 cm for waist circumference, 2.9 mm Hg for SBP, 1.4 mm Hg for DBP, 0.02 mmol/L for triglycerides, 0.10 mmol/L for total cholesterol, 0.01 mmol/L for HDL cholesterol, 0.11 mmol/L for LDL cholesterol, and 0.07 mmol/L for glycaemia. Similar results were obtained when the analysis was restricted to studies collecting fasting blood samples. Similar seasonal variations were found for most CVRFs in the Southern Hemisphere, with the exception of waist circumference, HDL, and LDL cholesterol. Conclusions: CVRFs show a seasonal pattern characterised by higher levels in winter, and lower levels in summer. This pattern could contribute to the seasonality of CV mortality.
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“This is to some extent due to analytical variation, but is also due to environmental factors such as diet and physical activity, and a seasonal variation, with higher levels of TC and HDL-C during the winter. 78”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [78]
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“There is a considerable intra-individual variation in plasma lipids.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [78]
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BackgroundSocioeconomic Status Modifies the Seasonal Effect on Blood Pressure
Cois, A., & Ehrlich, R. I. (2015) · Medicine · doi:10.1097/md.0000000000001389 · Cited by 14
“Trigonometric splines are frequently used in epidemiological studies to model seasonal patterns, and they have been previously applied in the study of seasonal variations in blood pressure.(5,12,13) Our specific implementation, including interaction terms for each age category, allowed for the estimation of the magnit…”
MethodResultInfluentialSeasonality of cognitive function in the general population: the Rotterdam Study
Mooldijk, S. S., Licher, S., Vernooij, M. W., Ikram, M. K., & Ikram, M. A. (2021) · GeroScience · doi:10.1007/s11357-021-00485-0 · Cited by 14
Владимировна, К. Н., Tsyrlin, V. A., Плисс, М. Г., & Galagudza, M. M. (2022) · Human Physiology · doi:10.1134/s0362119722030100 · Cited by 13
Seasonal changes in HbA1c values from young to elderly diabetic patients
Bando, H., Kato, Y., Yamashita, H., Yada, S., Tokuhara, S., Tokuhara, H., & Mutsuda, T. (2019) · Journal of Diabetes Metabolic Disorders & Control · doi:10.15406/jdmdc.2019.06.00187 · Cited by 11
Martí-Soler, H., Pommier, C., Bochud, M., Guessous, I., Ponte, B., Pruijm, M. T., Ackermann, D., Ogna, V. F., Paccaud, F. M., Burnier, M., et al. (2017) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2017.06.012 · Cited by 14
“A possible explanation lies in the seasonality of cardiovascular risk factors, which 75 present higher levels in winter than in summer [3].”
BackgroundInfluentialSelf-citationCornélissen, G., Gubin, D. G., Beaty, L. A., & Otsuka, K. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17093083 · Cited by 14
“Several risk factors underlying adverse cardiovascular events such as body mass index, blood pressure, low-density lipoprotein (LDL) cholesterol, triglycerides, and glucose concentrations also follow a circannual rhythm [21].”
BackgroundSeasonal Variation in Demand for Smoking Cessation Treatment and Clinical Outcomes
Veldhuizen, S., Zawertailo, L. A., Ivanova, A., Hussain, S., & Selby, P. L. (2020) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntaa214 · Cited by 13
Владимировна, К. Н., Плисс, М. Г., & Tsyrlin, V. A. (2019) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2019-1-80-93 · Cited by 11
Enhörning, S., Melander, O., Engström, G., Elmståhl, S., Lind, L., Nilsson, P. M., Pihlsgård, M., & Timpka, S. (2022) · Journal of Internal Medicine · doi:10.1111/joim.13489 · Cited by 11
Seasonal Variations of Nutritional Status in Maintenance Hemodialysis Patients
Begović, T. I., Radić, J., Radić, M., Kovačić, V., Šain, M., & Ljutić, D. (2016) · Therapeutic Apheresis and Dialysis · doi:10.1111/1744-9987.12405 · Cited by 9
Karamercan, M. A., Dündar, Z. D., Ergın, M., van Meer, O. A., Body, R. M., Harjola, V., Verschuren, F., Christ, M., Golea, A. C., Capsec, J., et al. (2020) · TURKISH JOURNAL OF MEDICAL SCIENCES · doi:10.3906/sag-2002-221 · Cited by 9
Seasonal variation in estimated cardiovascular risk in patients with type 2 diabetes
Ciardullo, S., Muraca, E., Cannistraci, R., Manzoni, G., Perra, S., Bianconi, E., Oltolini, A., Zerbini, F., Grassi, G. M., Mancia, G., et al. (2021) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2021.01.022 · Cited by 9
Basic Aspects of Seasonal Cardiovascular Mortality
Фатиховна, А. Г., & Gorbunov, V. M. (2021) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2021-02-01 · Cited by 8
Васильевна, К. А., Lukyanov, М. М., Khudyakov, M. B., Klyashtorny, V. G., Balanova, Y. А., Калинина, А. М., & Boytsov, S. A. (2015) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2014-11-25-30 · Cited by 8
Alpine Skiing as Winter-Time High-Intensity Training
STÖGGL, T. L., Schwarzl, C., Müller, E. E., Nagasaki, M., Stöggl, J., Schönfelder, M., & Niebauer, J. (2017) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001289 · Cited by 8
The hazard of rounding Cape Horn: is it changing?
Modesti, P. A. (2014) · Heart · doi:10.1136/heartjnl-2014-306160 · Cited by 8
Владимировна, К. Н., Плисс, М. Г., Galagudza, M. M., & Tsyrlin, V. A. (2020) · Advances in Gerontology · doi:10.1134/s2079057020020095 · Cited by 7
Loader, J., Chan, Y., Hawley, J. A., Moholdt, T. T., McDonald, C. F., Jhund, P. S., Petrie, M. C., McMurray, J. J. V., Scuffham, P., Ramchand, J., et al. (2019) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.12.060 · Cited by 7
“Behavioural seasonality has been demonstrated in several studies [27,28],where peaks in alcohol consumption and energy intake (including increases in fat-intake) and troughs in physical activity levels, occur in the cooler months; coinciding with winter peaks in cardiovascular events [20,29,30].”
BackgroundSeasonality as a risk factor for deaths in Parkinson's disease
Fonseca, M. C. M., Sansone, D., Farah, D., FIORINI, A. C., Scorza, C. A., & Scorza, F. A. (2024) · Clinics · doi:10.1016/j.clinsp.2024.100506 · Cited by 7
“[40] In fact, the prevalence of hypertension rises throughout the winter season, [46 − 49] and low temperatures exacerbate hypertension [47,50 − 55] and precipitate cardiovascular events such as stroke, acute myocardial infarction, and heart failure.”
Cold-Induced Hypertension as Life-Environment Disease in Winter: Focus on Data From Japan
Kario, K. (2026) · Hypertension · doi:10.1161/hypertensionaha.125.26518 · Cited by 6
The effect of cold exposure on serum cholesterol is dependent upon ApoE
He, F., Su, W., Wu, R., Li, H., Lou, L., Wu, A., Xie, L., Du, Y., & Wu, S. (2021) · Journal of Thermal Biology · doi:10.1016/j.jtherbio.2021.102972 · Cited by 6
Honda, H., Igaki, M., Komatsu, M., & Tanaka, S. (2021) · Endocrines · doi:10.3390/endocrines2020015 · Cited by 7
“, temperature, sun exposure that induces vitamin D synthesis) [16,17], can induce variations in metabolic and vascular function [17,18].”
BackgroundMétéo et saisons influencent-elles notre cœur ?
Gibelin, P. (2015) · La Presse Médicale · doi:10.1016/j.lpm.2015.07.004 · Cited by 6
Dong, Y., Liu, X., Zhao, Y., Chai, Q., Zhang, H., Gao, Y., & Liu, Z. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.692773 · Cited by 6
Influence of meteorological factors on human health
Mirković, A., & Savić, N. (2022) · Sestrinska vizija · doi:10.5937/sestrviz2210017m · Cited by 6
Gül, M., Batur, A. F., Böcü, K., Kaynar, M., Kılıç, Ö., & Göktaş, S. (2021) · Andrologia · doi:10.1111/and.14019 · Cited by 6
Tang, L., Zhang, J., Xu, Y., Xu, T., Yang, Y., & Wang, J. (2022) · BMC Cardiovascular Disorders · doi:10.1186/s12872-022-02840-1 · Cited by 6
“4 mmHg in the Northern and Southern Hemispheres, with the lowest points occurring in June and January, respectively [28].”
BackgroundTesfa, M., Motbainor, A., & Yenesew, M. A. (2025) · Frontiers in Epidemiology · doi:10.3389/fepid.2024.1498203 · Cited by 5
Is the weekend effect true in acute stroke patients at tertiary stroke center?
Räty, S., Martinez‐Majander, N., Suomalainen, O., Sibolt, G., Tiainen, M., Valkonen, K., Sairanen, T., Forss, N., & Curtze, S. (2021) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2021.117557 · Cited by 5
COVID-19 Pandemic and Cardiovascular Diseases: Lessons and Prospects
Shlyakhto, E. V., Конради, А. О., Каронова, Т. Л., & Федотов, П. А. (2022) · Herald of the Russian Academy of Sciences · doi:10.1134/s1019331622040098 · Cited by 5
Boytsov, S. A., Lukyanov, М. М., Деев, А. Д., Klyashtorny, V. G., Ivanenko, A. V., Volkova, N. S., Kuznetsov, A. S., Skvortsov, A. S., & Solov’yov, D. V. (2016) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2016-6-34-40 · Cited by 5
Virág, K., & Nyári, T. (2018) · Central European Journal of Public Health · doi:10.21101/cejph.a4928 · Cited by 5
Age-dependent seasonality in the incidence of stroke: A 21-year population-based study
Libruder, C., Yaari, R., Fluss, R., Hershkovitz, Y., Ram, A., Tanné, D., Huppert, A., & Zucker, I. (2024) · European Stroke Journal · doi:10.1177/23969873231223031 · Cited by 4
“20,21 This may lead to seasonal variation in the occurrence of events according to age, and thus hold important epidemiological and practical implications to better understand and reduce the burden of stroke.”
BackgroundThe impact of cold weather on older people and the vital role of community nurses
da Silva, T. M. H. R. (2024) · British Journal of Community Nursing · doi:10.12968/bjcn.2024.0003 · Cited by 4
Metadata
- Authors
- Marti-Soler, H., Gubelmann, C., Aeschbacher, S., Alves, L., Bobak, M., Bongard, V., Clays, E., de Gaetano, G., Di Castelnuovo, A., Elosua, R., Ferrieres, J., Guessous, I., Igland, J., Jørgensen, T., Nikitin, Y., O'Doherty, M. G., Palmieri, L., Ramos, R., Simons, J., Sulo, G., Vanuzzo, D., Vila, J., Barros, H., Borglykke, A., Conen, D., De Bacquer, D., Donfrancesco, C., Gaspoz, J.-M., Giampaoli, S., Giles, G. G., Iacoviello, L., Kee, F., Kubinova, R., Malyutina, S., Marrugat, J., Prescott, E., Ruidavets, J. B., Scragg, R., Simons, L. A., Tamosiunas, A., Tell, G. S., Vollenweider, P., & Marques-Vidal, P.
- Affiliations
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
- Institute of Social and Preventive Medicine (CH)
- University Hospital of Basel (CH)
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
- Department of Epidemiology and Public Health, University College London, London, UK
- Inserm (FR)
- Ghent University (BE)
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
- Cardiovascular and Genetic Epidemiology Research Group (ULEC-EGEC), Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM, Barcelona, Spain
- Department of Epidemiology, UMR 1027- INSERM, Toulouse University—CHU Toulouse, Toulouse, France
- University Hospital of Geneva (CH)
- University of Bergen (NO)
- University of Copenhagen (DK)
- Laboratory of Internal Medicine, Institute of Internal Medicine, Siberian Branch RAMS, Novosibirsk, Russia
- UKCRC Centre of Excellence for Public Health, Queens University of Belfast, Belfast, UK
- Istituto Superiore di Sanità (IT)
- Universitat de Girona (ES)
- UNSW Sydney (AU)
- Centro di Prevenzione Cardiovascolare, ASS 4 ‘Medio Friuli’, Udine, Italy
- Hospital del Mar Research Institute (ES)
- Universidade do Porto (PT)
- Capital Region of Denmark (DK)
- Department of Public Health, Ghent University, Ghent, Belgium
- Cancer Council Victoria (AU)
- Istituto Neurologico Mediterraneo (IT)
- Queen's University Belfast (GB)
- Centre for Health Monitoring, National Institute of Public Health, Prague, Czech Republic
- Novosibirsk State Medical University (RU)
- Frederiksberg Hospital (DK)
- University of Auckland (NZ)
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Internal Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland
- Corresponding author
- Marques-Vidal, Pedro
- ORCID
- Gubelmann, Cédric
- Aeschbacher, Stefanie
- Bongard, Vanina
- Clays, Els
- Guessous, Idris
- Igland, Jannicke
- Jørgensen, Torben
- Palmieri, Luigi
- Ramos, Rafel
- Sulo, Gerhard
- Vanuzzo, Diego
- Vila, Joan
- Barros, Henrique
- Donfrancesco, Chiara
- Giles, Graham G
- Iacoviello, Licia
- Kee, Frank
- Malyutina, Sofia
- Marrugat, Jaume
- Prescott, Eva
- Scragg, Robert
- Simons, Leon A
- Tell, Grethe S
- Marques-Vidal, Pedro
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2014-05-30
- Volume
- 100
- Issue
- 19
- Pages
- 1517-1523
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- OpenAlex
- W2140020569
- Cited by
- 151
- References
- 37
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 17 · 2023: 7 · 2022: 18 · 2021: 23 · 2020: 11 · 2019: 15 · 2018: 12 · 2017: 12 · 2016: 12 · 2015: 11 · 2014: 2
- FWCI
- 9.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- IRIS (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Lithuanian University of Health Sciences (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- National Science Foundation (33CSCO-122661)
- John D. and Catherine T. MacArthur Foundation (064947/Z/01/Z)
- Pfizer
- GlaxoSmithKline (3200B0–105993, 33CSCO-122661, 3200B0-118308)
- Velux Stiftung
- Hjerteforeningen
- Universität Basel (PP00P3_133681)
- Sundhed og Sygdom, Det Frie Forskningsråd (396414, 209057)
- Wellcome Trust (064947/Z/01/Z, 081081/Z/06/Z, 209057, 081081, 081081/Z)
- Universitätsspital Basel
- Agence Nationale de la Recherche (396414, 209057)
- Institut National de la Santé et de la Recherche Médicale (209057, 396414)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (122661, 124087, 33CSCO, 118308, 133681, 105993, 3200B0, 139468, 108315, FN 33CSC0-)
- Fonds De La Recherche Scientifique - FNRS (3200B0-105993, 3200B0-118308, 33CSCO-122661)
- Fonds Wetenschappelijk Onderzoek (209057, 396414)
- Ministero della Salute
- Ministero dell’Istruzione, dell’Università e della Ricerca
- Istituto Superiore di Sanità
- Schweizerische Herzstiftung
- China Scholarship Council
- Ministerio de Ciencia e Innovación
- Region Hovedstaden
- Hôpitaux Universitaires de Genève
- Institut de Veille Sanitaire
- Chinese Society of Clinical Oncology
- Canton de Genève
- Vlaamse regering
- Pfizer Foundation
- Forsknings- og Innovationsstyrelsen
- Medical Research Council (MR/K023241/1, 396414, 209057)
- National Health and Medical Research Council (396414, 251533, 209057)
- Cancer Council Victoria (209057, 396414)
- Health Research Council of New Zealand
- Danish Agency for Science and Higher Education
- Fundação para a Ciência e a Tecnologia (PTDC/SAU-ESA/108315/2008)
- Agència de Gestió d'Ajuts Universitaris i de Recerca
- Instituto de Salud Carlos III (RD12/0042)
- European Regional Development Fund (RD12/0042)
- National Institute on Aging (R01AG023522)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- seasonal variation, cardiovascular risk factors, body mass index, waist circumference, blood pressure, lipoprotein cholesterol, triglycerides, blood glucose, hemispheric differences, cardiovascular mortality
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Pressure, Cardiovascular Diseases, Cold Temperature, Cross-Sectional Studies, Data Interpretation, Statistical, Europe, Female, Humans, Lipids, Male, Middle Aged, Mortality, New Zealand, Risk Factors, Seasons, Triglycerides, Body Mass Index, Risk Assessment
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