University of Oulu

Ryti, N. R. I. et al. Cold spells and ischaemic sudden cardiac death: effect modification by prior diagnosis of ischaemic heart disease and cardioprotective medication. Sci. Rep. 7, 41060; doi: 10.1038/srep41060 (2017).

Cold spells and ischaemic sudden cardiac death : effect modification by prior diagnosis of ischaemic heart disease and cardioprotective medication

Saved in:
Author: Ryti, Niilo R. I.1,2; Mäkikyrö, Elina M. S.1,2; Antikainen, Harri3;
Organizations: 1Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Department of Geography, University of Oulu, Oulu, Finland
4Division of Cardiology, Department of Internal Medicine, University of Oulu, Finland
5Department of Forensic Medicine, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: Springer Nature, 2017
Publish Date: 2017-03-31


Sudden cardiac death (SCD) is the leading cause of death. The current paradigm in SCD requires the presence of an abnormal myocardial substrate and an internal or external transient factor that triggers cardiac arrest. Based on prior mechanistic evidence, we hypothesized that an unusually cold weather event (a cold spell) could act as an external factor triggering SCD. We tested potential effect modification of prior diagnoses and select pharmacological agents disrupting pathological pathways between cold exposure and death. The home coordinates of 2572 autopsy-verified cases of ischaemic SCD aged ≥35 in the Province of Oulu, Finland, were linked to 51 years of home-specific weather data. Based on conditional logistic regression, an increased risk of ischaemic SCD associated with a cold spell preceding death (OR 1.49; 95% CI: 1.06–2.09). Cases without a prior diagnosis of ischaemic heart disease seemed more susceptible to the effects of cold spells (OR 1.70; 95% CI: 1.13–2.56) than cases who had been diagnosed during lifetime (OR 1.14; 95% CI: 0.61–2.10). The use of aspirin, β-blockers, and/or nitrates, independently and in combinations decreased the risk of ischaemic SCD during cold spells. The findings open up new lines of research in mitigating the adverse health effects of weather.

see all

Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 7
Article number: 41060
DOI: 10.1038/srep41060
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This work was funded by Research Council for Health, Academy of Finland [266314 and 267435], University of Oulu Strategic Funding for CERH, Finnish Medical Foundation, Emil Aaltonen Foundation, Sigrid Juselius Foundation, and Foundation for Cardiovascular Disease.
Academy of Finland Grant Number: 266314
Detailed Information: 266314 (Academy of Finland Funding decision)
267435 (Academy of Finland Funding decision)
Copyright information: © The Author(s) 2017. This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit