Associations of long-term exposure to temperature with coronary artery calcification risk among middle-aged adults: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Background: The impact of ambient temperature on population health has drawn increasing attention as climate change drives more extreme temperatures globally. However, little research has investigated its connection to subclinical cardiovascular diseases. This study aims to examine the impact of long-term exposure to temperature on coronary artery calcification (CAC) among middle-aged Black and White adults in four U.S. areas with varying climate and weather conditions. Methods: This study compiled long-term environmental temperature data and individual coronary artery Agatston score (0 vs. >0) from the Coronary Artery Risk Development in Young Adults study. It employed logistic regression and examined the influences of multiple temperature metrics, including average temperature and variation in the summer, winter, or during the year. Subgroup analyses by sex and race were also conducted. Results: Increased average temperatures were associated with lower odds in the presence of CAC (winter average: odds ratio, 0.988 [95 % CI, 0.979–0.998]; yearly average: 0.981 [0.964–0.999]), and yearly variation in temperatures was positively related to individuals' CAC risk (1.031 [1.005–1.057]). With statistical adjustment, female participants' CAC risk was significantly related to winter and yearly average temperatures (0.964 [0.932–0.998] and 0.943 [0.891–0.999], respectively), and White participants' CAC risk would increase with greater annual temperature variations (1.181 [1.023–1.363]). Conclusions: This study appears to be the first to examine the impact of long-term exposure to ambient temperature on subclinical cardiovascular diseases. Increased risks of CAC are linked to decreased average winter/yearly temperatures among females and greater yearly temperature variations among White adults.