Editing IPCC:AR6/WGII/Chapter-7 (section)

==== 7.3.1.7 Future Risks Related to Cardiovascular Diseases ====

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''Climate change is expected to increase heat-related CVD mortality by the end of the 21st century, particularly under higher emission scenarios'' ( ''high confidence'' ) ''.'' Most modelling studies conducted since AR5 project higher rates of heat-related CVD mortality throughout the remainder of this century (Huang and et al., 2018; [[#Li--2015|Li et al., 2015]] ; [[#Li--2018|Li et al., 2018]] ; [[#Limaye--2018|Limaye et al., 2018]] ; [[#Zhang--2018a|Zhang et al., 2018a]] ; [[#Silveira--2021a|Silveira et al., 2021a]] ; [[#Yang--2021|Yang et al., 2021]] ). CVD mortality in Beijing, China, could increase by an average of 18.4%, 47.8% and 69.0% in the 2020s, 2050s and 2080s, respectively, under RCP4.5 and by 16.6%, 73.8% and 134%, respectively, under RCP8.5 relative to a 1980s baseline ( [[#Li--2015|Li et al., 2015]] ). Projections of temperature-related mortality from CVD for Beijing in the 2080s vary depending on RCP and population assumptions ( [[#Zhang--2018a|Zhang et al., 2018a]] ). Projections for Ningo, China, suggest heat-related years of life lost (YLL) could increase significantly in the month of August by between 3 and 11.5 times over current baselines by the 2070s, even with adaptation (Huang and et al., 2018). Yang and colleagues project that heat-related excess CVD mortality in China could increase to approximately 6% (from a 2010 baseline of under 2%) by the end of the century under RCP8.5 and to over 3% under RCP4.5 ( [[#Yang--2021|Yang et al., 2021]] ). The future burden of temperature-related myocardial infarctions in Germany is projected to rise under high emissions scenarios ( [[#Chen--2019|Chen et al., 2019]] ), while in the eastern USA, [[#Limaye--2018|Limaye et al. (2018)]] projected an additional 11,562 annual deaths (95% CI: 2,641–20,095) by mid-century due to cardiovascular stress in the population 65 years of age and above. CVD mortality in Brazil is projected to increase up to 8.6% by the end of the century under RCP8.5, compared with an increase of 0.7% for RCP4.5 ( [[#Silveira--2021a|Silveira et al., 2021a]] ).

It is important to note that the assessed studies typically take an observed epidemiological relationship and apply future temperature projections (often derived from regional climate projections) to these relationships. Because the relationships between temperature and CVD deaths are influenced by both climatic and non-climatic factors (such as population fitness and aging), future projections are highly sensitive to assumptions about interactions between climate, population characteristics and adaptation pathways. Changes in air quality because of climate change are an additional important factor. For example, an assessment of future annual and seasonal excess mortality from short-term exposure to higher levels of ambient ozone in Chinese cities under RCP8.5 projected approximately 1,500 excess annual CVD deaths in 2050 ( [[#Chen--2018|Chen et al., 2018]] ). To the extent possible, the relationships reported above reflect changes derived from changes in heat exposure driven by climate change and not changes in population demographics or air pollution exposure.

Climate change could impact CVD through other pathways, including exposure to fine dust. For example, adult mortality attributable to fine dust exposure in the American southwest could increase by 750 deaths yr –1 (a 130% increase over baseline) by the end of the century under RCP8.5 ( [[#Achakulwisut--2018|Achakulwisut et al., 2018]] ).

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