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Born in winter or spring more susceptible to all-cause and cardiovascular disease death in rural areas of China: results from a 11.9-year follow-up study

Journal of Human Hypertension volume 35, pages 1170–1179 (2021)Cite this article

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Abstract

There has been no evidence on the effects of birth season and birth month on mortality in China. We aimed to explore the association between birth season, birth month and all-cause and cardiovascular disease (CVD) death. A population-based sample of 21,338 Chinese rural participants aged ≥35 years at baseline was included in our analysis. Age and multivariable adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the relationship between astronomical birth season (autumn as the reference), birth month (November as the reference), and all-cause and CVD mortality. During a median follow-up period of 11.9 years, 2,207 people died from all-cause and 1,214 people were attributed to CVD death. In multivariable adjusted analyses, for all-cause death, spring and winter had HRs (95% CIs) of 1.134 (1.005–1.280) and 1.162 (1.038–1.301), respectively; January, March, May, and August had HRs (95% CIs) of 1.249 (1.027–1.518), 1.234 (1.008–1.512), 1.276 (1.037–1.571), and 1.232 (1.003–1.513), respectively. For CVD death, spring and winter with HRs (95% CIs) of mortality were 1.232 (1.048–1.449) and 1.174 (1.007–1.369), respectively; March with HR (95% CI) of mortality were 1.343 (1.030–1.750) (all P < 0.05). Our study indicated that people born in the winter or spring were significantly associated with all-cause and cardiovascular disease mortality in rural areas of China.

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Fig. 1
Fig. 2: The event rates of all-cause death and cardiovascular disease death by seasons.
Fig. 3: The event rates of all-cause death and cardiovascular disease death by months.

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Acknowledgements

All of the investigators and staff members were gratefully acknowledged. Thanks for all the enthusiastic participants.

Funding

This research was supported by funds from National Key R&D Program of China [Grant#2018YFC1311600], Xingliao Talents Program of Liaoning Province [Grant #XLYC1808036], National Nature Science Foundation of China [No. 81773510], National Key R&D Program of China [Grant #2017YFC1307600], and 345 Talent Project of Shengjing Hospital.

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  1. These authors contributed equally: Zihui Gao, Sitong Liu

Authors and Affiliations

  1. Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, 110004, PR China

    Zihui Gao, Sitong Liu, Yue Dai, Rongrong Guo, Yali Wang & Liqiang Zheng

  2. Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, PR China

    Zhaoqing Sun & Yingxian Sun

  3. Institute of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110005, PR China

    Liying Xing

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  1. Zihui Gao
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Contributions

ZG: Conceptualization; Writing—original draft. SL: Methodology; Validation. YD: Formal analysis. RG: Investigation. YW: Data curation. ZS: Supervision; Resources. LX: Investigation; Resources. YS: Project administration. LZ: Conceptualization; Writing—review and editing.

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Correspondence to Yingxian Sun or Liqiang Zheng.

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Gao, Z., Liu, S., Dai, Y. et al. Born in winter or spring more susceptible to all-cause and cardiovascular disease death in rural areas of China: results from a 11.9-year follow-up study. J Hum Hypertens 35, 1170–1179 (2021). https://doi.org/10.1038/s41371-020-00432-0

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