Diurnal temperature range, daily mean temperature, and incident cardiovascular disease in older adults: A longitudinal cohort study

doi:10.4330/wjc.125761

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World Journal of Cardiology

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1949-8462

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Cardiol. Oct 26, 2026; 18(10): 125761
Published online Oct 26, 2026. doi: 10.4330/wjc.125761

Table 1 Baseline characteristics of participants according to incident cardiovascular disease status, n (%)

Variable	Overall, n = 4333	No incident CVD, n = 3351	Incident CVD, n = 982
Age, mean (SD)	67.41 (6.35)	67.40 (6.46)	67.43 (5.97)
Sex
Male	2178 (50.3)	1752 (52.3)	426 (43.4)
Female	2155 (49.7)	1599 (47.7)	556 (56.6)
Education
Below upper secondary	4093 (94.5)	3178 (94.8)	915 (93.2)
Upper secondary or above	240 (5.5)	173 (5.2)	67 (6.8)
Marital status
Partnered	3464 (79.9)	2682 (80.0)	782 (79.6)
Not partnered	869 (20.1)	669 (20.0)	200 (20.4)
Smoking
Yes	1822 (42.0)	1447 (43.2)	375 (38.2)
No	2511 (58.0)	1904 (56.8)	607 (61.8)
Drinking
Yes	1768 (40.9)	1383 (41.3)	385 (39.3)
No	2559 (59.1)	1964 (58.7)	595 (60.7)
Wealth quartile
Q1	761 (24.2)	565 (23.5)	196 (26.6)
Q2	839 (26.7)	659 (27.4)	180 (24.5)
Q3	803 (25.5)	609 (25.3)	194 (26.4)
Q4	740 (23.5)	574 (23.8)	166 (22.6)
Dyslipidemia
Yes	308 (7.2)	184 (5.6)	124 (12.8)
No	3957 (92.8)	3114 (94.4)	843 (87.2)
Diabetes
Yes	239 (5.5)	162 (4.9)	77 (7.9)
No	4070 (94.5)	3168 (95.1)	902 (92.1)
Hypertension
Yes	1170 (27.1)	787 (23.6)	383 (39.1)
No	3145 (72.9)	2549 (76.4)	596 (60.9)
BMI, mean (SD)	22.68 (3.78)	22.49 (3.70)	23.36 (3.97)
PM_2.5, mean (SD)	59.70 (18.81)	58.82 (18.62)	62.71 (19.15)
mDMT, mean (SD)	15.09 (4.83)	15.44 (4.72)	13.88 (4.99)
mDTR, mean (SD)	13.75 (3.94)	13.60 (3.88)	14.28 (4.07)

Continuous variables are presented as mean (SD) and compared between groups using Student’s t test or the Wilcoxon rank-sum test, as appropriate. Categorical variables are presented as n (%) and compared using Pearson’s χ² test. The number of participants may be less than 4333 for variables with missing data. Wealth was handled using multiple imputation in subsequent analyses, whereas missing drinking status was not imputed. Dyslipidemia, diabetes, and hypertension were not included as covariates in the multivariable models and were not imputed. SD: Standard deviation; BMI: Body mass index; CVD: Cardiovascular disease; mDTR: Mean diurnal temperature range; mDMT: Mean daily mean temperature; PM_2.5: Fine particulate matter with an aerodynamic diameter ≤ 2.5 μm.

Full Size Table

Table 2 Cox regression models for the association of mean diurnal temperature range and mean daily mean temperature with incident cardiovascular disease risk

Exposure	Model 1		Model 2		Model 3		Model 4
Exposure	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
mDTR (per 1 SD)	1.04 (1.03, 1.06)	< 0.001	1.04 (1.03, 1.06)	< 0.001	1.05 (1.03, 1.06)	< 0.001	1.06 (1.05, 1.08)	< 0.001
mDTR quartiles
Q1	Ref		Ref		Ref
Q2	1.51 (1.25, 1.83)	< 0.001	1.52 (1.26, 1.84)	< 0.001	1.51 (1.24, 1.83)	< 0.001	1.30 (1.06, 1.58)	0.011
Q3	1.92 (1.60, 2.32)	< 0.001	1.93 (1.60, 2.33)	< 0.001	1.94 (1.61, 2.35)	< 0.001	1.90 (1.58, 2.30)	< 0.001
Q4	1.81 (1.49, 2.19)	< 0.001	1.83 (1.51, 2.21)	< 0.001	1.88 (1.55, 2.28)	< 0.001	2.02 (1.67, 2.46)	< 0.001
P for trend		< 0.001		< 0.001		< 0.001		< 0.001
mDMT (per 1 SD)	0.94 (0.93, 0.95)	< 0.001	0.94 (0.93, 0.95)	< 0.001	0.94 (0.93, 0.96)	< 0.001	0.94 (0.93, 0.95)	< 0.001
mDMT quartiles
Q1	Ref		Ref		Ref		Ref
Q2	0.77 (0.66, 0.90)	0.001	0.76 (0.65, 0.89)	< 0.001	0.77 (0.65, 0.90)	0.001	0.69 (0.58, 0.82)	< 0.001
Q3	0.61 (0.51, 0.72)	< 0.001	0.60 (0.51, 0.72)	< 0.001	0.61 (0.51, 0.73)	< 0.001	0.60 (0.51, 0.72)	< 0.001
Q4	0.40 (0.33, 0.48)	< 0.001	0.39 (0.32, 0.47)	< 0.001	0.41 (0.34, 0.49)	< 0.001	0.44 (0.36, 0.53)	< 0.001
P for trend		< 0.001		< 0.001		< 0.001		< 0.001

Model 1: Crude model.

Model 2: Adjusted for age and sex.

Model 3: Adjusted for age, sex, education, wealth, residence, marital status, smoking, drinking, and body mass index.

Model 4: Adjusted for age, sex, education, wealth, residence, marital status, smoking, drinking, body mass index, and fine particulate matter with an aerodynamic diameter ≤ 2.5 μm.

Continuous analyses were scaled per 1 SD increase.

SD: Standard deviation; mDTR: Mean diurnal temperature range; mDMT: Mean daily mean temperature; HR: Hazard ratio.

Full Size Table

Citation: Yang TY, Zhang YH, Sun QY, Wang YR, Wang KJ. Diurnal temperature range, daily mean temperature, and incident cardiovascular disease in older adults: A longitudinal cohort study. World J Cardiol 2026; 18(10): 125761
URL: https://www.wjgnet.com/1949-8462/full/v18/i10/125761.htm
DOI: https://dx.doi.org/10.4330/wjc.125761

Yang TY, Zhang YH, Sun QY, Wang YR, Wang KJ. Diurnal temperature range, daily mean temperature, and incident cardiovascular disease in older adults: A longitudinal cohort study. World J Cardiol 2026; 18(10): 125761 [DOI: 10.4330/wjc.125761]

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