University of Leicester
Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study..pdf (1.35 MB)
Download file

Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study

Download (1.35 MB)
journal contribution
posted on 2016-04-08, 10:17 authored by D. Zheng, H. Arima, S. Sato, A. Gasparrini, E. Heeley, C. Delcourt, S. Lo, Y. Huang, J. Wang, C. Stapf, Thompson Gordon Robinson, P. Lavados, J. Chalmers, C. S. Anderson, INTERACT2 investigators
BACKGROUND: Rates of acute intracerebral hemorrhage (ICH) increase in winter months but the magnitude of risk is unknown. We aimed to quantify the association of ambient temperature with the risk of ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2) participants on an hourly timescale. METHODS: INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of patients with spontaneous ICH (<6h of onset) and elevated systolic blood pressure (SBP, 150-220 mmHg) assigned to intensive (target SBP <140 mmHg) or guideline-recommended (SBP <180 mmHg) BP treatment. We linked individual level hourly temperature to baseline data of 1997 participants, and performed case-crossover analyses using a distributed lag non-linear model with 24h lag period to assess the association of ambient temperature and risk of ICH. Results were presented as overall cumulative odds ratios (ORs) and 95% CI. RESULTS: Low ambient temperature (≤10°C) was associated with increased risks of ICH: overall cumulative OR was 1.37 (0.99-1.91) for 10°C, 1.92 (1.31-2.81) for 0°C, 3.13 (1.89-5.19) for -10°C, and 5.76 (2.30-14.42) for -20°C, as compared with a reference temperature of 20°C.There was no clear relation of low temperature beyond three hours after exposure. Results were consistent in sensitivity analyses. CONCLUSIONS: Exposure to low ambient temperature within several hours increases the risk of ICH. TRIAL REGISTRATION: NCT00716079.



PLoS One, 2016, 11 (2), e0149040

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences


  • VoR (Version of Record)

Published in

PLoS One


Public Library of Science



Acceptance date


Copyright date


Available date


Publisher version