Background/Aims
Rising ambient temperatures associated with climate change may influence cardiovascular risk through effects on chronic disease control. Poor control of diabetes mellitus, hypertension, and obesity are major modifiable risk factors for stroke. However, population-level evidence linking temperature, metabolic risk factor control, and stroke burden remains limited in many middle-income countries. This study examined the association between ambient temperature and control of major metabolic risk factors across provinces in Thailand and described geographic variation in stroke incidence.
Methods
This ecological study used provincial-level data from 77 provinces in Thailand between 2022 and 2025. Mean annual temperature data were derived from the ERA5 dataset. Provincial indicators of diabetes, hypertension, and obesity control were obtained from national health databases. Stroke incidence data from 2023 to 2024 were analysed descriptively and expressed per 100,000 population. Generalised linear models assessed associations between temperature and metabolic risk factor control, adjusting for fiscal year and geographic region.
Results
Higher mean annual temperature (per 1°C increase) was associated with lower diabetes control rates (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.94–0.98) and lower obesity control rates (OR 0.88, 95% CI 0.84–0.92). Higher temperature was associated with slightly higher hypertension control rates (OR 1.04, 95% CI 1.01–1.07). Geographic variation in stroke incidence was observed across Thailand, with a mean incidence of 187.9 per 100,000 population.
Conclusion
Ambient temperature may influence cardiovascular risk through its impact on metabolic risk factor control. Regional disparities in stroke incidence highlight the need for climate-sensitive prevention strategies.