Objective To quantitatively estimate the number of cardiovascular disease mortality related with non-optimal temperature in seven geographic regions of China.

Methods Based on the data of temperature exposure and deaths in 180 districts and counties of China from 2013 to 2018, the exposure-response curves for temperature and cardiovascular disease mortality were fitted by a time series method in each geographic region, and then the numbers of excess deaths due to cardiovascular diseases related with non-optimal-, cold-, and heat-temperature were estimated in China in 2015 and 2020.

Results There were 396 thousand (29/100 000) and 425 thousand excess deaths (30/100 000) due to cardiovascular diseases related to non-optimal temperature exposure, which were mainly attributed to cold temperature (76.5%and 62.8%) in 2015 and 2020, respectively. Compared with 2015, the number of excess deaths of cardiovascular diseases related to non-optimal temperature exposure in China increased by 7.3%in 2020, of which the number of heat-related excess cardiovascular disease deaths increased by 70.0%, while the number of cold-related excess cardiovascular disease deaths decreased by 11.9%.Among the seven geographic regions, Eastern China had the highest number of excess cardiovascular disease deaths related to non-optimal temperature.

Conclusion Non-optimal temperature seriously threatened the health of the population with cardiovascular diseases from 2015 to 2020 in China, which showed an increasing trend in the number of excess deaths. With the aggravation of climate change in the future, it is necessary to take corresponding policies for population protection in each region based on the differences in climate and demographic features across regions.