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This study suggests that heat-related illness has significant long-term impacts on future cardiovascular disease (CVD) incidence, which can be mitigated by heatwave warnings. Global warming is intensifying, exacerbating associated health issues. Heat-related illness, a critical risk during heatwaves, significantly impacts public health, yet its long-term health effects remain poorly understood. A cohort was established to investigate these health impacts and explore the mitigative role of heatwave warnings.

Among 9,658,745 participants followed up to 6 years, 238,278 (2.47%) developed cardiovascular disease (CVD). People who developed CVD were generally older, male, with a higher degree of education, and with more hospital admissions before baseline. Heat-related illness was associated with CVD, with a hazard ratio of CVD 2.526 (95% CI = 2.301-2.773) among patients with heat-related illness compared with those without heat-related illness, and instrumental variable approach analysis suggested causation. Issuing heatwave warnings reduced hospital admissions for heat-related illness (OR [95% CI] = 0.902 [0.832-0.977]) and future CVD risk (OR [95% CI] = 0.964 [0.946-0.982]). The mitigative role of heatwave warnings suggested delayed effect, with mitigative effect at greatest magnitude one to two days after issuance for heat-related illness admission and three to four days for CVD.