Multimorbid heart failure (HF) and cardiorenal metabolic (CaReMe) syndrome, exploring integrated models of care: A scoping review.

Against the backdrop of the accelerated transformation of the climate system, the frequency, intensity, and duration of extreme weather events are all on the rise, and human health is exposed to unprecedented environmental pressure. In 2024, the global average temperature exceeded the pre-industrial level by 1.55 °C, surpassing the 1.5 °C temperature control target set by the Paris Agreement for the first time. Extreme climate change has a huge impact on health. In China alone, the number of heat-related deaths in 2024 will be 1.7 times the average annual level of the base period (1986–2005). The per capita loss of heat-related labor productivity, safe outdoor exercise time, and sleep will increase by 49.1, 85, and 14.9%, respectively, further intensifying the economic pressure on the country (). Facing the severe challenge of climate health risks, the international community has moved from consensus to action. In 2025, the 78th World Health Assembly adopted the Global Plan of Action on Climate Change and Health, providing a specific roadmap for countries to incorporate health issues into their national climate commitments and promoting the implementation of policies that view the climate crisis as a health crisis. In China, climate health governance has been incorporated into the national strategic framework, which explicitly requires the development of meteorological health impact forecast and risk early warning models for the population, and provides refined risk warning services by region, season and population to the general public, medical institutions and older population care institutions. Meanwhile, the urbanization process has brought about economic development and social progress, but it has also been accompanied by a series of PH challenges, such as air pollution, the heat island effect, noise exposure, increased psychological stress, and insufficient physical activity (). In this context, a fundamental scientific question remains unanswered: Does the impact of climate risk (CR) on public health (PH) take on some complex non-linear form? Is this nonlinear relationship regulated by different social factors? This not only concerns the scientific assessment of climate health risks, but also directly determines the proactive response strategies of PH resources under different social factors. The risks related to climate change are huge, threatening the livelihoods and even life safety of countless people, but some of its economic consequences are still immeasurable at present (). CR caused by climate change refers to the direct damage to economic and social activities and the human living environment; they are caused by hurricanes, droughts, floods, heat waves and physical events directly related to climate warming (). Unlike the traditional single perspective on meteorological disasters, modern climatic physical risks cover multiple dimensions such as extreme temperatures, extreme precipitation, drought and wind speed, and have a systemic impact on PH through multiple paths. In China, at the level of high-temperature related risks, for every 1 °C increase in environmental temperature, the risk of injury increases by 1.2%. Among them, men, children aged 0–4, agricultural workers and animal injury categories are particularly sensitive to temperature changes (). Conversely, sudden drops in temperature and prolonged low temperatures can cause blood vessels to constrict, blood pressure to rise, and heart rate to accelerate, which can easily lead to cardiovascular and cerebrovascular diseases such as myocardial infarction and stroke. Alarmingly, the compounding of extreme weather events exacerbates health risks. For instance, compound diurnal heatwaves and combined hot-dry events are associated with higher mortality risks than isolated extreme climate events (, ).