Seasonal variation in coronary artery disease mortality in Hawaii: observational study

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Abstract
Hawaii consists of six main islands, with a population of 1.1 million.4 We obtained monthly rates of deaths from coronary artery disease (ICD-9 410-414) as recorded on death certificates during 1984-93 from the state of Hawaii. All non-residents of Hawaii were excluded. Because the likelihood of a diagnosis of a respiratory infection might vary by season, we used mortality from respiratory infection (ICD-9 480-487) as a proxy for incidence of respiratory infection. We used the average 24 hour temperature and hours of sunlight in Honolulu for each year as an estimate for the entire state.