Extreme heat, dehydration and vasodilation can ruin the heart: heart patients and those who take antihypertensives are at risk


Extreme heat, dehydration and vasodilation can ruin the heart: heart patients and those who take antihypertensives are at risk
Written by aquitodovale

Climate change, with the increase of extreme events, undoubtedly involves changes in our habits. And it also carries serious risks for the health of the weakest. The extreme heat in particular, as well as its effects on the cardiovascular system have been studied by various authors in different countries. In the latest issue of the prestigious American journal Circulation, Sameed Khatana and his collaborators from the Perelman School of Medicine at Pennsylvania University in Philadelphia analyzed the relationship between high temperatures (in the months from May to September) and cardiovascular mortality over the ten years in over 3,000 US counties.

Redundancy fund, INPS and Inail: “Yes if you exceed 35 degrees, even perceived”. Sectors and categories involved

Extreme heat refers to daily temperatures significantly higher than normal: they could not be below 32.2 degrees centigrade. The cardiovascular accidents of the population were analyzed, starting from 20 years of age, in the hottest periods compared to the same heart problems that may be present in the other periods of the year.

In the ten years there have been about three million deaths, about 50% women. Over 80% in older patients. The mean monthly cardiovascular mortality over the 10 years of the study was between 22 and 26 people per 100,000 inhabitants. Men were affected much more than women and the elderly, like all frail subjects, more than others.
The heat did more damage to the population of metropolitan areas than to rural areas. Each additional day of extreme heat was associated with an increase in monthly mortality between 0.12% and 0.19% and mainly concerned the cardiovascular system, while the neurovascular system (stroke or hemorrhage) did not change.

The last interesting detail was that the high temperature changes were more affected by the inhabitants of the less hot regions of the United States, as if those of the warmer regions had become accustomed to high temperatures and were therefore less vulnerable to the effects of the same.
What are the biological mechanisms underlying the damage of high temperatures? Multiple. An increase in cardiac work due to increased frequency and contractility, as well as a greater expression of inflammatory mediators that can increase the risk of thrombosis. Excessive sweating that leads to dehydration could also contribute to this, especially in the elderly who feel less thirsty and may not drink enough to compensate for losses.

And again the vasodilation caused by the heat, which reduces the pressure and in this can be favored by some drugs such as antianginal drugs, diuretics or hypotensives. And finally, the imbalance of mineral salts given by dehydration which can cause arrhythmias that are also life-threatening.
Hence the importance for heart patients, including hypertensive ones, to protect themselves with great attention in this period of great heat.

* Professor of Cardiology
Catholic University of Rome



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