2023-07-10 12:32:04
Health This is the profile of the victims of the heat wave:
Excess heat alters the thermoregulation systems and some pathologies are exacerbated. Blood pressure, heart, stomach, and brain are most at risk.
Illnesses that worsen with heat
Excess heat is dangerous for all patients with a pathology that alters thermoregulation systems or considerably increases the general fragility of the body. Who are they obese o excessively thin, for example, do not adapt well to high temperatures; people with severe chronic obstructive pulmonary disease may be much more susceptible to excessive heat.
People with cardiovascular disease are also at high risk. The heart and blood vessels are put to the test by the heat and those who have already had heart attacks or strokePeople, suffer from arrhythmias or heart failure or have risk factors such as high cholesterol may find it more difficult to tolerate high temperatures.
Hypertensive and heart patients, especially if they are elderly, are more sensitive to the negative effects of heat and, for example, may experience sudden drops in blood pressure, especially when going from a lying down to an upright position, the so-called ‘ orthostatic hypotension.
Those who suffer diabetes, Alzheimer, Parkinson or other neurological pathologies that alter the brain’s response to dehydration are also at higher risk, as they may have difficulty perceiving the sensation of thirst and therefore may experience dehydration more frequently.
Severe kidney failure increases the hazards from heat because it exposes you to greater pressure changes. It is important check your blood pressure and weight frequentlyinforming your doctor in case of excessive weight loss or significant drops in blood pressure.
Psychiatric pathologies are just as dangerous, because the patient may have a lower degree of awareness of the risk and therefore assume inappropriate behaviors; In addition, psychiatric patients often regularly use drugs that can aggravate the effects of heat.
Medications that may have side effects from heat
whatever i take more than 4 types of medications a day You may be at higher risk, as the mechanism of action of some medicines may be enhanced by heat or promote heat illness. Therefore, it is necessary to pay attention to drugs that lower blood pressure, such as all antihypertensives or antianginal drugs; those that promote diuresis such as diuretics; those who may experience vomiting/diarrhea as a side effect (for example some antibiotics or colchicine); medicines that can affect kidney function, such as sulfonamide antibiotics, cyclosporine and all non-steroidal anti-inflammatory drugs (such as ibuprofen, nimesulide, ketoprofen, etc.), including salicylates.
Caution is also necessary if drugs that alter alertness as they could increase the dangers by modifying behaviour, or drugs with potential effects on dehydration (for example, antiepileptics, lithium salts, biguanides and statins).
These are just a few examples of medicines that can increase the danger for a patient who is exposed to heat: if you are undergoing therapy and have questions about it, you should consult your doctor. However, ongoing treatments should never be suspended independentlyIt is always necessary to consult a doctor if there is any contraindication with heat and, where appropriate, adapt the treatment; In addition, not all medications can have effects that can be easily correlated with heat, so it is good to report any discomfort, even minor, that arises during treatment.
Finally, in summer, even the storage of medicines becomes more problematic. They must be kept away from sources of heat and direct sunlight, placing in the refrigerator those that must always and necessarily remain below 25C, unless otherwise indicated.
What happens to blood pressure?
The main consequence of heat on the cardiovascular system is precisely the reduction in pressure, which drops because the blood vessels dilate to better dissipate heat and reduce internal temperature; this increases the risk of sncopeespecially in those who are more frail, who are treated with antihypertensive drugs or who, under normal conditions, have low blood pressure.
The risk of syncope in case of dehydration is high, especially during transition from lying to standing position: if you have to get out of bed, especially at night, never do it quickly, but stop at intermediate positions (for example, sit on the edge of the bed for a few minutes) before standing up.
What risks does the heart run?
The drop in blood pressure increases the rate and contractility of the heart, which pumps to keep blood pressure at normal levels. The acceleration can be tolerated relatively well by healthy people, but it can become too much if you have a high cardiovascular risk and, for example, you have a heart that has already suffered a heart attack, if high cholesterol “clogs” the vessels and therefore makes the blood resistant or even if you take drugs that slow down the heart rate, such as beta-blockers .
Therefore, it is not only the extreme cold that hurts the heart, the heat is also dangerous. In addition, dehydration caused by heat increases the probability of blood clots forming that occlude arteries, causing heart attacks and strokes, the mortality of which increases by 16% and 21% respectively during heat waves.
What to do if you are hypertensive?
Those who have high blood pressure and are being treated with antihypertensives they should re-evaluate the situation with their doctor, as it may be necessary to adjust the treatment a little by reducing the drug load or changing their dosage and/or type, since heat increases their effect.
Those with low blood pressure should be even more careful, because a further drop could cause syncope. Also, in summer, it is a good idea to check your blood pressure more often than usual to make sure it doesn’t drop too low.
What to do if you are diabetic?
People with diabetes are at increased risk of cardiovascular events related to the summer heat. The high blood sugarFor example, it increases fluid loss through urine and favors dehydration, as do some antidiabetic medications (such as SGLT-2 inhibitors), for which it is essential in these patients to drink plenty and even if they are not excessively thirsty. .
You have to control your blood glucose a little more because the hypoglycemic crisis They are more frequent in patients on insulin therapy, due, for example, to the fact that they move more, have longer intervals between meals, time changes and carbohydrate distribution. It is therefore necessary to adapt therapy to the change in summer lifestyle and pay attention to signs of low blood sugar, such as sweating more profusely than necessary.
Blood glucose measurements can be distorted by heat: sensors applied with the ‘patch’ on the skin may come off more easily and test strips may be less accurate if not stored properly away from sun and heat.
It is better never to walk barefoot, because even the slightest skin lesions due to the heat that could be derived from it (for example, those that can be obtained by walking on hot sand) can be complicated in diabetics.
Finally, patients with peripheral neuropathy are more susceptible to heat and sun damage because they sweat less efficiently and because they feel less pain, so they may burn more easily.
What risks does the respiratory system run?
The lack of water makes the secretions of the respiratory tract less fluid: therefore, they stagnate in the bronchi, favoring respiratory diseases (including bronchopneumonia) and causing relapses in those who suffer from diseases such as chronic bronchitis or emphysema.
In patients with chronic obstructive pulmonary disease, heat worsens symptoms, leads to increased use of drugs, and reduced lung function. During heat waves, mortality increases by 22.5% in those with chronic obstructive pulmonary disease and by 36% for other respiratory diseases in general.
The dyspnoea (ie, shortness of breath) and asthmatic episodes can also occur when you suddenly move from an air-conditioned environment to the heat outside, especially if it is very humid.
Finally, in summer the amount of ozone in the air, a gas that is formed precisely by the reaction between sunlight and the oxides of gases from traffic exhaust pipes and that greatly irritates the respiratory tract, especially in those who already suffer from respiratory diseases. like ‘asthma.
What are the risks to the kidneys?
Greater dehydration due to heat and sweating causes a greater concentration of urine (which acquires a darker color) and therefore an increase in the probability that the salts present will precipitate in the urine itself, forming stones and giving rise to urinary tracts. painful cramps.
Those with impaired kidney function are also at risk because peripheral vasodilatation and consequent drop in pressure reduce kidney filtration: translated, the kidney has more difficulty filtering the blood and may suffer acute kidney failure.
Therefore, more careful control of the funcin renalwith more frequent blood tests, but above all it is important to drink to compensate for the disorders.
According to the criteria of The Trust Project
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