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Extreme heat: adjust dose of blood pressure medication and drinking amount


Summer temperatures: adjusting the dose of blood pressure medication
Summer temperatures can be a challenge, especially for people who are being treated for heart or blood pressure problems. The heart has to work harder in the heat to cool the body. These patients should therefore have their medication dosage checked by a doctor.

Heat demands a lot from cardiac patients
The current summer temperatures do not bring joy to everyone. The heat is particularly demanding for patients with high blood pressure and other cardiovascular diseases. Possible consequences of the high temperatures are fatigue and dizziness, as well as a drop in blood pressure and even a circulatory collapse, as well as cardiac arrhythmias or muscle cramps. Experts therefore recommend that those affected have their medication dosage checked.

Have the medication dosage checked regularly
Cardiac patients must take medication in most cases. For some medicines for the treatment of cardiovascular diseases, a change in the dosage may be necessary due to extreme heat, reports the German Heart Foundation in a current message.

"Heart patients should therefore have their doctor regularly check the dosage and discuss which medications can be reduced in the heat and for how long," says cardiologist Prof. Dr. med. Markus Haass from the Scientific Advisory Board of the German Heart Foundation.

It is not only about antihypertensive drugs for hypertension patients (ACE inhibitors, sartans, calcium channel blockers), but also about diuretics (dehydrating agents) for patients with heart failure.

More strain on the heart
When the outside temperature is high, our heart has to pump more blood through the body to regulate the body temperature. A healthy heart can easily cope with this additional burden. A sick heart, on the other hand, quickly reaches its limits.

"Older people and especially patients with heart failure should avoid as much heat as possible, be physically careful and take special care to dress in summer," said cardiologist Prof. Dietrich Andresen (Berlin) from the board of the German Heart Foundation.

Cooling works best with low clothing such as a T-shirt, shorts, summer dress and avoiding direct sunlight (e.g. by covering your head).

Increased sweating and drinking
The body also gives off heat through sweat, but loses liquid and electrolytes (salts: sodium, potassium, magnesium): in very hot weather, one to two liters of liquid per day. Drinking is therefore so important to compensate for this loss of fluid and salt.

“When you are thirsty, healthy people automatically drink as much as they need to balance. But in older or heart-sick people, the thirst feeling cannot be intact, so that they do not drink enough and the loss of fluid is not compensated for, ”warned Prof. Andresen.

"If, in such a situation, an additional intake of water-propelling medication (diuretics) leads to a greater loss of fluid, the blood volume in the vessels decreases: blood pressure drops and, especially when you get up from a lying or sitting position, circulatory collapse with brief loss of consciousness can occur. "

Danger due to excessive hydration
Since the sweat-out salts are not adequately balanced, there are further complaints such as headaches, general fatigue but also muscle cramps and sometimes cardiac arrhythmias.

But how much water should we drink? According to the Heart Foundation, older people and patients with heart failure must be stopped on hot days to drink enough, in addition, one to two liters a day.

However: "Enough" also means: Not too much! Because excessive hydration can lead to a deterioration in cardiac output in cardiac patients, ”says Prof. Andresen.

“For this reason, patients with heart problems should coordinate the amount they drink and the medication they take with their doctor in charge. Weighing every day helps to determine the amount of drinking required. ”(Ad)

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