Extreme heat for cardiac patients and the elderly represents a considerable risk

What do cardiac patients and the elderly have to consider at high temperatures?
The warm weather is pleasant for many people, but the high temperatures can also pose a health risk for some. This applies, for example, to cardiac patients. The German Heart Foundation has therefore compiled important "heat tips for heart-sick and elderly people" in a current communication.

The summer heat with temperatures above 30 degrees Celsius can be a risk, especially for older people and those who are already being treated for heart or blood pressure problems. In this context, the German Heart Foundation names “fatigue and Dizziness and a drop in blood pressure to circulatory collapse, cardiac arrhythmia or muscle cramps. ”Therefore, people at risk should urgently take precautionary measures.

Discuss precautionary measures with the doctor
In order to prevent complications at high temperatures, the cardiac specialist Professor Dr. med. Markus Haass from the Scientific Advisory Board of the German Heart Foundation asked those affected to discuss special precautionary measures with their doctor. According to the expert, these can vary depending on the heart disease and treatment. For example, it may be necessary to adjust the amount of drink or change the dosage of the medication.

Adjust dosage of medication
Most cardiac patients must take medication that may require a change in dosage due to excessive heat. This applies, for example, to the antihypertensive medication for hypertension patients (ACE inhibitors, sartans, calcium antagonists) and the diuretics (drainage agents) for patients with heart failure, according to the German Heart Foundation. According to Professor Haas, cardiac patients should have their doctor regularly check the dosage of the medication and discuss which medication can be reduced in the heat and for how long.

Stress from regulating body temperature
Another problem arises, according to the experts, from regulating body temperature at very high outside temperatures. As mammals, we are so-called "same-warm creatures" who have to maintain a constant body temperature of around 37 degrees Celsius, no matter how cold or hot the environment is. When the heat is high, the body heats up too much, so the heat has to be given off again, which can be done in two ways: On the one hand, heat is given off directly through the skin and on the other hand through increased sweating, explains the German Heart Foundation.

Cooling through the heat given off by the skin
For the heat to be released through the skin, the blood absorbs the excessive heat from the body and transports it to the small skin vessels, which work like “cooling coils” and dissipate the heat to the air, the experts explain. The heat output is higher, "the larger the area of ​​the uncovered skin, the cooler and drier the air flowing past, and above all the more blood that is pumped from the heart through the skin vessels." A healthy heart can easily cope with this additional burden, but it can a sick heart reaches its limits more quickly, reports the heart foundation.

Pay attention to summer clothes
According to Professor Dr. Dietrich Andresen from the board of the German Heart Foundation should “avoid older people and especially patients with a weak heart, as much heat as possible, protect themselves physically and take special care to dress in summer.” The cooling works best with low clothing such as a T-shirt , shorts or summer dress and by avoiding direct sunlight. Wearing a hat can also help here.

Falling blood pressure due to lack of fluid
The heat released during sweating is accompanied by an increased loss of fluid and electrolytes (salts: sodium, potassium, magnesium). In order to compensate for this loss of fluid and salt, it is particularly important to drink one to two liters more per day in very hot weather, according to the experts of the German Heart Foundation. However, in elderly or heart-sick people, “the thirst is not really intact, so that they don't drink enough and the loss of fluid is not compensated for,” warns Prof. Andresen. If, in such a situation, additional water-propelling medications (diuretics) are taken, the blood volume in the vessels decreases too much, the blood pressure drops and, especially when standing up from a lying or sitting position, a circulatory collapse with brief loss of consciousness can occur, the warning of Cardiac specialists.

Too much fluid intake can also strain the heart
Because the sweated salts are often not adequately balanced in cardiac patients, according to the German Heart Foundation, there are often further complaints such as headaches, general fatigue, but also muscle cramps and sometimes cardiac arrhythmias. Older people and patients with heart failure, in particular, must therefore be stopped on hot days by drinking enough (an additional one to two liters per day), the Foundation says. However, care should also be taken to ensure that they do not drink too much, since excessive hydration in cardiac patients can lead to a deterioration in their cardiac output, warns Prof. The expert therefore advises cardiac patients to coordinate their drinking volume and medication intake with their doctor in charge . Daily weighing can also help determine the amount of drinking needed. (fp)

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