Protective measures of patients with cardiovascular diseases from exposure to heat waves: medicated and non-medicated

Abstract

In conditions of climate warming with an increase in heat waves associated with an increase in cardiovascular morbidity and mortality, the particular interest is the effect of cardiovascular drugs on adaptation to high temperatures. The review reflects the results of European and domestic studies on the safety of therapy during long and short heat waves. Recommendations for the correction of therapy during this period are given. Self-control of blood pressure (SCAD) is a mandatory component of the therapy of arterial hypertension during heat waves. With the development of clinically significant hypotension, a reduction in the dose of antihypertensive drugs is necessary. It is recommended to start with a dose reduction and/or withdrawal of diuretics and nitrates. Not recommended the complete abolition of antihypertensive therapy because of the risk of hypertensive crises, characteristic of abnormal heat, as well as due to the increase in blood pressure when the weather changes and the temperature drops. With increasing blood pressure during heat waves, it is recommended to give preference to calcium channel antagonists, angiotensin converting enzyme inhibitors (ACE inhibitors) and selective beta-blockers. It is necessary to inform patients about the additional protective effect of statins in order to increase adherence to therapy. Patients taking diuretics require individual daily monitoring of fluid intake and body weight. An overview of recommendations on sanogenic behavior during heat waves is given. Details are considered rules for the use of air conditioning, methods of diagnosis of dehydration and drinking mode

Les reins : cibles du réchauffement climatique ?

“…Concernant les patients hypertendus, un groupe de cardiologues russes a récemment formulé la recommandation d'arrêter les diurétiques en cas de canicule, et de surveiller quotidiennement le poids et la pression artérielle. 22 À notre connaissance, les sociétés internationales des néphrologues et spécialistes d'hypertension n'ont pas encore formulé de recommandations spécifiques, et les spécialistes sont donc souvent appelés à utiliser leur bon sens clinique.…”