A heatwave like the one that is generating oppressive temperatures throughout the Central and Southeastern U.S. this week presents additional risk to the millions of Americans who take drugs for common diseases like high blood pressure or heart disease.
According to David Eisenman, a doctor and researcher at the University of California, Los Angeles, some drugs can alter how people’s bodies naturally regulate heat, which could make them more prone to overheating.
Eisenman emphasizes the importance of patients continuing to take their prescription drugs. However, he encourages students to consider the dangers of heat and create a strategy to stay cool by doing things like using fans or air conditioning to cool their homes, drinking water, and avoiding the sun.
Why do some medications affect heat tolerance?
When internal temperatures rise too high for an extended period of time, the results can be severe: an overworked heart, renal problems, brain damage, and even death.
“I think of core temperature as your body’s internal temperature like a car engine,” Eisenman explains. Similar to a body, an automobile’s engine must be kept at a comfortable temperature.
The body adapts in a variety of ways. Sweat’s quantity and salinity can be adjusted by them. Your brain may have a system that causes you to feel thirsty, which will make you drink enough water to perspire enough. More blood is diverted by the vascular system to the skin, where it can be cooled by perspiration or breeze.
However, a number of drug groups, including beta blockers, diuretics, and antidepressants, can alter how the body responds to or perceives heat. Beta blockers, another heart medicine, can reduce sweating, making it more difficult to cool down, while ACE inhibitors, which are frequently recommended for heart problems, make it harder to recognize when you’re thirsty.
“When you’re taking these medications and you’re exposed to heat, it’s like asking a car to drive up a mountain in the summer with the air conditioner broken, low on coolant and no warning signals,” Eisenman explains. “Overheating becomes much more likely.”
Eisenman emphasizes that this does not imply that you should cease using your prescription drugs during heat waves. In the first place, it means preventing yourself from becoming overheated. “Making sure people have access to a cool space” should be the top goal, he says, whether that means finding a nearby cooling center or using an air conditioner at home.
What medications increase heat risk?
Based on how various drug kinds function, the Centers for Disease Control and Prevention lists a wide range of pharmaceuticals that may interfere with the body’s heat regulation system.
- Millions of Americans take ACE inhibitors or ARBs to manage high blood pressure. But they can affect people’s ability to sense thirst, potentially leaving them dehydrated.
- Beta blockers can keep blood from flowing toward the skin, where it can cool, and decrease sweat.
- Diuretics, commonly prescribed for kidney problems, may contribute to dehydration.
- Anticholinergic medications including some over-the-counter antihistamines, like Benadryl can reduce sweating.
- Antipsychotics can make it harder for people to sense their own temperature, so they can’t tell when they’re overheating.
Numerous other medications, such as some antidepressants and ADHD meds, may potentially affect heat risk.
Even without additional pharmaceutical dangers, older adults typically struggle to manage heat, according to researcher and physician Soko Setaguchi of Rutgers University. She oversaw a study of Medicare patients, all of whom were over 65, and discovered that individuals on ACE inhibitors, anticholinergics, and antipsychotics had a greater risk of hospitalization during summer heat waves.
Like Eisenman, however, she emphasizes that patients should continue taking their prescriptions during hot weather. “The message for now is, there are potential risks,” she says, and recommends that patients “avoid heat, anticipate heat, and plan for heat.”
What is still unknown?
Yorgi Mavros, a heat expert at The University of Sydney, says that while the theoretical ways that medications can alter heat tolerance are widely recognized, there haven’t been enough comprehensive assessments examining how, at what amounts, and for whom drugs affect heat tolerance. However, some messages have started to surface.
People who had been administered pharmaceuticals, such as anti-epileptic meds, antipsychotics, and some beta blockers, had a higher chance of dying amid the intense heat during the 2021 heat dome that hit the Pacific Northwest than those who had not.
The risk of heart attacks during periods of high heat in Germany was examined in another study. Patients who were on beta-receptor blockers and anti-platelet drugs had a higher risk of dying than those who were not.
Another examined the impact of several drugs on hospitalizations due to kidney disease in the Atlanta region throughout the summer. According to lead researcher Zachary McCann, who was at Emory University when the study was published, individuals who were using antidepressants and those who were taking several drugs at once ended up in the hospital at a higher rate.
According to McCann, it’s typical for patients to take many drugs at once. However, he claims that the combined hazards have not been fully evaluated, a worry that Eisenman and Mavros also share.
According to McCann, the need to address some of these issues is becoming more pressing. Climate warming prolongs heat waves, intensifies heat, and pushes summers later in the year.
“It will get hotter in the summer. He predicts that they will get longer. “We know that heat causes dysregulation of all kinds of organ systems and wreaks havoc on the body in all kinds of different ways.” According to McCann, it is therefore essential that patients and physicians collaborate to develop self-defense strategies.
“Prevention is really the best medication when it comes to the management of heat,” he claims.
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