Berkat OSH Newsletter #4 – Heat & Heart

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Greetings from Berkat OSH (BOSH)!

The weather as of late has been unforgiving, hasn’t it? 

The scorching heat has made us constantly reach for iced cold drinks and run towards an air-conditioned  room. In fact, just two weeks ago, the Malaysian Meteorological Department (MET) declared a level one  alert for eight areas across four states in Peninsular Malaysia (Human Resources Online, 2024). 

The alert was announced as these areas posed the risk of reaching a maximum daily temperature between  35-37° celsius for three consecutive days. To top it all off, the health director-general, Dr. Radzi Abu  Hassan, had previously shared that the Ministry of Health (MoH) had received 45 cases of heatstroke, two  of which resulted in death (The Star, 2024). 

Now, living in a tropical climate, we are used to the heat. However, the extreme heat has a detrimental  impact on our health that goes beyond increasing the risk of skin cancer due to overexposure to the sun’s  UV rays (Cancer Research UK, 2023). Due to the extreme heat, our body temperature rises rapidly, which  leads to our body’s inability to cool down (Centers for Disease Control and Prevention, n.d.). To top it all  off, it can set off chronic conditions like migraine and cardiovascular diseases (Harvard T.H. Chan, 2022). 

Considering its perilous side effects, we believe that it is important for you to be aware of the dangers of  heat-related illnesses and arm yourself with the knowledge to better protect yourself from the blazing heat. 

So, get comfortable, as today’s article will highlight how the heat impacts your cardiovascular health and  share what you can do to beat the heat! 

Warmest Regards,

Dr Sabariah Said
Chief Executive Officer

Heart problems and the heat: What to know and do

By Matthew Solan, Executive Editor, Harvard Men’s Health Watch

This spring, many parts of United States experienced historic heat waves. Now summer is officially  underway, and experts are predicting hotter than normal temperatures across most of the country. 

Extreme temperatures increase health risks for people with chronic conditions, including heart problems. If you do have a heart condition, here’s how to keep cool and protect yourself when  temperatures rise.

How does hot weather affect the heart? 

Not only does exposure to high heat increase the risk for heat exhaustion and heat stroke, but it can  also place a particular burden on heart health. It stresses the cardiovascular system and makes the  heart work harder. This can increase the chance of heart attacks, heart arrhythmias (irregular  heartbeat), and heart failure. 

According to the Environmental Protection Agency, the interaction of high heat and cardiovascular  disease contributes to about a quarter of heat-related deaths. 

And the higher the temperature, the greater the threat. A recent study in the journal Circulation looked at cardiovascular death rates over seven years in Kuwait, where daytime temperatures can  reach triple digits in the hottest months. The researchers found a link between rising temperatures  and the risk of cardiovascular deaths, with most occurring between temperatures of 95° F to 109° F. 

“Climate change is giving us more, and unprecedented, heat that can be deadly, especially for  people with heart disease,” says Dr. Aaron Bernstein, interim director of the Center for Climate,  Health, and the Global Environment at Harvard T.H. Chan School of Public Health. 

How does the body shed heat? 

Your body is designed to shed extra heat in two major ways, each of which may affect the heart: 

Radiation. When the air around you is cooler than your body, you radiate extra heat into the air.  This process requires rerouting blood flow so that more of it goes to the skin. 

Evaporation. Evaporating sweat helps cool you down by pulling heat away from your skin. When  the air is dry, this works well. But when it’s hot and humid, sweat just sits on the skin as your body  temperature rises. 

When air temperature approaches or exceeds body temperature, especially in high humidity, the  heart has to beat faster and pump harder to help your body shed heat. On a hot and humid day,  your heart may circulate two to four times as much blood each minute compared with a cool day.

Some medicines meant to help the heart can add to problems on hot days. For example, beta blockers slow the heartbeat and hinder the heart’s ability to circulate blood fast enough for effective heat exchange. Diuretics (water pills) increase urine output and raise the risk of dehydration. 

How can you protect yourself and your heart when temperatures rise? 

While exposure to high heat and heat waves affects everyone, having existing heart problems raises  your risk for heat-related illness and hospitalization. So it’s especially important to try to follow basic  strategies for staying cool, including these: 

  • Monitor weather forecasts for heat advisories and stay inside on those days. If home is  too hot, check with your town or city health department for cooling centers and other options  to help you stay cool. If you venture outside, evening and early morning are often the coolest  times. Rest in the shade whenever possible. 
  • When outside, try to drink 8 ounces of water every 20 minutes. Set a timer to remind  you. Never wait until you’re thirsty to drink,” says Dr. Bernstein. If you have heart failure, ask your doctor how much fluid you should drink daily, since fluids can build up and cause  swelling. If you take diuretics, ask how much you should drink during hot weather. 
  • Avoid soda or fruit juice and limit alcohol. Soda and fruit juice may slow the passage of  water from the digestive system to the bloodstream. While research is limited, some studies  have found that excessive alcohol intake may raise risk for heat stroke during scorching  weather. 
  • Protect your skin. Sunburn affects your body’s ability to cool down and increases  dehydration. Wear a wide-brimmed hat, wraparound sunglasses, and lightweight, light colored, loose-fitting clothing. Also, apply plenty of broad-spectrum or UVA/ UVB protection  sunscreen with SPF 30 or higher to all exposed skin 30 minutes before going out. Reapply  every hour. 

No content in this article, regardless of date, should ever be used as a substitute for direct medical  advice from your doctor or other qualified clinician.

References

[1] METMalaysia Issues Level One (Caution) Heat Warning For 10 Regions As Of 21 Apr 2024 (22 April  2024). Human Resources Online. Available at: https://www.humanresourcesonline.net/metmalaysia-issues level-one-caution-heat-warning-for-10-regions-as-of-21-apr-2024 (Accessed: 12 May 2024).  

[2] 2 Deaths Among 45 Heatstroke Cases Reported This Year, Says Health DG (14 April 2024). The Star.  Available at: https://www.freemalaysiatoday.com/category/nation/2024/04/14/2-deaths-among-45-heat-stroke cases-reported-this-year-says-health-dg/ (Accessed: 12 May 2024).  

[3] How Does The Sun And UV Cause Cancer? (30 November 2023). Cancer Research UK. Available at:  https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/sun-uv-and-cancer/how-does-the-sun-and uv-cause-cancer (Accessed: 12 May 2024). 

[4] Extreme Heat Can Impact Our Health In Many Ways (n.d.). Centers for Disease Control and Prevention.  Available at: https://www.cdc.gov/climateandhealth/pubs/extreme-heat-final_508.pdf (Accessed: 12 May 2024). 

[5] The Dangers Of Extreme Heat (26 July 2022). Harvard T.H. Chan School of Public Health. Available at:  https://www.hsph.harvard.edu/news/hsph-in-the-news/the-dangers-of-extreme-heat/ (Accessed: 12 May 2024).