Amidst the sweltering heatwave gripping the Central and Southeastern U.S., millions of Americans who rely on medications for heart disease and high blood pressure may face heightened risks. The intense heat can exacerbate the effects of certain medications, potentially increasing the danger of overheating.
David Eisenman, a physician and researcher at the University of California, Los Angeles, explains that some medications can interfere with the body’s natural heat management processes. While he advises against discontinuing medication, he emphasizes the importance of taking preventive measures to stay cool, such as using air conditioning, staying hydrated, and avoiding direct sunlight.
Medications and Heat Tolerance
When internal body temperatures rise excessively, the consequences can be severe, ranging from heart strain to kidney damage, and in extreme cases, even death. Eisenman likens the body’s core temperature to a car engine that must be kept within a safe range.
The body employs various mechanisms to regulate temperature, such as adjusting sweat levels and directing blood flow to the skin. However, certain medications can disrupt these processes. For instance, ACE inhibitors can dull the sensation of thirst, while beta blockers can reduce sweating, making it harder to cool down.
According to Eisenman, “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.” This underscores the importance of having access to a cool environment during heatwaves.
Drugs Increasing Heat Risks
The Centers for Disease Control and Prevention (CDC) has identified several medications that can interfere with the body’s ability to manage heat:
- ACE inhibitors and ARBs, used for high blood pressure, can impede thirst perception, risking dehydration.
- Beta blockers can limit blood flow to the skin and reduce sweat production.
- Diuretics, often prescribed for kidney issues, may lead to dehydration.
- Anticholinergic drugs, including OTC antihistamines like Benadryl, can diminish sweating.
- Antipsychotics can impair temperature perception, preventing recognition of overheating.
Other medications, such as antidepressants and those for ADHD, may also affect heat tolerance.
Older adults face additional challenges in managing heat, as noted by Soko Setaguchi, a Rutgers University researcher. Her study on Medicare patients revealed that those on anticholinergics, antipsychotics, and ACE inhibitors were more likely to require hospital care following heatwaves. Despite the risks, she advises against stopping medications, urging patients to prepare for heatwaves instead.
Unresolved Questions
While the theoretical impact of drugs on heat tolerance is understood, more systematic studies are needed, says Yorgi Mavros, a heat expert at The University of Sydney. Some insights are emerging, such as during the 2021 Pacific Northwest heat dome, when individuals on certain medications faced higher mortality rates.
Another study in Germany found increased heart attack risks during extreme heat for those on anti-platelet medication and beta-receptor blockers. Research in Atlanta highlighted higher kidney-related hospitalizations among patients on antidepressants and multiple medications.
Zachary McCann, an Emory University researcher, emphasizes the need to assess the combined risks of taking multiple medications. As climate change intensifies heatwaves, McCann warns, “Summers are going to get hotter. They’re going to get longer.” He advocates for proactive planning to mitigate heat-related health risks.
“Prevention is really the best medication when it comes to the management of heat,” McCann concludes.
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