Why some medications increase your heat risk : NPR

The heat presents an additional risk for millions of Americans who take medication for problems ranging from high blood pressure to antidepressants.

David Goldman / AP

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David Goldman / AP

For millions of Americans who take medication for common problems such as heart disease or high blood pressure, a heat wave like that causing stifling conditions through the center and the southeast of the United States this week has an additional risk.

Indeed, certain drugs can change the way people naturally manage the heat, explains David Eisenman, doctor and researcher at the University of California in Los Angeles, which makes people more likely to overheat.

Eisenman points out that patients should always take their medication. But he urges them to take the risks of heat seriously and develop a plan to stay cool – taking measures like cooling their houses with air conditioning or fans, drinking water and staying outside the hot sun.

Why do some drugs affect heat tolerance?

The consequences of overheating can be dramatic: an excessive heart, kidney problems, brain damage and even death are possible when internal temperatures climb too long for too long.

“I think of the central temperature as the internal temperature of your body as a car engine,” explains Eisenman. A car, like a body, must keep its engine at a reasonable temperature.

The bodies adapt to many respects. They can calibrate the quantity and salinity of perspiration. A mechanism in your brain can trigger a feeling of thirst, encouraging you to drink enough water to create enough sweat. The vascular system eliminates blood to the skin, where it can be cooled by an evaporating breeze or sweat.

But some classes of drugs – from certain beta -blockers to diuretics and antidepressants – can affect the way people react or perceive heat. ACE inhibitors, commonly prescribed for heart problems, make it more difficult to realize that you are thirsty, and beta -blockers – another heart medication – can reduce sweating, which makes refreshment more difficult.

“When you take these drugs and you are exposed to heat, it’s like asking a car to mount a mountain in summer with the broken air conditioner, low on the coolant and without warning signals,” explains Eisenman. “Overheating becomes much more likely.”

This does not mean that you should stop taking your medication during heat waves, underlines Eisenman. This means preventing you from becoming too hot in the first place. “Make sure that people have access to a cool space” should be the priority, “he says, whether it is an air conditioner at home or find a local cooling center.

What drugs are increasing the risk of heat?

Centers for Disease Control and Prevention catalog many different drugs that could interfere with the body heat management system, depending on how different types of drugs work.

• Millions of Americans take ECA inhibitors or ARB to manage high blood pressure. But they can affect people’s ability to feel thirst, letting them potentially dehydrated.
• Beta-blockers can prevent blood from flowing towards the skin, where it can cool and decrease sweat.
• Diuretics, commonly prescribed for kidney problems, can contribute to dehydration.
• Anticholinergic drugs – including some over -the -counter antihistamines, such as Benadryl – can reduce perspiration.
• Antipsychotics can make people more difficult for people to feel their own temperature, so they cannot say when they overheat.

Many other drugs, including ADHD medication and certain antidepressants, could also influence the risk of heat.

The elderly generally find it more difficult to manage heat even without the risk of added drugs, explains Soko Setaguchi, doctor and researcher from Rutgers University. She led a study focused on Medicare patients – who were all over 65 years old – who found that the chance to find themselves in the hospital after summer heat waves was higher for those who took anticholinergics and antipsychotics, as well as ECA inhibitors.

But like Eisenman, she points out that patients should not stop taking medication when it’s hot. “The message for the moment is that there are potential risks,” she says, patients should therefore strive to “avoid heat, anticipate heat and plan heat”.

What is still unknown?

The theoretical ways of drugs can affect heat tolerance are well known, but there have not been enough systematic analyzes by examining how and at what levels and for which drugs affect heat tolerance, explains Yorgi Mavros, a heat expert at the University of Sydney. But some messages have started to emerge.

During the heat of the heat that came down to the northwest of the Pacific in 2021, people who had received medication, including anti-epileptic drugs, antipsychotics and certain beta-blockers, were more likely to be died during extreme heat than people who had not been prescribed these drugs.

Another study examined the risk of heart attacks during extreme heat events in Germany. The chances of dying increased if patients had used anti-platform drugs and beta receptor blockers compared to patients who were not on medication.

Another examined the effect of various drugs on hospital -related hospitalizations in the Atlanta region during the summer months. Patients under antidepressants and patients taking several drugs at the same time ended up at the hospital at a higher rate, explains the principal researcher Zachary McCann, who was at Emory University at the time of the study of the study.

It is common for patients to take many drugs at a time, explains McCann. However, he said, the risks combined have not been evaluated in depth – a concern postponed by Eisenman and Mavros.

The urgency to answer some of these questions increases, explains McCann. Climate change intensifies heat, extends the length of heat waves and drags summers later in the year.

“The summers will become warmer. They will lie down,” he said. “We know that the heat causes a deregulation of all kinds of organ systems and wreaked havoc on the body of all kinds of different ways.” Thus, McCann says that it is essential that patients and doctors work together to make plans to protect themselves.

“Prevention is really the best medication with regard to heat management,” he says.