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Factors such as environmental pollution and low temperatures have been clearly related to a

higher incidence of acute myocardial infarction

.

In recent years, it has been investigated whether high temperatures are also a risk factor.

Studies are emerging that explore this association and suggest that as the planet warms, the heart can suffer in various ways.

There are studies that even point out that

the burden of heart attacks will grow as global warming increases by two or three degrees Celsius

.

This risk of non-fatal heart attack due to high temperatures could also be

more pronounced in patients who follow treatment with antiplatelet drugs and beta-blockers

, according to a study in

Nature Cardiovascular Research

.

The work attempts to identify patients who are more vulnerable to a heat attack, based on the medication they are taking.

To do this, a group of German-American epidemiologists collected

data from 2,494 people who had a heart attack

in the Augsburg region of Germany between May and September 2001 to 2014. These clinical data were crossed with daily weather information.

Thus, they found that in patients taking antiplatelet medication (indicated to prevent the formation of thrombi and reduce new episodes of infarction) and beta-blockers (prescribed in hypertension, arrhythmias and heart failure)

there was a greater risk of non-fatal infarction than among those who did not follow these treatments

.

By pharmacological families, before suffering the infarction, 30% of the patients in this registry were taking antiplatelet drugs;

25.2% of them, ACE inhibitors;

37.2%, beta-blockers;

15.9%, calcium channel blockers;

23.4%, diuretics, and 23.6%, statins.

New strategies in the face of rising temperatures

For the authors of this study, led by epidemiologist Kai Chen, from the Yale School of Public Health in New Haven, their findings could help develop specific strategies to

reduce the impact of cardiovascular disease related to increased temperature

, although they acknowledge that more research is needed to confirm this effect.

Eduardo Zataraín

, assistant doctor of the Cardiology Service of the Gregorio Marañón University Hospital, in Madrid,

abounds in this , who clarifies that

it is "an observational, retrospective study,

based on a registry of patients with infarction, without specifying the specific type".

Although

extreme heat and heat stroke can cause heart damage

, and therefore a heart attack, argues the cardiologist, "it is not clear that the

classic

heart attack - caused by a blockage of the coronary artery - is caused by heat or that this is a triggering factor for the attack".

On the other hand, the association between both types of medication and the number of heart attacks may be due to the fact that "

patients with more heart disease, who must take this medication, are more prone to them.

Therefore, the inference cannot be reached cause that

Aspirin

, for example, or beta-blockers -two very important treatments in heart patients- will produce a heart attack associated with high temperatures".

However, he indicates,

the work opens the hypothesis to investigate, through methodologically specific studies

, possible links between infarction, medication and extreme heat.

Roberto Martín Asenjo

, a cardiologist at the Coronary Unit of the Hospital Universitario 12 de Octubre, in Madrid, agrees in highlighting the observational nature of the study, whose conclusions remain hypothetical.

He finds it difficult to find a physiological explanation associating antiplatelet drugs with a higher risk of heart attack related to high temperatures;

On the other hand, he does

see some logic in the mechanisms of action

of beta-blockers, since

"they inhibit cutaneous vasodilation, an increase in the blood vessels of the skin and that is a mechanism that the body uses to regulate the loss of temperature

; in addition favor the drop in blood pressure, precisely one of the effects of dehydration caused by extreme heat".

However, it highlights that

this study does not provide sufficient evidence to establish this relationship

, and stresses the importance that patients who follow pharmacological treatment do not abandon it and always consult their doctor if they have any doubts.

Another of the most striking findings of this observational study is that

the association of both drugs with infarction was observed more markedly in younger patients (25 to 59 years old)

, who had a lower prevalence of pre-existing coronary diseases, compared with older patients (60 to 74 years).

Eduardo Zataraín indicates that, again, it is unknown if this effect is explained, because they have a higher cardiovascular risk, "which would justify that they had more heart attacks";

It could also be attributed, he points out, to

the fact that young people tend to be more exposed to heat and eventual heat strokes

.

Recommendations for patients

Both cardiologists point out that the data from the Heart Attack Code of the Community of Madrid have not detected a higher incidence of heart attacks during heat waves;

instead, the opposite occurs on colder days, when a higher incidence of attacks is detected.

Facing the extreme temperatures that the dog days have prepared for us,

Roberto Martín recalls that chronic patients, heart patients or not, are usually more vulnerable.

Among the recommendations to avoid heat stroke, people with heart disease and non-cardiopaths should avoid the hours of maximum heat and be exposed to extreme temperatures;

In particular, avoid physical activity in extreme heat.

It is also recommended to wear appropriate clothing, drink cool drinks, refrain from alcohol and have a source of coolness (air conditioning, fan, fan) that helps the body adapt to increased temperatures.

In the same way,

Eduardo Zataraín points out, it is important to maintain adequate hydration

, "which in patients with heart problems does not always imply that it should be abundant, since in some cases it can be harmful."

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