Prof. Dr. Dimitar Raev heads the Internal Medicine Clinic at the "St. Anna" - Sofia, one of the few specialists in clinical hypertension in our country with a diploma from the European Society of Hypertension
Prof. Raev has 2 doctorates in cardiology, and his direct scientific interests are in the field of arterial hypertension. He is the author and national coordinator of several scientific projects to study the degree of control and the type of initial therapy of arterial hypertension and dyslipidemia in our country.
He is the author of hundreds of scientific works and publications, including in foreign journals, on 2 rationalizations and on 1 patent. And last but not least, it has experience in over 120 international clinical trials. Prof. Raev is a Fellow of the American Heart Association and the European Society of Cardiology. He is a member of the New York Academy of Sciences, as well as the European and American Society of Hypertension. He is the chairman of the Working Group on Hypertension at the Bulgarian Society of Cardiology.
People with cardiovascular problems or the elderly may develop heatstroke during the heat, warns Prof. Dr. Dimitar Raev. We offer you commentary and useful advice from Prof. Raev on how the heat affects both he althy people and those suffering from various diseases.
"Heat and heart diseases are an unhe althy combination", assures Prof. Dimitar Raev. - Summer temperatures are expected to rise in a warming climate. In addition to this, heat waves are becoming more frequent, more intense and longer. It is these heat waves that are associated with an increased risk of death, hospitalizations, heatstroke and exhaustion, cardiovascular disease and respiratory disease. The heat wave causes discomfort in he althy people. But for those with cardiovascular problems, these hot days can be downright dangerous.”
Body temperature can vary within certain limits and should not become too high. If it gets too high, the proteins that make up the body and are involved in almost all chemical processes can be damaged. The human body maintains a normal temperature by releasing heat in two ways, both of which increase the demands on the heart:
1. Radiation. The body radiates heat to the air, but this transfer stops when it equals body temperature. Radiation requires redirecting blood flow to the skin. This makes the heart beat faster. On a hot day, blood circulation is 4 times greater than on a cool day.
2. Evaporation. Every molecule of sweat that evaporates from the skin cools the body. On a dry day, the evaporation of a spoonful of sweat can cool the whole blood by 2 degrees. At 75% humidity, however, evaporation becomes much more difficult. Evaporation also puts a strain on the cardiovascular system. Along with sweat, sodium, potassium and other minerals necessary for muscle contractions, nerve transmissions and water balance are released. To limit these losses, the body begins to secrete hormones that help the body retain water and minerals and minimize losses.
Prof. Dr. Dimitar Raev
Most he althy people tolerate these changes without problems. Those with cardiovascular problems or older people whose physiological responses to maintain normal body temperature and hydration are impaired may develop heat stroke. For example, a heart weakened by a previous heart attack cannot pump enough blood to increase radiation and thus maintain a normal body temperature.
Cholesterol-narrowed skin arteries restrict blood flow to the skin and thus make it difficult for heat to dissipate. Some medications also make heat regulation more difficult. Beta-blockers slow the heart rate and thus limit the heart's ability to pump enough blood to provide rapid and efficient heat exchange. Diuretics, by increasing the amount of urine, increase dehydration.
And some antidepressants and antihistamines can block sweating. On the other hand, a history of stroke, Parkinson's disease, Alzheimer's disease, diabetes, and other conditions can dull the sense of thirst and thus delay fluid intake.
“Hot and humid weather can be especially difficult for people with heart failure, explains the specialist. -The extra strain on the heart, combined with the loss of sodium and potassium, and the release of stress hormones, can cause them serious problems. The combination of increased blood flow to the skin and dehydration can cause blood pressure to drop, causing dizziness or falling.
Recent research has revealed that a major cause of worsening heart failure on hot days is inflammation, which is the body's response to stress. The results show that high temperatures increase heat stress in the body. Stress alters basic physiological responses associated with inflammation and cellular damage. These responses lead to heart failure by damaging heart tissue. This explains the observed association between the degree of vascular inflammation and the external temperature”.
• Stay in the shade.
• Keep activity levels to a minimum. If you exercise, do so during the cooler hours of the day. Evening and early morning are the best time for this. When exercising, drink more fluids than usual.
• Air-conditioned air is the best way to beat the heat. The fans work, but only as long as the air temperature is below the body temperature (36 degrees).
• Taking a cool shower or placing a cold, damp towel,or ice under the armpit or groin is also a solution. Like a car radiator, the lower the coolant level, the higher the risk of overheating.
Unfortunately, maintaining optimal hydration levels is not always easy. Stomach or intestinal problems, use of diuretics, a faulty thirst signal or low fluid intake are factors for this. On a very hot (and especially humid) day, drink a glass of water every hour (if you have heart failure, consult your doctor).
Fruit juices are a better option as they slow the passage of water from the digestive system into the bloodstream. Do not rely on caffeinated drinks or alcoholic liquids because they can cause or increase dehydration. Eat light food. Stick to smaller meals that don't overload the stomach. Cold soups, salad and fruit can satisfy your hunger and give you extra fluids.