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Heart failure, November heat can increase risk

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Heart failure, November heat can increase risk

After the October, also the November. The unseasonal heat is a worrying anomaly, given the temperatures. But we must never forget that there are people for whom the scorching heat, therefore that of the great summer heat, can put the heart at risk. In fact, there is a risk of weight loss, in particular linked to the loss of liquids, with a consequent worsening of the fragile balance of those suffering from decompensation.

To say it is a French research appeared on ESC Heart Failure, a journal of the European Society of Cardiology. “This is the first study that shows a close relationship between ambient temperature and body weight in patients with heart failure – is the comment of Francois Roubille of the University Hospital of Montpellier, author of the survey. The weight loss we’ve seen in people with heart failure can lead to low blood pressure, especially when standing up, and kidney failure, and is potentially life-threatening. With temperatures expected to rise in the future, doctors and patients should be prepared to reduce the dose of diuretics when weight loss occurs. ”

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Why weight control is important

When heart failure is hypothesized, difficulty breathing at rest or after a short exercise, swelling in the ankles, due to fluid accumulation and a sense of continuous fatigue must warn. But also unjustified weight gain or loss due to fluid gain or loss must be carefully considered. In fact, in people with heart failure, the heart generally tends not to pump blood around the body as it should. Then the waste products build up, causing shortness of breath and fluid buildup in the lungs, legs and abdomen.

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Weight is the cornerstone of monitoring because weight gain is related to congestion, which is one of the main reasons for hospitalization. For this you can use diuretics, in order to reduce dyspnea and swelling. And it is recommended that patients be educated to manage their diuretic dose and otherwise contact their healthcare team if they experience increased shortness of breath or swelling or sudden unexpected weight gain of more than 2 pounds in three days.

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What happens with heat waves

Unlike what happens in healthy people, who tend to drink more in the heat and therefore to regulate body fluids and urine production, in patients with decompensation who take diuretics this non-control system may not occur.

The study looked at the relationship between body weight and air temperature between June 1 and September 20, 2019, which covered the two heatwaves of late June and late July. The analysis included 1,420 patients, just under a third women, with a mean age of 73 years. A national telemedicine system was used to obtain information on weight and symptoms remotely. Patients weighed themselves each day using a connected scale that automatically sent measurements to the clinic.

Patients reported daily symptoms such as edema, fatigue, dyspnea and cough by answering questions on a personal device (e.g. smartphone, tablet), with answers automatically sent to the clinic. Daily temperatures (at noon) were obtained using data from the weather station closest to each patient’s home.

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Control with telemedicine

The researchers analyzed the association between patient weight, room temperature on the same day, and temperature two days before the weight measurement. According to Roubille, “the weight loss we observed during the heat wave was clinically relevant. Patients who weighed 78 kilos lost 1.5 kilos in a short period of time. We were surprised to see that the weight decreased. with warm temperatures, as we expected the opposite. Given the expectation of more heat waves, telemonitoring systems must also alert physicians to weight loss in heart failure patients. “

But that’s not enough. There should be tools that warn patients who are losing weight that it could be due to the heat and they should contact their doctor to reduce the dose of diuretics. And who is not under remote control? According to experts, a good rule of thumb would be to contact a health care practitioner if your weight drops 2 pounds during a heat wave for advice on regulating diuretic medications. “Reacting in advance should help us prevent complications – concludes the expert”.

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