breaking latest news – Heart, bronchi, lungs, but also joints and risk of falls. These are the key aspects to protect and keep in mind for good health even in sub-zero temperatures. With temperatures plummeting and snow covering our peninsula, we need to know how to defend ourselves from the perils of the extreme cold. The experts of the Italian Society of Internal Medicine (Simi) are generous with advice, especially for people most at risk, such as the elderly, the frail and those suffering from chronic diseases.
Winters characterized by extreme phenomena are now a habit, a direct consequence of climate change. But the concept of ‘extreme cold’ remains very relative: temperatures close to zero can be considered ‘extreme’ in Sicily, while they are completely normal in Abruzzo or Alto Adige, regions more accustomed to the great winter cold and therefore better equipped. Every year at least 7% of all deaths can be attributed to colda highly topical topic in times of energy crisis such as the ones we are going through.
Who risks the most and how to defend yourself
Thinking about the risks of cold temperatures, the mind immediately goes to flu, colds and all the plethora of respiratory viruses that surround us. “But in reality – explains Professor Giorgio Sesti, president of the Italian Society of Internal Medicine – one of the worst threats of the ‘general winter’ is that posed to the cardio-circulatory systemwith an increased incidence of heart attacks, strokes and a worsening of peripheral arterial disease (or PAD, those affecting the arteries of the lower limbs)”.
Above all, people suffering from known cardiovascular diseases are those most exposed to this risk, which relies on the way in which the body reacts to cold. “To avoid dispersing heat – explains Professor Sesti – the peripheral vessels ‘contract’ (vasoconstriction), but this in turn causes a reduced blood flow to the periphery (with the cold, the symptoms of claudication worsen, very strong cramping pains in the thigh or calf, which appear in those suffering from PAD) and an increase in blood pressure.This is why it is often necessary to adjust the dosages of antihypertensive therapy upwards in winter or to combine other drugs to keep blood pressure under control “.
Rising blood pressure and the cold not only pose a threat to the heart and brain vessels, but also lead to more urination, thus exposing you to the risk of dehydration (which may seem strange in winter, but it happens), consequently making the blood thicker and less ‘flowing’ inside the vessels, phenomena that can favor the formation of thrombi.
“And therefore – recalls Professor Sesti – in addition to reducing the pressure adequately, it is necessary ensure a good liquid income. But absolutely not alcohol. The idea that alcohol ‘warms’ is a deceptive feeling; in reality, by producing peripheral vasodilation, alcohol favors the dispersion of heat. All the more reason therefore to avoid the consumption of alcoholic beverages, which never has any beneficial effects”.
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The respiratory system is also affected by the drop in temperatures. And we’re not just talking about flu and respiratory viruses that circulate abundantly in winter. “This season – continues Sesti – we are witnessing an exacerbation of chronic respiratory diseases such as obstructive bronchitis (COPD) and asthma because the passage of cold air along the airways causes irritation and consequently, cough, increase in catarrhal secretions and difficult and labored breathing (dyspnoea).For this reason it is important to avoid leaving the house in the coldest hours, protect your nose and mouth well with a scarf (and a mask, especially when getting on crowded public transport) to warm up the air that we inhale; it will also be necessary to evaluate with your doctor whether it is appropriate to add a ‘puff’ of bronchodilator / anti-inflammatory in therapy. Asthma sufferers should always have an emergency puff inhaler with them.. People with long Covid must be particularly careful in case of cold and bad weather because according to a review recently published in the Bmj, their lung function can remain compromised for a variable time after the Covid infection and this exposes them to greater risk of respiratory infections. If necessary to go out, in addition to protecting themselves well from the cold, these people should wear a Ffp2 mask, especially in crowded and poorly ventilated environments”.
Cold and humidity are not good for bones and joints. All those who suffer from inflammatory rheumatic diseases or arthrosis are well aware of this, even if a convincing scientific explanation for this phenomenon has not yet been found. “It is therefore necessary to cover oneself adequately to keep the body warm – recalls Professor Sesti – to wear waterproof gloves and jackets if you leave the house; those suffering from Raynaud’s phenomenon (an important peripheral vasoconstriction especially affecting the fingers which become then purplish and red with so much pain), he must be particularly careful of sudden changes in temperature (protect his hands well from the cold and avoid putting them on the radiator or in hot water, once back home); from absolutely eliminate smoking, which can aggravate the phenomenon“.
Even if forced indoors by bad weather, you must avoid staying still for too long, getting up frequently from the armchair or sofa and doing some home gymnastics, even with the help of one-kilo weights. Also be careful not to exaggerate with calories at the table because every extra kilo will weigh on the joints. Important fill up on vitamin D and calcium (with low-fat milk and dairy products and any supplements, as advised by your doctor), especially if you don’t leave the house and don’t expose yourself to sunlight. A frozen sidewalk or even just shiny from the rain, a cap pulled over the eyes or an open umbrella that reduce visibility can represent a danger and favor a fall which, in the frail and elderly, is often not without consequences.
“It is therefore better to prevent this risk – advises the professor – by leaving the house, if possible, only in the central hours of the day, made warmer by the sun and avoiding going out in the rain or snow. Wear woolen socks and comfortable shoes with non-slip and with a good ‘grip’ and prefer woolen hats to wide-brimmed or cloche ones, so as not to obstruct visibility.People with diabetic neuropathy (nerve damage in the extremities) need to be especially careful because they may not notice that the feet are getting too cold, putting themselves at risk of chilblains or frostbite.”