At least 7% of all deaths each year can be attributed to the cold. With the temperatures plummeting and the white blanket of snow covering our peninsula, the advice of the Italian Society of Internal Medicine (Simi) arrives, which explains who is at greater risk, such as the elderly, the frail and those suffering from chronic pathologies and how to defend yourself.
First, pay attention to the heart. “One of the worst threats of the ‘general winter’ is that posed to the cardio-circulatory system – explains Giorgio Sesti, president of Simi – with an increased incidence of heart attacks, strokes and a worsening of peripheral arterial disease (or PAD, those affecting of the arteries of the lower limbs). Above all, people with cardiovascular diseases are the ones most exposed to this risk, which relies on the way in which the body reacts to cold. “To avoid dispersing heat – continues 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 in the 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 also lead to more urination, thus exposing you to the risk of dehydration, which may seem strange in winter, but it happens. “It is necessary to ensure a good intake of liquids – recalls Sesti – but absolutely not of alcohol. The idea that alcohol ‘warms up’ is a misleading sensation; in reality, by producing peripheral vasodilation, alcohol favors the dispersion of All the more reason – he recommends – to avoid the consumption of alcoholic beverages, which never have beneficial effects”.
Protect nose and mouth for the sake of bronchi and lungs. The respiratory system is also affected by the drop in temperatures. “This season – says Sesti – we are witnessing an exacerbation of chronic respiratory diseases such as obstructive bronchitis and asthma because the passage of cold air along the airways causes irritation and, consequently, cough, increase in catarrhal secretions and a difficult and labored breathing (dyspnoea).For this reason it is important to avoid leaving the house in the coldest hours, to protect your nose and mouth well with a scarf (and a mask, especially when getting on crowded public transport) to warm the air 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. Anyone suffering from asthma should always have an inhaler with them for an emergency ‘puff'”.
Even 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 – he underlines the expert – exposes them to a greater risk of respiratory infections. If it is 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”.
The Achilles heel of the joints. Cold and humidity are not a panacea for bones and joints, as all those who suffer from inflammatory rheumatic diseases or arthrosis are well aware. “It is therefore necessary to cover oneself adequately to keep the body warm – advises 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 turn white , then purplish and red with so much pain) he must be particularly careful of sudden changes in temperature, protecting his hands well from the cold and avoiding putting them on the radiator or in hot water, once back home; smoking must be absolutely eliminated, 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, the experts recommend. Also be careful not to exaggerate with calories at the table, because every extra kilo will put a strain on the joints. It is important to fill up on vitamin D and calcium, especially if you do not leave the house and are not exposed to sunlight.
Finally, how to adjust with physical activity and cold. Runners in good health can continue running even with low temperatures, taking care to dress appropriately, paying attention to humidity and sweat that must not remain in contact with the body, as well as to the cold, and to hydrate adequately . “People with known cardiovascular problems or subjects at risk such as hypertensives, diabetics, overweight people – warns Sesti – must instead be very careful not to make excessive efforts outdoors, if the temperatures are rigid. In this season, walks are good during the hot hours and on sunny days, but for everything else, physical exercise should be done indoors: in the gym, by the pool or at home.Remember to dress very well even when you take the dog out, especially early in the morning and the evening. Finally, great attention also to physical activity ‘induced’ by bad weather: shoveling snow can prove to be decidedly dangerous for the heart, as can changing a flat tire in freezing temperatures”.