A study from the Yale School of Public Health (USA) suggests that two medications for the heart (metablockers and antiplatelet agents) are linked to a increased risk of heart attack in very hot weather.
For coronary patients, beta-blockers can improve survival and quality of life, while aspirin and other antiplatelet drugs can reduce the risk of heart attack.
But those protections could backfire in hot weather, when heart attacks are more likely. And this study revealed that among people who have nonfatal heat-related heart attacksa very large number take these heart medications.
“Patients taking both of these drugs are at increased risk,” says Kai Chen, associate professor in the Department of Epidemiology (Environmental Health) at the Yale School of Public Health and first author of the study. “During a heat wave, they really have to take their precautions”Express.
These precautions include cooling strategies such as using air conditioning or visiting a public cooling center.
External environmental factors, such as air pollution and cold, can trigger heart attacks. There is growing evidence that heat can also do this. But epidemiologists are still working to identify what groups of people are most vulnerable to these environmental extremes.
methods
Using a registry, the authors analyzed 2,494 cases of people who suffered a nonfatal heart attack in Augsburg, Germany, during the warm months (May to September) between 2001 and 2014.
In previous research, they had shown that exposure to heat or cold increased the likelihood of heart attacks and calculated that rates of heat-related heart attacks would increase onceThe planet will warm up between 2 and 3 degrees Celsius.
The current study builds on that research by looking at patients’ medication use before their heart attack. They analyzed the data so that patients served as their own controls, comparing heat exposure on the day of the heart attack with the same weekdays in the same month.
That is, if a person had a heart attack on the third Thursday in June, the authors compared their temperature exposure on that day with their temperature exposure on other “control” Thursdays in June.
Two drugs linked to risk
It turned out that users of beta-blockers or antiplatelet drugs were more likely to have heart attacks on hotter days than on control days.
The use of antiplatelet drugs was associated with an increased risk of 63% and that of beta-blockers with 65%. People taking both drugs had a 75% increased risk. Non-users of these drugs were no more likely to have a heart attack in hot weather.
The study does not prove that these drugs caused the heart attacks, or that they make people more susceptible to heart attacks. While they may increase the risk of heat-triggered heart attacks, it’s also possible that patients’ underlying heart conditions explain both the prescriptions and the increased susceptibility to heart attacks in hot weather.
However, one clue suggests that drugs might be to blame. When the researchers compared younger patients (aged 25 to 59) with older patients (aged 60 to 74), they found, unsurprisingly, that younger patients were a healthier group, with lower rates of coronary heart disease.
However, younger patients taking beta-blockers and antiplatelet drugs were more likely to have heat-related myocardial infarction than older patients, despite the latter having more heart disease.
Another clue that these two types of drugs can make people more vulnerable. For the most part, other heart medications have not been shown to be linked to heat-related heart attacks.
However, an exception was statins. When taken by younger people, statins are associated with a higher risk of three times more likely to have a heart attack in hot weather.
“Our hypothesis is that some of the drugs may make it more difficult to regulate body temperature,” says Chen, adding that he plans to try to untangle these relationships in future studies.
The results suggest that, as the climate changeheart attacks could become a greater danger for some people with cardiovascular disease.