From the Guidelines
Heat stroke and hypertension are closely linked, and individuals with hypertension should take extra precautions to prevent heat stroke, especially during hot weather, as their cardiovascular system is already under strain. People with hypertension face a significantly higher risk of heat stroke because their cardiovascular system is compromised, making it harder for their body to cool down. If you have hypertension, you should take extra precautions during hot weather by staying hydrated with water, avoiding outdoor activities during peak heat hours (10am-4pm), seeking air-conditioned environments, wearing lightweight clothing, and monitoring your blood pressure regularly 1. Some blood pressure medications, particularly diuretics, beta-blockers, and ACE inhibitors, can affect your body's ability to regulate temperature or cause dehydration, potentially increasing heat stroke risk 1.
Key Considerations
- Don't stop taking your medications, but consult your doctor about possible adjustments during extreme heat 1.
- Heat stroke symptoms include high body temperature (above 103°F), altered mental state, hot and dry skin, nausea, rapid breathing, racing heart rate, and headache.
- This dangerous condition occurs because hypertension impairs blood vessel dilation needed for cooling, while also potentially causing kidney dysfunction that affects fluid balance.
- If you suspect heat stroke, seek emergency medical attention immediately as it can be life-threatening 1.
Management and Prevention
- The management of circulatory failure in heatstroke is crucial, and hypotension is associated with a high mortality rate 1.
- Fluid replacement sufficient to restore blood pressure and tissue perfusion is recommended, but careful fluid replacement is necessary to avoid pulmonary edema 1.
- The therapeutic approach recommended for hemodynamic management of sepsis can also be applied to heatstroke due to the pathophysiological similarities between the two diseases 1.
From the Research
Heat Stroke and Hypertension
There is no direct evidence in the provided studies that links heat stroke and hypertension. However, the studies provide information on the treatment and management of heat stroke.
Treatment of Heat Stroke
- Immediate cooling and support of organ-system function are the two main therapeutic objectives in patients with heat stroke 2.
- Immersion in an ice-water bath is the most effective cooling method, and evaporative cooling is a rapid and effective alternative 2, 3.
- Aggressive IV rehydration should be continued for the first 24 to 72 hours to prevent the development of rhabdomyolysis-induced acute renal failure 2.
- Cooling techniques such as ice-water immersion, evaporative cooling, and chilled intravenous fluids can be used to cool heat-stroke patients 4, 5.
Cooling Methods
- Water immersion of adults with exertional hyperthermia resulted in faster cooling rates when compared to passive cooling 5.
- No single water temperature range was found to be associated with a quicker core temperature reduction than another (cold, colder or ice) 5.
- Evaporative cooling is advocated as the most efficient method based on military and civilian experiences worldwide 6.
Management of Heat Stroke
- Rapid cooling is the most important feature in the management of heat stroke 3, 6.
- Cooling should be initiated immediately at the time of collapse and should be based on feasible field measures including ice or tepid water 3.
- Management should be matched to the patient's age and medical background and include immersion in ice water or evaporative cooling 3.