Two heart medications are associated with an increased risk of heart attacks during very hot weather

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For people with coronary heart disease, beta-blockers can improve survival and quality of life, while aspirin and other anti-platelet drugs can reduce the risk of heart attack.

But this protection can backfire during hot weather events, which is the time when the likelihood of heart attacks is highest. A new study finds that among people who suffer nonfatal heart attacks related to hot weather, a significant portion of them take these heart medications.

“Patients who take these two drugs have a higher risk,” said 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 heat waves, they should take precautions.”

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 weather can lead to heart attacks. Mounting evidence suggests that hot weather can do just that, too. But epidemiologists are still working to identify the groups of people most vulnerable to these environmental extremes.

Methods

Using the registry, the authors looked at 2,494 cases in which individuals experienced non-fatal heart attacks in Augsburg, Germany during the hot weather months (May to September) between 2001 and 2014.

In previous research, they showed that exposure to heat or cold increases the likelihood of heart attacks, and they calculated that heat-related heart attack rates would rise once the planet’s temperature rose by 2 to 3 degrees Celsius.

The current study built on this research by examining the use of medications for patients prior to a heart attack.

They analyzed the data in a way that allowed patients to act as their own controls, by comparing heat exposure on the day of the heart attack versus the same days of the week in the same month. This means that if a person had a heart attack on the third Thursday in June, the authors compared their temperature exposure on that day to their temperature exposure on the other Thursdays in the June “control.”

Two drugs linked to risks

It turns out that users of beta-blockers or anti-platelet drugs were more likely to have heart attacks on hot days than on control days. Use of anti-platelet drugs was associated with an increased risk of 63% and beta-blockers by 65%. People who take both drugs have a 75% higher risk. People not taking these medications were no more likely to have a heart attack on hot days.

The study did not prove that these drugs caused heart attacks, nor did they make people more likely to have heart attacks. Although they likely increased the risk of heart attacks caused by hot weather, it is also possible that the patients’ underlying heart disease explains both the prescription and susceptibility to heart attacks during hot weather.

However, one piece of evidence suggests that medications may be the culprit.

When the researchers compared younger patients (25 to 59 years old) to older patients (60 to 74 years old), they found, as expected, that younger patients were healthier, with lower rates of coronary heart disease. However, younger patients taking beta-blockers and anti-platelet drugs were more likely to have heat-related heart attacks than older patients, although older patients had more heart disease.

Further evidence that these two types of medications may make people more at risk: For the most part, other heart medications haven’t shown a link to heat-related heart attacks. (The exceptions were statins. When young people took them, statins were associated with more than three times the risk of heart attack on hot days.)

“We hypothesize that some medications may make it difficult to regulate body temperature,” Chen said. He plans to attempt to decipher these relationships in future studies.

The findings suggest that as climate change progresses, heart attacks may become more dangerous for some people with cardiovascular disease.


The study found a strong association between prediabetes and heart attack risk


more information:
Kai Chen et al, The pathogenesis of myocardial infarction by exposure to heat is modified by the administration of drugs, Cardiovascular Nature Research (2022). DOI: 10.1038 / s44161-022-00102-z

Submitted by Yale School of Public Health

the quote: Two heart medications linked to increased risk of heart attack during very hot weather (2022, August 1) Retrieved on August 2, 2022 from https://medicalxpress.com/news/2022-08-heart-medications-tied-gictures-hot. html

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