Heart health and heat: How hot is too much?

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Extreme temperatures put people with heart and cardiovascular disease at risk for life-threatening illness, especially in hot weather.

As temperatures rise, so does the risk of those heat-related ailments.

Extreme heat is dangerous for many reasons, especially for people living with heart disease who need to be particularly careful during the summer. Black people face a disproportionately higher burden of cardiovascular disease compared to white their white peers – they are 30% more likely to die from heart disease and significantly more prone to hypertension and strokes. Extreme heat increases those chances. 

Dr. Sai Vanam, a cardiologist with Novant Health, says it is common for the heart to work harder in hotter weather. 

“As temperatures rise, it puts more stress on the heart, specifically,” Vanam said. “I see a lot of patients. Dehydration is probably one of the most common reasons for me seeing a patient, to be honest, and we should … drink about 2 liters of water, but in the summer I think we should aim for a higher goal, so probably around 2.5 to 3.”

Dehydration can also affect those with pre-existing heart conditions at a more severe level.

“If you have pre-existing cardiac conditions you should aim to increase your water intake, because in the summer it is natural to sweat more, but in doing so you are losing so much water out of your body that dehydration becomes likely. And dehydration is a big stress on the heart. When you are dehydrated, you get less blood to the rest of your organs because the heart slows down when you're dehydrated.”

Vanam cited the disproportionate number of African Americans affected by cardiovascular disease for understanding the effect of heat-related illness. 

“Heart conditions in general are more prevalent in African Americans,” he said, “things like coronary artery disease, heart failure. If you look at demographics, African Americans tend to be more prone to these conditions. So, if you have pre-existing heart conditions, such as the ones I mentioned, it puts you at greater risk when, as it gets hotter, dehydration poses a higher risk, especially when you have pre-existing heart conditions.”

Vanam also adds older people are at higher risk of heat-related illness. 

“The older you get, the more your skin tends to be a little bit thinner,” he said. “If you are out in the sun, you have a tendency to get dehydrated and put more stress on the heart. I think that is one population that needs to be careful and especially anyone in the geriatric community with a pre-existing heart condition.”

While remining indoors in air conditioning is preferable, other factors play a role in heat exposure, including jobs that require outdoors work. 

“Socioeconomic factors play a big role in this, but staying out of the heat at all costs for extended periods of time is definitely my recommendation,” Vanam said. “If you have an A/C unit, keeping the house cool is important. Also, putting cold water on yourself too can help decrease the body’s temperature. Lastly, when you’re out in the sun it affects the skin directly too, so sunscreen is important to prevent things like skin cancer as well.” 

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