Beer, shade and positive emotions fight the heat

A little beer, a lot of shade and doctors recommend positive emotions to deal with the heat, BTA reported.

Doctors Prof. Arman Postadjian - head of the Department of Cardiology at the Cardiology Clinic at the Metropolitan University General Hospital for Active Treatment (UMBAL) spoke for BTA about dealing with the heat that has continued for the third month “St. Anna“, Prof. Rosen Kalpachki - Head of the Clinic for Nervous Diseases at the Hospital "St. Anna“, Dr. Svetozar Marangozov - vascular surgeon at the Military Medical Academy (MMA), and Dr. Yoanna Marinova, psychiatrist at the MMA.

Because of the extremely high temperatures that last for a long time, patients affected by heart failure, cardiomyopathy or who have experienced multiple heart attacks suffer much more compared to the general population, said Prof. Arman Postajian. According to him, people instinctively know what to do on warm days, but at the moment there is too long a period of heat. It is forgotten that adults should not go outside between 2:00 p.m. and 4:00 p.m. Wear light and loose clothes, a hat, and do not stay in the sun for no reason, advises the doctor.

Young men more often have sudden cardiovascular events compared to young women, Prof. Postadjian also said and specified that young people are generally more difficult to convince to adhere to their prescribed therapy.

Summer and arrhythmia

The majority of people seek medical help because of their "mistakes” - not taking enough fluids and overheating due to a long stay in the sun. Dehydration leads to lower blood pressure values, increased heart rate or arrhythmia. These complaints are not a cardiovascular disease, but are provoked by the summer period, Prof. Postadjian explained, but reminded that those who have experienced a cardiovascular accident should be especially careful.

Healthy people and heat

If one is young and of good enough reactivity, one can handle the current heat. In a healthy heart, the main thing that happens because of the heat is vasodilation – dilation of the vessels and the need to drink more fluids to compensate for their deficiency. Otherwise, the heart begins to work faster, people feel rapid heartbeat and fainting, said the cardiologist.

Liquids, but mainly water

Fluid loss – mainly through respiration or perspiration, is much greater during hot weather. It is best to drink water. In healthy people, the increased amount of fluids does not burden the kidneys, as they work normally and will remove the unnecessary from the body. Younger women who have blood pressure values of 90/60 are advised to drink more sweetened or saltier drinks on hot days, as this way the fluid would be retained for a longer time in the vessels. This is especially important for young but healthy people, Prof. Arman Postadjian emphasized. This recommendation does not apply to people who have had a heart attack or have diabetes.

Sudden cardiac arrest in young men

The problem of "rejuvenation” of cardiovascular disease occurs because people are subject to the classic risk factors for cardiovascular disease – hypertension, high cholesterol level, smoking, Prof. Postajian also pointed out. According to him, no one knows what his own blood vessels hide, which is the big problem.

Non-adherence to treatment is more common among young people, especially men, the doctor added. It is difficult to say why this is so, he added, explaining that young people have a hard time accepting the thought that treatment will last for years. Young men are more likely to have sudden cardiovascular events than young women, Prof. Postajian added.

In summer, heart attacks occur less often than in autumn and winter, he added.

Heat is a risk factor for stroke

Heat affects stroke survivors badly and creates risks for new strokes, said Associate Professor Rosen Kalpachki. Heat is one of the risk factors for stroke, he said, because heat leads to dehydration, and dehydration makes the blood thicker and more prone to clot formation. Most strokes are caused by a blood clot – clot, in some of the vessels of the brain. The other type of stroke, which is called cerebral hemorrhage, occurs by a different mechanism – rupture of a cerebral artery and effusion of blood. The heat also contributes to these strokes, because the possibility of rupture of a cerebral vessel is created due to the heating of the head, the doctor explained.

Five beers for five glasses of water

Hot weather is not a good time to drink alcohol, as it is an additional risk factor for brain hemorrhages. In general, alcohol consumption should be moderate, and in the heat – twice as moderate, added Prof. Kalpachki.

In beer, as a drink preferred in the heat, the standard alcohol content is 4-5 percent, and the rest - up to 100 percent, is water, but five beers of 300 ml each bring into the body nearly 100 ml of pure alcohol, which is about 150 ml of vodka, added Prof. Kalpachki. Alcohol dilates all blood vessels, and if direct solar heating of a person's head is added to this fact, the blood concentrates, the blood pressure rises, and cerebral hemorrhage can occur. The big problem with alcohol is that it makes the vessels narrower and for this reason is a serious provoking factor for cerebral hemorrhage. Apart from that, alcohol can provoke a fall, injuring the head and causing bleeding.

Five beers can be drunk on a day off, Prof. Kalpachki also said and reminded that the brain "doesn't like" risky moves – a long time without alcohol and suddenly drinking a large amount of beer.

Stroke in young people

All the risk factors for stroke are also found in young people, which is the reason why stroke does not only occur in the elderly population. Stroke is a consequence of high blood pressure, diabetes, high cholesterol, heart disease. Young people love the harmful a little more – lack of sleep, sedentary lifestyle, staring at screens, smoking, drinking, and all of them are stroke-prone, added Prof. Kalpachki. According to him, the biggest scourge is high blood pressure, and because it doesn't hurt, people don't treat it properly. Blood pressure control should not be stopped. No one died from low blood pressure, but high blood pressure kills every day, added Prof. Kalpachki.

Hat, shadow, movement, water

When there is no hat on the head and if it is possible to measure the temperature of the liquid that is around the brain, it will be established that there is a negative effect of direct sunlight on the skull, Prof. Kalpacki also said. Without a cap, the skull cools, but the temperature of this fluid becomes higher. People in the desert walk with their heads covered, the doctor recalled, adding that historical experience shows that whoever went through the desert with a bare head did not return alive. A thin, ray-repelling hat with a brim keeps the temperature of the fluid around the brain slightly cooler than if the head were exposed to direct heat. Direct heating is a risk factor because, in addition to the head, the face and eyes are heated. A covered head is certainly cooler. The best advice for people is to stay in the shade, drink more fluids, move and have positive emotions.

Strokes occur more often in the summer and winter, and cases are more frequent among people who have a predisposition to stroke – high blood pressure, heart problems, blood that clots easily, long-term overuse of alcohol and cigarettes, high cholesterol, drug users or drug users.

Among healthy people, neither heat nor cold will provoke a stroke, Prof. Kalpachki also said.

"Lead legs"

On hot days, healthy people most often feel heaviness in their legs and have slight swelling in their ankles, as if they had a bag of sand tied to their legs, said Dr. Svetozar Marangozov. These are the so-called lead legs. Almost every second patient who comes to my office has swollen feet, he added, pointing out that the feet swell mostly at the end of the day, after sitting for a long time, traveling for a long time or being exposed to the sun. The heat leads to dilation of the small vessels, to lymphatic stagnation, and from there, the swelling in the legs that people feel at the end of the day. An examination is needed to determine whether the patient has lymphatic stasis, a venous disorder, or another problem, and then make recommendations and prescribe treatment if necessary. In people who have been proven to have venous pathology, we increasingly observe superficial thrombophlebitis or deep venous thrombosis, which are not rare this summer, the doctor also pointed out.

Swelling of fingers

Swelling of the fingers could occur during a long journey in which a person is immobilized or during a long hike in nature. Dr. Marangozov recommended using poles for long hikes, which would make the muscles of the arms move, and the swelling would be small. Fingers swell from the heat and from the static posture of our body during the day, as our limbs stay in one position and do no physical activity that helps reduce swelling.

Swelling in one leg

Whenever there is a sudden onset of edema or swelling of only one limb, medical help should be sought, Dr. Marangozov added. An examination is necessary because people suffering from venous pathology and those who have evidence of such problems in the past, often due to dehydration and overheating, get thromboses. Thrombosis is a serious complication of the venous system, which can even be life-threatening, he added. If there is edema that affects only one leg or edema that has not gone away in the morning, a consultation with a vascular surgeon must be done, advised Dr. Marangozov.

Every hour – five minutes

The best prevention of the cardiovascular system is movement. Static posture and/or overheating of the feet predisposes to swelling even in the cold months.

People whose occupations are static are recommended to get up every hour and for five minutes move or do exercises, stepping from heels to toes and back. A light foot massage can also be done, he added. According to him, when working in a static position, it is good to have a chair or other aid under the desk on which the legs can be kept slightly elevated.

The advice to people suffering from obesity or vein problems is to avoid going outside during the hottest hours.

Good hydration is very important, said Dr. Marangozov and indicated that a person weighing 70 kg should drink at least two liters of fluids. Alcohol and coffee are not recommended.

There are no special requirements for food intake, but it is better if it is easily digestible, since constipation aggravates venous pathology and increases the pressure in the veins of the legs.

Sea at home?

Salty seawater has an extremely beneficial effect on blood vessels, but saltwater prepared at home does not have the same properties as seawater. Seawater also contains minerals that support the veins, which cannot be obtained at home. Patients who have vein problems, even when at sea, should avoid the hottest hours outside, added the doctor.

Elastic socks are not a panacea

Elastic stockings can be used in some conditions, but they are worn only after a doctor's consultation, as the doctor should first clarify whether there is a need for them, and then their compression and length. These socks can cause harm if their compression is not dosed correctly. Patients who have severe lymphatic congestion – the so-called "elephant legs", wear elastic stockings made according to individual parameters, pointed out Dr. Marangozov.

Irritable and unmotivated

As a result of the long-lasting heat, among healthy people without any mental illnesses, we observe general fatigue, irritability and lability, lack of motivation to work, said Dr. Joanna Marinova. According to my observations, heat lasting about two weeks is enough to have quite an adverse effect on people's ability to work and desire to work, she added. When you have no control over the environment, and you feel lost, it is normal to show some irritability and behavior that is not very typical in other conditions, the doctor added. According to her, in the heat of the moment, people who have not yet sought help from psychiatrists turn to them. The number of people suffering from anxiety-depressive disorders seeking psychiatric help has increased.

Wave of anxiety

From mid-July to mid-August, there was a wave of patients exhibiting anxiety. According to Dr. Marinova, this is normal, as the weather affects blood pressure, and this usually worries everyone. As a result, his mental condition worsened and he had to seek help. Patients usually say they feel sick and tense, can't sleep, and their blood pressure and heart rate change, and they think something bad is going to happen to them, that they're going to have a heart attack or stroke, she added. In very hot weather, blood vessels dilate, blood pressure drops, and this leads to a rapid heart rate. People feel their heart racing and think they are having a heart attack. These are complaints related to the anxiety spectrum, and some people even seek emergency care. When they are examined, they see that they have no reason to worry about their health and do not need help. We must consider that some factors are beyond our control and it is important to try as much as we can to consciously control our reactions, added Dr. Marinova.

Advice for healthy people

Not to go outside during the hottest hours, to provide additional cooling at home and at work, to have good sleep hygiene, as well as adherence to a balanced diet and moderate physical activity, advises Dr. Marinova.

Patients with mental illness

Patients with mental illnesses react differently to continued heat, depending on the illness, but not infrequently their condition worsens and an adjustment of their therapy is necessary. Adherence to their prescribed therapy is extremely important. Some patients become very irritable, aggressive and violent, and people with anxiety disorders become even more anxious, added Dr. Joanna Marinova.