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Heat Stroke: Symptoms and Treatment

Risk Factors for Heat Stroke

Heat stroke is most likely to affect older people who live in apartments or homes lacking air-conditioning or good airflow. Other high-risk groups include people of any age who don't drink enough water, have chronic diseases, or who drink excessive amounts of alcohol.

Heat stroke is strongly related to the heat index, which is a measurement of how hot you feel when the effects of relative humidity and air temperature are combined. A relative humidity of 60% or more hampers sweat evaporation, which hinders your body's ability to cool itself.

The risk of heat-related illness dramatically increases when the heat index climbs to 90 degrees or more. So it's important -- especially during heat waves -- to pay attention to the reported heat index, and also to remember that exposure to full sunshine can increase the reported heat index by 15 degrees.

If you live in an urban area, you may be especially prone to develop heat stroke during a prolonged heat wave, particularly if there are stagnant atmospheric conditions and poor air quality. In what is known as the "heat island effect," asphalt and concrete store heat during the day and only gradually release it at night, resulting in higher nighttime temperatures.

Other risk factors associated with heat-related illness include:

Age. Infants and children up to age 4, and adults over age 65, are particularly vulnerable because they adjust to heat more slowly than other people.

Health conditions. These include heart, lung, or kidney disease, obesity or underweight, high blood pressure, diabetes, mental illness, sickle cell trait, alcoholism, sunburn, and any conditions that cause fever.

Medications. These include antihistamines, diet pills, diuretics, sedatives, tranquilizers, stimulants, seizure medications (anticonvulsants), heart and blood pressure medications such as beta-blockers and vasoconstrictors, and medications for psychiatric illnesses such as antidepressants and antipsychotics. Illegal drugs such as cocaine and methamphetamine also are associated with increased risk of heat stroke.

People with diabetes -- who are at increased risk of emergency room visits, hospitalization, and death from heat-related illness -- may be especially likely to underestimate their risk during heat waves, according to a recent study presented at the Endocrine Society's annual meeting by researchers from the Mayo Clinic in Arizona, the National Ocean and Atmospheric Administration, and the National Weather Service.

Check with your doctor to see if your health conditions and medications are likely to affect your ability to cope with extreme heat and humidity.

Preventing Heat Stroke

When the heat index is high, it's best to stay in an air-conditioned environment. If you must go outdoors, you can prevent heat stroke by taking these steps:

  • Wear lightweight, light-colored, loose-fitting clothing, and a wide-brimmed hat.
  • Use a sunscreen with a sun protection factor (SPF) of 30 or more.
  • Drink extra fluids. To prevent dehydration, it's generally recommended to drink at least eight glasses of water, fruit juice, or vegetable juice per day. Because heat-related illness also can result from salt depletion, it may be advisable to substitute an electrolyte-rich sports drink for water during periods of extreme heat and humidity.
  • Take additional precautions when exercising or working outdoors.The general recommendation is to drink 24 ounces of fluid two hours before exercise, and consider adding another 8 ounces of water or sports drink right before exercise. During exercise, you should consume another 8 ounces of water every 20 minutes, even if you don't feel thirsty.
  • Reschedule or cancel outdoor activity. If possible, shift your time outdoors to the coolest times of the day, either early morning or after sunset.

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