Heat waves, aging, and human cardiovascular health.
Heat waves, aging, and human cardiovascular health.
复制标题
DOI：
10.1249/mss.0000000000000325
复制
发表时间：
2014-10
影响因子：
4.1
通讯作者：
Alexander LM
中科院分区：
文献类型：
--
作者：
Kenney WL;Craighead DH;Alexander LM
这篇简短的综述基于 2013 年美国运动医学会年会上发表的校长演讲。这篇综述的目的是评估气候变化和随之而来的环境热应激增加对老化心血管系统的影响。地球平均温度正在缓慢但持续地上升，随着平均温度的变化，热浪频率和严重程度也随之增加。由于环境温度长时间升高以及在炎热环境中长时间进行体力活动而产生的极端被动热应激，对左心室向皮肤泵血以散热的要求很高。即使健康的衰老也会伴随着心血管功能的改变，这限制了老年人在暴露于极端环境时维持每搏输出量、增加心输出量和增加皮肤血流量的程度。对于老年人来说，热浪期间心血管需求的增加往往是致命的，因为已经受损的左心室压力增加。毫不奇怪，热浪期间的过量死亡 1) 主要发生在老年人中，2) 绝大多数是心血管原因造成的。热浪的频率和严重程度不断增加，加上高危人群迅速增长，极大地增加了未来不良健康后果的程度。
This brief review is based on a President’s Lecture presented at the Annual Meeting of the American College of Sports Medicine in 2013. The purpose of this review is to assess the effects of climate change and consequent increases in environmental heat stress on the aging cardiovascular system. The earth’s average global temperature is slowly but consistently increasing, and along with mean temperature changes come increases in heat wave frequency and severity. Extreme passive thermal stress resulting from prolonged elevations in ambient temperature, as well as prolonged physical activity in hot environments, creates a high demand on the left ventricle to pump blood to the skin to dissipate heat. Even healthy aging is accompanied by altered cardiovascular function, which limits the extent to which older individuals can maintain stroke volume, increase cardiac output, and increase skin blood flow when exposed to environmental extremes. In the elderly, the increased cardiovascular demand during heat waves is often fatal due to increased strain on an already compromised left ventricle. Not surprisingly, excess deaths during heat waves 1) occur predominantly in older individuals and 2) are overwhelmingly cardiovascular in origin. Increasing frequency and severity of heat waves coupled with a rapidly growing at-risk population dramatically increases the extent of future untoward health outcomes.