Heat waves and the elderly: reducing thermal and cardiovascular consequences

热浪与老年人：减少热和心血管后果

• 批准号: 10468087
• 负责人: CRAIG G CRANDALL
• 金额: $ 55.22万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10468087
• 关键词: Activities of Daily Living; Address; Adverse effects; Aging; Air; Air Conditioning; American; Attenuated; Body Temperature; COVID-19; Cardiovascular Physiology; Cardiovascular system; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chicago; Coupled; Data; Elderly; Electricity; Encapsulated; Exhibits; Experimental Models; Exposure to; Frequencies; Future; Generations; Government; Heat Stress Disorders; Heat Waves; Heating; Home; Household; Human; Humidity; Hyperthermia; Impairment; Individual; Industry; Injury; Libraries; Literature; Los Angeles; Low income; Metabolic; Midwestern United States; Modality; Morbidity - disease rate; Outcome; Physiological; Population; Quarantine; Reporting; Risk; Savings; Shapes; Skin; Socioeconomic Status; Stress; Temperature; Testing; Time; United States; Vulnerable Populations; Water; Work; age effect; age group; cost; global temperature; indoor air; mortality; pandemic disease; prevent; response; socioeconomics; young adult

Abstract Heat waves are lethal and cause a disproportionate number of deaths in the elderly relative to any other age group. It is important to note that such deaths are primarily cardiovascular, not hyperthermia itself, in origin. Nevertheless, we know relatively little about the effects of aging on cardiovascular function during actual heat wave-like conditions. The central hypothesis of this work is that the elderly exhibit greater cardiovascular stress during heat wave conditions, which can be mitigated by employing low-energy demand cooling strategies. Aim 1 will test the hypothesis that recognized impairments in thermoregulatory capacity in the elderly will culminate in heightened cardiovascular stress during prolonged exposure to heat wave conditions. Comprehensive cardiovascular and thermal responses in the elderly, relative to younger adults, will be evaluated during exposure to two prolonged heat wave conditions: hot and humid (replicating the 1995 Chicago heat wave), very hot and dry (replicating the 2018 Los Angeles heat wave). Aim 2 will test the hypothesis that skin wetting is an effective cooling modality to attenuate elevations in core body temperature and accompanying cardiovascular stress during heat waves in the elderly, while the use of a fan may be detrimental depending on air temperature and whether skin wetting is employed. Though air conditioning is the most effective strategy to prevent heat- related morbidity and mortality, 1 in 8 (~12%) Americans do not have access to air conditioners, and this percentage is likely higher in the Midwest and Northeast United States where injury and deaths during heat waves are particularly high. Moreover, factors such as socio-economic status, power outages, government- imposed rolling blackouts, and COVID-19 related closures of public spaces (e.g., malls, libraries, senior centers, etc.) threaten region-wide access to air conditioning often at times when it is most needed. Therefore, it is essential to identify non-air conditioning dependent modalities that will attenuate excessive elevations in core body temperature and associated cardiovascular stress in the elderly during heat wave conditions. This aim will assess the efficacy of skin wetting only, fan use only, and a combination of skin wetting and fan use in mitigating excessive elevations in core body temperature and associated cardiovascular stress in the elderly during both types of heat waves outlined in Aim 1. The expected outcomes from this body of work will re-shape our understanding of the consequences of aging on cardiovascular function during heat waves, as well as identify the efficacy of low-energy cooling modalities directed towards saving the lives of this vulnerable population during heat wave exposure.

抽象的 热浪是致命的，与其他年龄段相比，老年人的死亡人数不成比例 团体。值得注意的是，此类死亡主要是心血管死亡，而不是高热本身。 然而，我们对实际高温期间衰老对心血管功能的影响知之甚少。 波状条件。这项工作的中心假设是老年人表现出更强的心血管 热浪条件下的应力，可以通过采用低能耗冷却来缓解 策略。目标 1 将验证老年人体温调节能力受损的假设 长时间暴露在热浪条件下，最终会导致心血管压力加剧。 将评估老年人相对于年轻人的综合心血管和热反应 在暴露于两种长期热浪条件下：炎热和潮湿（复制 1995 年芝加哥热浪）， 非常炎热和干燥（复制 2018 年洛杉矶热浪）。目标 2 将检验皮肤润湿的假设 一种有效的降温方式，可减轻核心体温和伴随的心血管疾病的升高 老年人在热浪期间会感到压力，而根据气温，使用风扇可能是有害的 以及是否采用皮肤润湿。虽然空调是防暑最有效的策略 相关的发病率和死亡率，八分之一 (~12%) 的美国人无法使用空调，而这 美国中西部和东北部的百分比可能更高，这些地区在高温期间受伤和死亡 波浪特别高。此外，社会经济地位、停电、政府- 实行轮流停电，并关闭与 COVID-19 相关的公共场所（例如商场、图书馆、老年中心、 等）往往在最需要的时候威胁到整个地区的空调使用。因此，它是 对于确定非空调依赖性模式至关重要，这些模式将减弱核心的过度升高 热浪条件下老年人的体温和相关心血管应激。这一目标将 评估仅润湿皮肤、仅使用风扇以及皮肤润湿和风扇组合使用的缓解效果 老年人的核心体温过度升高以及相关的心血管压力 目标 1 中概述的热浪类型。这项工作的预期结果将重塑我们的 了解热浪期间衰老对心血管功能的影响，并确定 旨在挽救这一弱势群体生命的低能耗冷却方式的功效 热浪暴露。