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: 10701720
• 负责人: CRAIG G CRANDALL
• 金额: $ 56.04万
• 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/10701720
• 关键词: Acceleration; 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; Dryness; Elderly; Electricity; Encapsulated; Exhibits; Experimental Models; Exposure to; Frequencies; Generations; Government; Heat Stress Disorders; Heat Waves; Heating; Home; Household; Human; Humidity; Hyperthermia; Impairment; Individual; Industry; Injury; Libraries; Literature; Los Angeles; Low Income Population; Metabolic; Midwestern United States; Modality; Morbidity - disease rate; Outcome; Perfusion; Physiological; Population; Predisposition; Quarantine; Reporting; Risk; Shapes; Skin; Socioeconomic Status; Stress; Temperature; Testing; Time; United States; Vulnerable Populations; Water; Work; age effect; age group; cost; current pandemic; efficacy evaluation; future pandemic; 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，相对于任何其他年龄，老年人的死亡人数不成比例 团体。重要的是要注意，这种死亡主要是心血管，而不是高温本身的起源。 然而，我们对实际热量中衰老对心血管功能的影响相对较少 波状条件。这项工作的中心假设是老年人表现出更大的心血管 在热浪条件下的压力，可以通过使用低能需求冷却来减轻这种压力 策略。 AIM 1将检验以下假设，即老年人的热调节能力受损 在长期暴露于热浪条件下，将达到高潮的心血管应激。 相对于年轻人，将评估老年人的全面心血管和热反应 在暴露于两个长时​​间的热浪条件下：潮湿潮湿（复制1995年芝加哥热浪）， 非常干燥（复制2018年洛杉矶热浪）。 AIM 2将测试皮肤润湿的假设 一种有效的冷却方式，可减弱核心体温和伴随心血管的高程 老年人热浪期间的压力，而风扇的使用可能会有害于空气温度 以及是否使用皮肤润湿。尽管空调是防止热量的最有效策略 相关的发病率和死亡率，八分之一（约12％）美国人无法使用空调，这是 在美国中西部和东北地区，高温和死亡人数的百分比可能更高 海浪特别高。此外，诸如社会经济地位，停电，政府等因素 - 施加滚动停电，以及共同封闭的公共场所（例如，购物中心，图书馆，高级中心， 等等。）在最需要时，通常会在范围内范围内访问空调。因此，是 确定非空气条件依赖方式的必要 在热浪条件下，老年人的体温和相关的心血管应激。这个目标 仅评估皮肤润湿的功效，仅使用风扇，并在减轻皮肤润湿和风扇的结合 两者中核心体温和相关的心血管应激的高度过高 AIM 1中概述的热浪类型。这项工作的预期结果将重新塑造我们的 了解衰老对热浪期间心血管功能的后果以及识别 低能冷却方式的功效是针对挽救这种脆弱人群的生命的 热浪暴露。