How Your Medicine Might Make You More Susceptible to Heat Stroke

For many of us, the warm weather months are a great time to be outside. You may enjoy evening strolls, gardening,
exercising and other outdoors activities during warm days.

Aging, however, can pose challenges when you’re hanging out in hot weather. Geriatric specialist Ronan Factora, MD, says this is not only because it’s harder for you to regulate your body temperature as you age, but also could be related to the medications you take.

Impaired ability to cool off

As you age, it’s often more difficult to recognize when you’re thirsty. This change combined with a normal reduction of water in your body increases your likelihood for dehydration. If you take diuretics such as furosemide (such as Lasix®) or a combination diuretic/beta blocker like hydrochlorothiazide or propranolol) for other health conditions, these also reduce excess fluid in the body. As the temperatures rise outside, these medications can result in real problems for older adults, who may also struggle with dehydration to begin with.

Additionally, you don’t sweat as much when you’re older as when you were younger, so it’s harder for your body to cool itself when your core temperature rises. Dr. Factora says this can be magnified by taking medicines such as oxybutynin or tolterodine, which are prescribed for overactive bladder, but also impair the ability to sweat. “If you can’t sweat, you lose some of your natural ability to control your core temperature,” he says.

Risk for heat stroke rises

The inability to regulate temperature and a decrease in sweating can contribute to symptoms of lightheadedness and dizziness. “When your body’s ability to cool itself becomes significantly hindered, the risk for heat stroke increases,” says Dr. Factora.

There are a host of medications to watch out for during the heat of the summer. These include blood pressure medications, medications for enlarged prostate such as tamsulosin, and those medications mentioned above.

In particular, orthostatic hypotension, which is a reduction in blood flow to the brain caused by moving from lying down to standing or sitting, can lead to dizziness and increased risk of a fall. “For many older adults, this fall can lead to a fracture and can become a serious event,” says Dr. Factora.

How to protect yourself

Here are a few suggestions to prevent complications due to warm weather:

• Drink fluids to prevent dehydration. What color is your pee when you go to the bathroom? Darker urine is your body’s way of saying you should drink more fluids. Urine should be a light, clear amber/yellow color.
• Wear a hat to keep cool if you’re spending time in the sun.
• Take breaks and sit down in shaded and air-conditioned areas to prevent overheating.
• Watch out for these symptoms: lightheadedness with change of position; headache; confusion; and reduced sweating. They may be signs of heat stroke and require immediate medical attention.

“My general advice is to enjoy the outdoors. It’s a great way to keep active,” says Dr. Factora. “But be aware of the signs of heat stroke and how to prevent it.”