Turn off the heat

Patients taking diuretics (water pills) need to be more careful. It is seen often that the requirement of blood pressure medicines can come down during the summer and in particular for those patients needing a high dose of diuretics. It is advisable to see your doctor for the adjustment of medicines especially the diuretics.

It is a common perception that due to excessive sweating there is loss of salt and people increase the intake of salt. This is wrong and can lead to increase in blood pressure.

• What are the precautions patients with heart failure and those with stents and prosthetic valves should take?

Patients with enlarged hearts and heart failure are often on restricted fluids in addition to diuretics. It is advisable for such people to prevent going out exposing themselves to high temperatures which brings sweating and disturbs the fluid balance leading to problems like profound weakness,giddiness,unconsciousness etc.

Patients with coronary stents and those with valve replacements need to be extremely careful. Excessive sweating due to strenuous exercises in hot environment can render the blood more prone to clotting and complicate matters through clotting of valve or stent. Proper hydration is important so drink plenty of cool water,lemonade or mild beverages. Exercise in a cool place such as an air-conditioned gym,or early in the morning or later in the evening.

n Diabetes being a common association with heart disease,what are the special tips for diabetic patients?

If you have diabetes,dehydration also can occur when blood glucose is not under control. When blood glucose is elevated,it can lead to an increase in the body’s excretion of urine. To prevent dehydration,drink plenty of caffeine-free fluids such as water,seltzer,sugar-free drinks like iced tea and lemonade. Limit your intake of alcohol. Store your blood glucose meter,strips and insulin in a cool,dry place. Do not store insulin in extreme temperatures. Never store insulin in the freezer,direct sunlight or in the car or in the glove compartment of the car. Examine your vial of insulin. Clear insulin (Regular,Humalog,Novolog,Apidra,Lantus,Levimir) should remain clear. NPH insulin should not have any clumping or “frosting” on the vials.

The author is Executive Director,Cardiology,

Escorts Heart Institute,New Delhi