Epidemiology
Each year, millions of people are exposed to the dangers of extreme heat. In the US, heat waves cause more fatalities than any other extreme weather events.[2] Most people in the US who experience heat stroke are older inner-city residents.[1][3] Children, athletes, people with chronic illnesses, and outdoor laborers are also at increased risk.[2] Residents of areas that experience heat waves are most at risk. Epidemiologic studies report heat stroke incidence of between 17.6 and 26.5 cases per 100,000 population in urban areas of the US during heat waves; heat stroke accounts for at least 240 deaths annually in the US.[4][5]
Worldwide, heat stroke is uncommon in subtropical climates. Climate change can lead to an increased risk of heat stroke, as heat waves may increase or occur in areas where residents and public infrastructure are unprepared.[2][6]
Urban heat islands, created in densely populated urban centers with dark rooftops, and bitumen roads tend to concentrate solar heat and prevent its dispersal. This confers a disproportionate risk of heat-related illnesses among urban dwellers.[7]
Risk factors
Older adults are at particular risk as they may be less able to recognize and respond to thermal loading.[12]
Patients with impaired cognitive function (e.g., dementia, Parkinson disease) may be less able to recognize and respond to thermal loading.[12]
Less able to recognize and respond to thermal loading.[12]
May predispose patients to heat stroke; these include diuretics, antihypertensives, anticholinergics, phenothiazines, tricyclic antidepressants, and certain party/rave drugs (e.g., MDMA, etc.).[1]
Acclimatization reduces risk of heat stroke by making compensatory mechanisms more efficient at dissipating heat.
Intrinsic and extrinsic factors can compromise the body's ability to dissipate heat and maintain homeostasis.[1]
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