Heat waves and the elderly with copd: reducing thermal and cardiovascular consequences

This federal Project Grant award, titled "HEAT WAVES AND THE ELDERLY WITH COPD: REDUCING THERMAL AND CARDIOVASCULAR CONSEQUENCES", is funded by the National Heart, Lung, and Blood Institute (NHLBI) under CFDA 93.837 - Cardiovascular Diseases Research. The $143,784 grant, awarded on Sep 8, 2024, aims to investigate the physiological impact of heat wave exposure on cardiovascular, pulmonary, and thermoregulatory responses in older individuals with chronic obstructive pulmonary disease (COPD), and to evaluate the efficacy of water spraying as a cooling strategy to mitigate any adverse effects. This project will be conducted by the University of Texas Southwestern Medical Center, a prominent academic medical center, in collaboration with an interdisciplinary team of experts. The expected outcomes will provide critical insights to guide interventions that can reduce heat-related illness and mortality among the elderly, particularly those with COPD, during heat waves.

Abstract

Heat waves are the leading cause of death among natural disasters in the united states. Given the continued rise in global temperatures, heat waves are predicted to increase in frequency, intensity and duration. Elderly individuals are more likely to become ILL or DIE during heat waves. While body temperature regulation is reduced in the elderly, most of the hospitalizations and deaths in this population during heat waves are due to cardiovascular and respiratory complications, not hyperthermia per-SE. Despite numerous investigations on the thermoregulatory consequences of healthy aging, there is little research focus on the physiological responses to heat exposure in older individuals with chronic disease, such as chronic obstructive pulmonary disease (copd). Epidemiological data suggests that pulmonary complications are a leading cause of heat wave-related hospitalizations in older adults with copd, yet nothing is known regarding the physiological mechanisms by which those with copd are most susceptible to heat waves. The broad goal of this project is to identify the unique physiological mechanisms/responses that place those with copd at an increased morbidity and mortality risk during heat waves, and to explore a cooling modality to mitigate any such risk. The overall aim of this project will a) investigate the impact of simulated heat wave exposure on cardiovascular, pulmonary, and thermoregulatory responses in older individuals with copd, and b) identify to what extend water spraying is beneficial in mitigating any adverse responses to heat wave exposures in both healthy aging and in those with copd. Specifically, older individuals with copd, along with age-matched healthy individuals, will be exposed to two different environmental conditions 1) hot and humid and 2) very hot and dry. The project will include activities of daily living to simulate typical metabolic heat generation, as well as the efficacy of water spray to mitigate adverse physiological responses to heat wave exposure. The expected outcomes from this work will have a direct positive impact on the elderly (both healthy individuals and those with copd) by evaluating the efficacy of a practical, low-energy cooling strategy that has the potential to save lives during heat waves. Further, we will provide critical information that characterizes the extent of respiratory stress during simulated heat waves in elderly individuals with copd. This research directly supports the mission of NIH in that we will uncover mechanistic physiological findings from human participants with the goal of translating those findings to guide individuals, caregivers, and communities on effective approaches to reduce heat related illness/injury. To ensure that this study is designed to maximize clinical relevance and my scientific training, i assembled a strong interdisciplinary clinical research/mentoring team consisting of expert integrative physiologists, physician- scientists, and a biostatistician. My primary goals during this fellowship are to complete the proposed project, master several technical skills (e.g., echocardiography, etc.), improve my ability to obtain future extramural research funding, and publish research findings in peer-reviewed medical and physiology journals.