Heat Exposure and Antihypertensive Treatment: Unravelling causal Pathways

ongoing

Heatwaves have increased in frequency, duration, and intensity over the past decades, placing individuals with cardiovascular diseases at higher risk of hospitalisation and death. Hypertension affects a third of adults and is a key risk factor for these diseases. Blood pressure control through medication is essential to prevent adverse cardiovascular events during and between heatwaves. However, concerns arise that antihypertensive drugs may increase the risks of hospitalisation and mortality during heatwaves. Certain antihypertensive drugs or their combinations may worsen dehydration, inhibit thirst perception, and interfere with heat adaptation. There is a lack of clinical guidelines for hypertension management during heatwaves. To address this, I propose the HEAT-UP project, which aims to use expertise from environmental epidemiology, clinical practice, urban planning, geography, and causal inference to i) measure how the causal effects of heatwaves on emergency hospital visits vary across individuals taking different antihypertensive drugs, ii) map how heatwaves contribute to orthostatic hypotension when standing blood pressure drops, potentially leading to dizziness and falls, injury, and death across people with different antihypertensive treatments, and iii) develop a heat vulnerability index to support counselling interventions for hypertensive patients in areas with overheating risk. This project will integrate advanced causal inference methods (causal random forest, case time series) and complementary data sources (French, Dutch administrative databases, and hospital databases). The findings will inform stakeholders creating safe treatment guidelines for hypertensive patients during heatwaves, as well as improve monitoring in vulnerable areas with limited medical access. This project will broaden my scientific expertise (technical and transferable skills) and my international network for pursuing an academic career and becoming an independent researcher.