Heatwaves and Heart Health: A Survey Study and Discussion on the Current Knowledge and Attitudes of Cardiac Rehabilitation Clinicians

Purpose: Heat-related cardiovascular deaths are increasingly common for people with cardiovascular disease (CVD) in the face of a warming climate. Cardiac rehabilitation clinicians are well placed to educate people with CVD about the risks of heatwaves, but little is understood about their knowledge of this issue. We conducted an Australia-wide survey to understand cardiac rehabilitation clinician knowledge and attitudes regarding the health impacts of heatwaves for people with CVD. Methods: This online REDCap survey was distributed through the National Heart Foundation, Australian Cardiovascular Health and Rehabilitation Association, and SOLVE-CHD networks to cardiac rehabilitation clinicians across Australia. Questions were open-ended and multiple choice about the health impacts of heatwaves and available support for people with CVD. Open-ended questions were thematically coded, and all other responses were presented as percentages. Results: Ninety-nine clinicians in 7 states/territories (70% registered nurses) completed the survey. Only 17% believed sufficient information existed on the heat-health impacts for people with CVD, and 16% thought those with CVD were aware of these negative effects. Half (51%) of the respondents were aware that medication could influence physiological responses to heat but raised concerns regarding a lack of clear hydration guidance for people taking diuretics during a heatwave. Forty-five percent of clinicians said adequate information was available regarding exercise in the heat. Electric fan use (65%) and visiting a cooling center (64%) were the most recommended cooling strategies. Conclusions: Generating educational material and incorporating evidence-based heat management strategies into rehabilitation programs will be vital to reduce cardiovascular events during heatwaves.