, Volume 192, Issue 4, pp 619–624 | Cite as

Heat Stress is Associated with Reduced Health Status in Pulmonary Arterial Hypertension: A Prospective Study Cohort

  • Melissa Jehn
  • Andreas Gebhardt
  • Uta Liebers
  • Bahar Kiran
  • Dieter Scherer
  • Wilfried Endlicher
  • Christian Witt



Summer heat waves with temperature extremes are becoming more frequent with growing numbers in morbidity and mortality in patients with respiratory diseases. The aim of this study was to evaluate the ramifications of heat stress (temperature >25 °C) on the health status of patients with pulmonary arterial hypertension (PAH).


Fifteen patients with PAH (mean age = 66.7 ± 5.2 years) continuously wore an accelerometer from April 1 to September 30, 2011, and their daily step count was recorded. In addition, patients kept a diary to record data on seven standardized questions regarding their daily symptoms. Echocardiography, 6-minute walk test, NTproBNP, and Modified Medical Research Council Scale (MMRC) were assessed at baseline and at the end of the study after 6 months.


On heat-stress days, patients showed significantly more symptoms and lower total steps/day compared to thermal comfort days (3,995 ± 2,013 steps/day vs. 5,567 ± 2,434 steps/day, respectively; P < 0.001). There was a significant negative correlation between total steps/day and Tempmax (R = −0.47; P < 0.001) and humidity (R = −0.34; P < 0.001). A significant positive correlation was found between daily symptoms and Tempmax (R = +0.79; P < 0.001) and humidity (R = +0.23; P < 0.001).


Heat stress is associated with a compromised clinical status in patients with PAH. Adaptation strategies must be implemented to prevent heart-related morbidity, including therapeutic adjustments and adequate room cooling in the patient’s home and at the hospital.


Vulnerability Heat stress Exacerbation frequency Activity monitoring 



This study was funded by the German Ministry for Education and Research (BMBF: NCT01LR0803L) and Deutsche Forschungsgemeinschaft (DFG), Research Unit 1736 Urban Climate Change and Heat Stress in mid-latitude cities in view of climate change (UCaHS) WI-1516/2-1.

Conflict of interest

The authors declare that they have no conflicts of interest in relation to this article.


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Copyright information

© European Union 2014

Authors and Affiliations

  • Melissa Jehn
    • 1
  • Andreas Gebhardt
    • 1
  • Uta Liebers
    • 1
  • Bahar Kiran
    • 1
  • Dieter Scherer
    • 2
  • Wilfried Endlicher
    • 3
  • Christian Witt
    • 1
  1. 1.Division of Pneumological Oncology and TransplantologyCharité Universitätsmedizin BerlinBerlinGermany
  2. 2.Institute for EcologyTechnische Universität Berlin (on behalf of the UCaSH Research Group)BerlinGermany
  3. 3.Geography DepartmentHumboldt-Universität zu Berlin (on behalf of the KLIMZUG Research Group)BerlinGermany

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