A scoping review of recommendations for adults with cardiovascular disease to remain physically active during hot weather

Abstract Aims Climate change is intensifying the occurrence and intensity of hot weather that is associated with cardiovascular health risks and disengagement from physical activity. To help promote safe and continued engagement with physical activity despite a warming climate, we aimed to map existing recommendations for physical activity in hot weather that are specific to adults living with cardiovascular disease. Methods and results We conducted a scoping review of MEDLINE, Web of Science, and SPORTDiscus, supplemented by cross-referencing and grey literature. Sources were included if they reported temperature thresholds or behavioural recommendations for physical activity in hot weather for adults (≥18 years). Data on source characteristics, target populations, temperature thresholds, and specific guidelines or suggested behaviours were extracted. Of 32 included sources, 24 reported at least one temperature above which physical activity should be limited. The most frequently covered themes were preventive recommendations (100%; 20 different recommendations), symptoms (81%; most cited being heat stroke and exhaustion), heat-related risk factors (56%), and treatments (53%). No source mentioned adverse cardiac events as possible health risks. Of the 20 sources highlighting populations at greater risk when exercising in the heat, 12 mentioned individuals with cardiovascular disease. However, no specific recommendations for this population were retrieved. Conclusion Few sources acknowledge that adults living with cardiovascular disease are at greater health risks during physical activity in hot weather, and specific recommendations for this population are absent. These gaps highlight a need to develop recommendations tailored to adults living with cardiovascular disease.