By Dr. Nikhil Dongre, Senior Consultant – Neurology
This summer, India is witnessing extreme heat conditions, with cities like Nagpur experiencing particularly severe temperatures. Weather forecasts suggest that extreme high temperatures expected in May 2026. While cases of heat stroke and heat stress are already increasing, a surge in stroke cases is also being reported.
Stroke is a neurological emergency that occurs due to a sudden interruption of blood supply to the brain, either because of a clot blocking a blood vessel (ischaemic stroke) or rupture of a blood vessel (haemorrhagic stroke). If not treated promptly, stroke can lead to permanent disability or even death.
Extreme summer temperatures have increasingly been associated with a rise in stroke incidence worldwide. Heatwaves place significant physiological stress on the body, particularly affecting the cardiovascular and cerebrovascular systems. Prolonged exposure to high temperatures can lead to dehydration, electrolyte imbalance, and increased blood viscosity, all of which elevate the risk of both ischaemic and haemorrhagic strokes.
During extreme heat, dehydration reduces plasma volume and increases haematocrit levels, promoting thrombosis and impairing cerebral blood flow. Heat stress also causes vasodilation and fluctuations in blood pressure, which may trigger stroke in individuals with pre-existing conditions such as hypertension, diabetes, and heart disease. Older adults are particularly vulnerable due to reduced thermoregulation and the higher prevalence of chronic illnesses.
Several epidemiological studies have demonstrated a clear association between heatwaves and increased stroke-related hospital admissions and mortality. Research indicates that each 1°C rise above threshold temperatures significantly increases stroke risk, particularly during prolonged heat events. Urban populations are at greater risk because of the urban heat island effect, limited green spaces, and socio-economic constraints that reduce access to cooling measures.
Climate change has further intensified the frequency and severity of extreme summer heat, making heat-related strokes a growing public health concern. Preventive strategies such as early heat warnings, public awareness about adequate hydration, avoiding outdoor exposure during peak heat hours, and targeted protection of high-risk groups are essential. Healthcare systems must also prepare for seasonal surges in stroke cases by strengthening emergency response mechanisms and community-level interventions.
In conclusion, extreme summer heat is an important and modifiable environmental risk factor for stroke. Addressing this challenge requires coordinated efforts involving climate adaptation policies, public health planning, and individual behavioural changes to reduce the burden of heat-related strokes.
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