Heat and exercise. Effects on blood volume.

The ability of the cardiovascular system to meet the competing demands of skin and muscle for blood flow without compromising regulation of blood pressure is a critical factor influencing the capacity for prolonged work in hot environments. Unfortunately, this competition is exacerbated by the progressive reduction in blood volume (haemoconcentration) which can occur during exercise in the heat. Thermal stress alone induces haemoconcentration only above the upper limit of the prescriptive zone. Exercise performed in a supine or seated position is associated with an initial rapid haemoconcentration, which, if the environmental temperature is high, is followed by a slower, secondary haemoconcentration. Exercise performed in a standing position is associated with variable changes in blood volume, and effects of a superimposed thermal stress are small unless dehydration supervenes. The magnitude of exercise-induced primary haemoconcentration is limited, probably by oedema-preventing mechanisms, and is inversely related to the magnitude of any preceding postural haemoconcentration. Dehydration reduces absolute blood volume (induces hypovolaemia), and accentuates exercise haemoconcentration. Heat acclimatization attenuates dehydration by inducing hypervolaemia, but still appears to accentuate exercise haemoconcentration. During exercise in the heat haemoconcentration represents an undesirable response, the effects of which can be mitigated by heat acclimatization, endurance training, and preventing dehydration.