Visiting high-altitude locations can pose risks for individuals with pre-existing heart conditions. A recent scientific statement from the American Heart Association (AHA) provides guidance on recreational activities in mountainous regions for people with cardiovascular issues. This article explores the potential dangers and offers advice for heart patients considering travel to high altitudes.
The statement, published in the Journal of the American Heart Association, marks the first time the AHA has specifically addressed the impact of physical activity at high altitude on individuals with heart conditions. It emphasizes the importance of consulting with a healthcare professional before traveling to mountainous regions, especially for those with high blood pressure, coronary artery disease, heart rhythm abnormalities, or heart failure.
Understanding the Risks of High Altitude for Heart Patients
At higher altitudes, typically defined as any location 9,840 feet above sea level or higher, the heart requires more oxygen-rich blood, even at rest. Activities like skiing, hiking, and climbing can significantly stress the heart and blood vessels due to lower oxygen levels, fluctuations in air pressure, temperature, and humidity. Even moderate altitudes (around 8,800 feet) can lead to fainting within the first 24 hours of ascent.
Dr. William Cornwell III, chair of the statement writing group and an assistant professor of cardiology at the University of Colorado School of Medicine in Aurora, explained that while many are aware of acute mountain sickness symptoms (headaches, dizziness, nausea, weakness), they may be less aware of the strain on the heart and lungs when those with cardiovascular disease travel to areas with reduced oxygen availability.
More than 100 million people travel to high-altitude regions in the U.S. annually for work or leisure. It’s crucial to understand the potential impact on the body, especially since medical centers providing advanced cardiac care may be difficult to access in some mountain areas.
Practical Tips for Safe High-Altitude Travel
The AHA statement offers several recommendations to minimize risks:
- Consult your doctor: Discuss your travel plans with a healthcare professional, especially if you have pre-existing heart conditions. They can advise on medication adjustments and potential risks.
- Acclimatize gradually: Increase altitude slowly to allow your body time to adjust to lower oxygen levels. This is particularly important for those with heart conditions.
- Stay hydrated: Drink plenty of fluids to maintain adequate hydration. Dehydration can exacerbate the effects of altitude on the cardiovascular system.
- Limit alcohol consumption: Alcohol can worsen altitude sickness and potentially interfere with heart medications.
- Plan for emergencies: Identify the location of nearby medical facilities and understand the symptoms that would warrant seeking emergency care.
- Consider your medication: Discuss with your doctor whether you need to adjust your heart medications before travel, especially if you have heart failure or difficult-to-control blood pressure.
Altitude Categories: What to Consider
The AHA statement categorizes altitude as follows:
- Low altitude: Under 6,560 feet above sea level (e.g., Denver).
- Moderate altitude: 6,560 to 9,840 feet above sea level (e.g., Park City, Utah).
- High altitude: 9,840 to 16,400 feet above sea level (e.g., Mount Rainier, Washington).
- Extreme altitude: Above 16,400 feet above sea level (e.g., the summit of Denali in Alaska).
The higher the altitude, the greater the potential risks for heart patients.
Specific Heart Conditions and High Altitude
- Coronary Artery Disease: Individuals with narrowed arteries may experience shortness of breath, chest pain, and dizziness at high altitude due to further constriction of arteries and reduced blood flow to the heart.
- Heart Failure: Changes in blood pressure and increased workload on the heart at higher altitudes may necessitate medication adjustments.
- High Blood Pressure: Those with difficult-to-control blood pressure or planning extended stays at high altitude should carefully monitor their blood pressure levels.
The Risk of Sudden Cardiac Death
Sudden cardiac death is the most frequent non-traumatic cause of death at altitude. It can occur without warning and be fatal within minutes without treatment. Risk factors include a history of heart attack, male sex, and older age. Gradual acclimatization, such as spending a night at around 3,381 feet before ascending to higher altitudes, can help mitigate this risk.
Conclusion
Traveling to high altitudes can be safe for heart patients with proper planning and precautions. Consulting with a healthcare professional, gradually acclimatizing, staying hydrated, and being aware of potential risks are essential steps. Prioritizing your health and understanding the effects of altitude on your heart will allow you to enjoy the beauty of mountainous regions safely.
