Traveling to high elevations can place added stress on the heart. To learn about key facts and steps that heart patients can take to ensure a safe trip, we caught up with Dr. Katarina Nelson, a cardiologist at St. Anthony Hospital in Summit County.
First, what defines high altitude? The threshold for high altitude starts at 8,000 feet (2,500 meters) above sea level, where individuals can develop symptoms from lower oxygen levels in the atmosphere. Since the lungs get less oxygen at high elevations, the lungs — and heart — must work harder to get oxygen-rich blood to the rest of the body. This can cause symptoms such as fatigue, headaches and dizziness even in healthy individuals.
For patients with high blood pressure, significant increases in blood pressure and heart rate develop shortly after arrival at high altitude. These changes are proportional to the altitude reached, can be more evident at night and may persist over the first week of altitude exposure or longer. Patients may notice a persistent increase in their heart rate both at rest and during exercise.
Simple precautions for all
There are several precautions that everyone, but especially those with heart disease, can take to minimize risk and make their time at altitude safer and more enjoyable.
Most importantly, ascend gradually. Avoid traveling from a low elevation to an elevation higher than 8,000 feet above sea level in one day. If possible, spend a day at 5,000 feet, and if your destination is above 10,000 feet, plan on staying another day or two at 8,000 to 9,000 feet before traveling higher. This gives your body time to adjust to the lower oxygen levels.
Likewise, exercise at a slower pace and lower intensity than you would at the sea level. For example, perform only light to moderate physical activity while at high altitudes to avoid putting added strain on the heart. Heart patients who are never physically active shouldn’t start being active while at high altitudes. Evidence suggests that heart failure patients should avoid climbing more than 300-500 meters a day when in high-altitude locations, since drastic changes in elevation can worsen symptoms.
Also, hydrate well, avoid excessive alcohol, and get sufficient rest and sleep. For most, these simple precautions should do the trick to ensure save travel.
More serious side effects
In heart patients, the effects of high altitudes can be more concerning. Changes in altitude can affect factors like blood pressure, potentially worsening existing heart conditions. Patients with severe heart conditions, such as those with a history of heart failure, high or uncontrolled blood pressure, or moderate-severe pulmonary hypertension, or those recovering from heart attack or a stent procedure, should avoid traveling to high altitudes. Evidence suggests that it could be dangerous and increase the risk of complications and cardiac events.
In addition, patients should wait at least six months before traveling to high altitudes after uncomplicated heart attacks, coronary stenting or bypass surgery. Trekking or hiking at high altitude within three months after stroke or transient ischemic attack (TIA) should also be avoided.
Patients with heart disease should continue taking their usual medications at high altitudes. Make sure you have enough medications to cover your travel and potential delays. Patients with moderate to severe hypertension should consult with their doctor to see whether any adjustments in medications are necessary for higher elevations. The compassionate providers at Centura are always here to help guide you in living life to its fullest while staying as healthy as humanly possible.