High-altitude medicine

ZONE OF KNOWLEDGE

About 28–44% of the population suffers from hypertension. Among people at altitudes of 1900–2900 m above sea level, 6–14% have hypertension. There is a lack of scientific studies regarding the effects of altitude above 3500 m above sea level on individuals with hypertension.

PLANNING AND PREPARATION

Before traveling, it is advisable to consult a doctor to stabilize blood pressure at an acceptable level.

STAYING AT ALTITUDES ABOVE 3000 M ABOVE SEA LEVEL CAUSES AN INCREASE IN BLOOD PRESSURE, HOWEVER:

➤ Well-controlled hypertension is not a contraindication for staying or exertion at altitude.

➤ Individuals with poorly controlled blood pressure should take frequent measurements and be aware of the possibility of sudden, significant fluctuations in blood pressure. It is recommended to normalize blood pressure levels before traveling to high mountains.

MEDICATIONS AND RECOMMENDATIONS

➤ Alpha-blockers and nifedipine are recommended for severe hypertension.

➤ Individuals taking diuretics must be cautious of dehydration and electrolyte disturbances.

➤ Individuals taking beta-blockers should know that these medications limit heart rate increase during exertion and may impair thermoregulation.

➤ Before traveling, consult with a doctor about how the effects of hypertension medications change during exertion, at altitude, and in low temperatures.

MONITORING

➤ There is no need to automatically increase medication doses, as the rise in blood pressure caused by hypoxia is usually small.

➤ Individuals with unstable hypertension and blood pressure spikes should frequently monitor their blood pressure.

MODIFICATION OF TREATMENT IS INDICATED WHEN:

➤ systolic blood pressure (SBP) >180 mmHg or diastolic (DBP) >120 mmHg with accompanying symptoms (visual disturbances, shortness of breath, chest pain, altered consciousness),

➤ SBP >220 mmHg or DBP >140 mmHg – even without symptoms.

With acclimatization, blood pressure may return to pre-travel values, and then medication doses should be appropriately reduced.

A condition for safe monitoring is frequent and regular blood pressure measurements.

SUMMARY OF RECOMMENDATIONS

➤ Consult with a doctor before traveling and stabilize your blood pressure.

➤ Frequently monitor blood pressure at altitude, especially if you have unstable hypertension.

➤ Be aware of the effects of medications (alpha-blockers, beta-blockers, diuretics) on performance and thermoregulation.

➤ Modify treatment in case of sudden and high blood pressure values.

➤ After acclimatization, observe the possibility of blood pressure returning to pre-travel levels.

BIBLIOGRAPHY

• Travel at High Altitude – www.medex.org.uk

• K. Mieske et al., Journeys to High Altitude—Risks and Recommendations for Travelers with Preexisting Medical Conditions, Journal of Travel Medicine, 2010; 17(1): 48–62

• A.M. Luks, Should Travelers with Hypertension Adjust Their Medications When Traveling to High Altitude?, High Altitude Medicine & Biology, 2009; 10(1): 11–15

• Ward, Milledge, Schoene, High Altitude Medicine and Physiology, 2007

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DO YOU WANT TO LEARNMORE?

If you want to better prepare health-wise for trekking or a high-altitude expedition, you can find an extended version of the guide in the ebook"High Altitude Medicine in Practice – A Guide for Trekking and Expeditions" >>

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You can also learn practical knowledge about emergency procedures in the mountains in the online training"High Altitude First Aid" >> - prepared for those planning trips to high altitudes.

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Meanwhile, you can find detailed contents of a first aid kit and a thorough guide to preparing an expedition first aid kit and a personal rescue kit in the ebook"Expedition First Aid Kit – A Complete Medical Guide" >>

ARE YOU PLANNING A TREKOR A HIGH-ALTITUDE EXPEDITION?

If you want to check whether your health condition allows you to safely participate in a trek or high-altitude expedition, it is worth usinga medical consultation >> ora telemedicine expedition package >>

This way, you can assess health risks in advance, prepare adequately for your trip, and increase safety while at altitude.

The company was established in 2004. The goal of MedEverest is education in the field of mountain medicine and the dangers of high altitudes. I deal with all medical aspects of staying at high altitude. I organize medical support for trekking and high-altitude expeditions.

Specialist Medical Practice Medeverest Robert Szymczak based in Gdańsk (80-360), at ul. Bolesława Krzywoustego 19F, NIP: 5841943576, REGON: 220148318.

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