High-Altitude Medical

HANDBOOK

Approximately 28–44% of the population has hypertension. Among people staying at altitudes of 1900–2900 m (6,200–9,500 ft), 6–14% have elevated blood pressure. There is a lack of studies on the effects of altitudes above 3500 m (11,500 ft) on people with hypertension.

PLANNING AND PREPARATION

Before traveling to high altitude, it is recommended to consult your physician to stabilize blood pressure at an acceptable level.

Staying at altitudes above 3000 m (9,800 ft) can increase blood pressure; however:

➤ Well-controlled hypertension is not a contraindication for high-altitude travel or physical activity.

➤ People with poorly controlled blood pressure should measure it frequently and be aware of the risk of sudden and significant fluctuations. Blood pressure should ideally be normalized before traveling to high altitude.

MEDICATIONS AND RECOMMENDATIONS

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

➤ People taking diuretics should monitor for dehydration and electrolyte imbalances.

➤ People taking beta-blockers should be aware that these medications limit heart rate response during exertion and may impair thermoregulation.

➤ Consult your doctor before travel on how your hypertension medications may be affected by physical exertion, high altitude, and cold conditions.

MONITORING AND ADJUSTMENT OF TREATMENT

➤ There is no need to automatically increase medication doses, as the altitude-induced rise in blood pressure is usually small.

➤ People with unstable hypertension or blood pressure spikes should monitor their blood pressure frequently.

➤ Adjustment of treatment is indicated when:

- Systolic blood pressure (SBP) >180 mmHg or diastolic (DBP) >120 mmHg with 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 levels, at which point medication doses should be reduced accordingly.

➤ Frequent and regular monitoring is essential for safe management.

SUMMARY OF RECOMMENDATIONS

➤ Consult your physician before traveling and stabilize your blood pressure.

➤ Monitor your blood pressure frequently at high altitude, especially if it is unstable.

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

➤ Adjust treatment in case of sudden or high blood pressure readings.

➤ Observe your blood pressure after acclimatization and adjust medications if it returns to pre-travel levels.

REFERENCES

• 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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WANT TO LEARN MORE?

If you want to better prepare your health for trekking or a high-altitude expeditions, check out the expanded guide in the ebook "High-Altitude Medicine for Trekkers and Climbers" >>

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Gain practical skills for handling emergencies in the mountains through our online training "High-Altitude First Aid" >> - prepared for those planning trips to high altitudes.

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 For a detailed list of what to include in your expedition medical kit and step-by-step instructions for assembling your personal first aid set, see the ebook "High-Altitude Expedition Medical Kit Guide" >>

PLANNING A TREK OR A HIGH-ALTITUDE EXPEDITION?

If you would like to check whether your health condition allows you to safely participate in a trek or high-altitude expedition, consider booking a medical consultation >> or using a telemedical expedition package >>

This allows you to assess potential health risks in advance, prepare properly fot altitude, and increase your safety during the expedition.

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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