In the mountains despite heart disease? Recommendations for cardiovascular patients
While medical professionals agree that mountain exercise is a good way to prevent cardiovascular disease, what about people who already have cardiovascular disease? Under what circumstances are they allowed to stay in the high mountains and which rules of conduct should they follow? Experts provide answers.
Walking lowers the risk of cardiovascular diseases
According to health experts, adequate exercise has a preventive effect against diseases of the cardiovascular system such as high blood pressure or heart attack. Hiking in particular lowers the cardiovascular risk. But what applies to people who already suffer from cardiovascular diseases? In any case, you shouldn't overdo it with the effort, but you don't usually have to do without physical training either. An older study showed that moderate exercise is suitable for heart patients. However, if those affected want to hike in the mountains, they have to follow some rules of conduct.
Altitudes above 2,500 meters
As reported by the research institute "Eurac Research" based in Bolzano (South Tyrol, Italy), a team of experts led by cardiologist Gianfranco Parati, professor at the University of Bicocca and head of the Istituto Auxologico in Milan, has evaluated numerous studies that examine how Altitudes above 2,500 m affect the most common cardiovascular diseases.
The detailed recommendations for cardiovascular patients, which the doctors derive from this, were recently published in the "European Heart Journal".
Physical stress increases
From an altitude of around 2,500 m, the physical load increases: the air contains less oxygen, this leads to an increased respiratory rate and an increase in blood pressure, the cardiovascular system is particularly stressed.
Great caution is required in the mountains, especially for people who suffer from cardiovascular diseases such as high blood pressure or coronary artery disease, or who have recently had a heart attack.
"However, the patient only has to do without hiking in the mountains in the case of very severe heart diseases," says Hermann Brugger, altitude medical specialist from Eurac Research and President of the International Society for Alpine Medicine.
"Provided that he follows the relevant instructions, he can do a lot and at best even improve his state of health."
Exclude possibly undetected heart diseases
"In order to ensure a safe ascent also for cardiac patients, the patient has to plan the tour carefully, whereby the time and the destination of the tour should be coordinated," said Gianfranco Parati, who led the evaluation.
"Together with the family doctor, all precautions have to be individually tailored to the patient and the necessary examinations have to be carried out in order to rule out possibly undetected heart diseases and to ensure optimal drug treatment."
For example, in the case of coronary artery disease, in which the coronary arteries are narrowed and the heart muscle is supplied with less oxygen, the experts recommend not to exceed certain maximum altitudes.
In the case of mild coronary artery disease, this is 4,200 vertical meters, with a medium up to 2,500 vertical meters. However, if the patient suffers from severe coronary artery disease, experts recommend avoiding mountain hiking altogether.
Taking the right medication
Taking the right medication is also fundamental, the two experts emphasize. "Hypotensive drugs are often diuretic, relieve the blood of salt and water, which reduces blood volume and consequently lowers blood pressure," explains Brugger.
"In the mountains, however, you have to be careful with these remedies: due to the increased exertion and perspiration, the body loses more fluid - there is a risk of drying out."
Patients suffering from moderate to severe high blood pressure are also advised to check their blood pressure levels regularly before and during their stay in the mountains.
If the patient follows all the recommendations, mountain hiking can have a very positive effect on the course of the disease, slow it down and in some cases even stop it.
“Mountain hiking also benefits the psyche of cardiovascular patients. The certainty of maintaining a level of freedom and independence despite cardiovascular disease significantly increases the patient's self-confidence and well-being, ”Brugger explains.
For longer tours, it takes one to two days to get used to it
The recommendations arose from the systematic evaluation of all studies on cardiovascular diseases and altitude exposure.
Experts from the leading European and Italian societies for cardiology and hypertension (high blood pressure) as well as from the international and Italian society for altitude medicine evaluated the study results and wrote the recommendations.
The German Heart Foundation has another tip on its website:
Cardiac patients who go hiking in the mountains are advised to get used to one or two days on site. During this period, you can get used to the climate and altitude with short and easy hikes.
Longer stages should only be on the program in the following days. (ad)