Altitude Illness Prevention & Treatment by Stephen Bezruchka

Author:Stephen Bezruchka
Language: eng
Format: epub

Chapter 6

Going to Altitude with a Preexisting Health Condition

As our population ages, more recognition is given to the beneficial physical, emotional, and psychological effects of exercise. More older people desire to travel to altitude for recreation. Some may be undertaking an altitude adventure for the first time in their lives; other seasoned travelers may have a chronic disease such as high blood pressure or diabetes. There are some published reports, but no controlled studies, of lowlanders with chronic diseases going to altitude. Not much is known about the effects of medicines at altitude, and advice by doctors to patients about their medication remains presumptive or speculative and patients should be cautious. In marginal clinical situations where a doctor has advised against taking an altitude sojourn, an individual who has a strong will and motivation to reach a personal goal might derive a far greater benefit from its attainment than from the loss of self-esteem resulting from staying at home in a low-risk environment and nursing the chronic illness.

If you have a chronic disease, such as high blood pressure, a heart condition, or diabetes, discuss the proposed altitude journey with your doctor. If your doctor is unfamiliar with the effects of altitude on your disease, refer her or him to the reading list for health workers in this book. Or, try to find an expert (see Where to Get More Information in Chapter 7). Your doctor working in conjunction with an altitude expert would be the best solution.

Some who should not venture to altitude, may wish to do so in spite of being advised against it by their doctors and experts. If you fall in the category of having a problem that will be made worse by altitude and want to go anyway, choose an itinerary with access to easy descent and medical help. Taking enough oxygen along is usually impractical but do bring a hyperbaric bag.

If you have a chronic disease that could cause problems at altitude, attempt a similar activity near home. Repeat the same effort at a moderate altitude (say 8,000 ft. or 2,450 m), also, hopefully, near home. If you perform well under both circumstances, consider that activity at even higher altitudes. The exercise guidelines for cardiac patients described under Heart Conditions, below, make sense for everyone.

The following advice is given regarding the more common chronic conditions affected by exposure to altitude.

High Blood Pressure

Individuals with hypertension may find their pressures elevated at altitude because of increased activity of the sympathetic nervous system. Eat a low salt diet and schedule increased rest during the first few days at altitude. Seek advice from a knowledgeable physician regarding your medicines. If your blood pressure is difficult to control, either you or a companion should check it and be prepared to modify your drug regimen. Beta blockers, including propranolol, atenolol, and metoprolol, are probably not as effective at altitude as lower down. Clonidine and prazosin may be useful to control pressures. Other categories of drugs that may be useful at altitude

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