أنشئ حسابًا أو سجّل الدخول للانضمام إلى مجتمعك المهني.
All people traveling to altitude should know the precise details of their planned trip, train for physical demands, be familiar with standard ascent and acclimatization protocols, and recognize the symptoms of altitude‐related illness. For people with preexisting medical conditions, the risks of altitude exposure and removal from potential medical support are significant and must be taken seriously. On the other hand, with proper planning and precautions, many people with preexisting medical conditions can safely take part in outdoor adventures at high altitude. Ultimately, avoidance of potential risk must be carefully weighed against an individual's desire to achieve personal goals.
Summary of recommendations
Medical condition Recommendations regarding altitude exposure Quality of evidence Hypertension Ascend with caution Case series Heart failure Contraindicated if symptomatic at resident altitude Expert opinion Ascend with caution if asymptomatic at resident altitude Coronary artery disease Contraindicated Multiple small case‐control studies • Unstable angina Ascend with caution • Exertional angina Contraindicated for 6 mo after MI • Myocardial infarction No contraindication if asymptomatic at resident altitude • CABG, angioplasty Cardiac arrhythmia Individual cardiology risk assessment needed Small cohort studies Congenital heart disease Ascend with caution Case series, multiple case reports Contraindicated if symptomatic pulmonary hypertension Chronic obstructive Ascend with precautions Case series and expert opinion pulmonary disease Ascend with caution, individual risk assessment needed • Mild Contraindicated • Moderate • Severe Bronchial asthma Ascend with specific precautions Multiple case series Obstructive sleep apnea Contraindicated if oxygen desaturation occurs at sea level Case report, expert opinion Pleural and interstitial lung Ascend with caution Expert opinion disease Contraindicated if symptomatic Clinical guidelines • Secondary pulmonary Contraindicated for 3 wk post resolution hypertension • Pneumothorax Peptic ulcer disease Contraindicated in active PUD Larger cohort study Specific precautions if history of PUD Inflammatory bowel disease Contraindicated in active disease; travel with limitations in quiescent disease Expert opinion Chronic kidney disease Ascend with specific precautions Expert opinion Diabetes mellitus Ascend with precautions Multiple small case‐control studies Relatively contraindicated if poor glycemic control or retinopathy Obesity Contraindicated in obesity–hypoventilation syndrome Two case‐control studies Epilepsy Ascend with caution Case reports Cerebrovascular disease Contraindicated for 90 d post CVA/TIA Case series Individual risk assessment needed Expert opinion Migraine Ascend with caution Small cohort study Iron deficiency anemia Correct prior to ascent Expert opinion Sickle cell anemia Contraindicated Case‐control study • Sickle cell disease Ascend within limitations Case series • Sickle cell trait Psychiatric conditions Ascend with caution Pregnancy Contraindicated in the first trimester if high risk of spontaneous abortion Cohort studies, expert consensus report Contraindicated beyond first trimester in the presence of certain co‐morbidities Raynaud's phenomenon Ascend with specific precautions Expert opinion Radial keratotomy Ascend with precautions Case‐control study LASIK Ascend with precautions Case series Contraindicated for 6 mo after LASIK Damage to carotid bodies Ascend with caution Case series