When we travel through mountains in high altitude how do we manage our energy and health?

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