Condition | Recommendations |
---|---|
Cardiovascular | |
Coronary heart disease | Limit activity in patients with stable angina; no altitude travel for 6 months after acute coronary syndrome |
Congenital heart disease | More susceptible to HAPE; contraindicated if symptomatic pulmonary hypertension at sea level |
Heart failure | Contraindicated if symptomatic at resident altitude; consider use of acetazolamide |
Hypertension | Slight increase in blood pressure; pathological large increase in some individuals; favour alpha-adrenergic blockers and nifedipine for improved control; caution with diuretics and beta-blockers at altitude |
Stroke | Increased risk of ischaemic stroke due to hyperviscosity; no altitude travel for 3 months post-stroke or transient ischaemic attack |
Respiratory | |
Asthma | Decreased allergens and reduced resistance may benefit some patients with asthma at 3500–5000 m; increased risk at 2000–3500 m; protect mouth from cold; use volumetric spacers for metered dose inhalers |
COPD | Chronic hypercapnia may blunt hypoxic ventilatory response; contraindicated for patients with dyspnoea at rest or on mild exertion at sea level |
Interstitial lung disease | May require echocardiography to assess for pulmonary hypertension; consider nifedipine prophylaxis |
Obstructive sleep apnoea | Increased risk of HAPE; contraindicated if hypoxic at sea level; acetazolamide is indicated; CPAP device may require pressure setting adjustment |
Pneumothorax | No air travel or other altitude ascent until 2 weeks following resolution |
COPD = chronic obstructive pulmonary disease. CPAP = continuous positive airway pressure. HAPE = high-altitude pulmonary edema.