Acclimate before hiking at high elevations.
Q. I had a mild heart attack a few years ago but am now feeling fine. I’m planning a trip to Colorado. Is it safe for me to hike at high elevations?
A. If you’re feeling well and don’t have any cardiovascular symptoms, hiking in the Rocky Mountains should probably be fine, though you should check with your cardiologist first. Doctors used to advise people with cardiovascular conditions—even just high blood pressure—not to spend time at high altitudes. But there wasn’t much evidence behind that recommendation. Now, there’s a general consensus that ascending up to 12,000 feet should be fine for most people with heart disease. Exceptions include people with unstable cardiac disease, heart failure, or severe lung disease, such as pulmonary hypertension.
The higher you go in altitude, the less oxygen you take in with each breath. Your body responds by raising your heart rate and the amount of blood pumped with each beat. This temporarily boosts blood pressure until your body adapts to the lower oxygen level, which usually takes just a few days.
A good rule of thumb is to go no higher than 8,000 feet during the first leg of the trip and to stay there at least one night. Take it easy for a day or two before any strenuous hiking, and pay attention to how you feel. If you’re feeling fine, then you should be okay to go a couple thousand feet higher each day.
— Deepak L. Bhatt, MD, MPH
Editor in Chief, Harvard Heart Letter