Cardiovascular Risk Profiles and Pre-Existing Health Conditions of Trekkers in the Solu-Khumbu Region, Nepal

Miriam Haunolder, Christian Apel, Daniela Bertsch, Carina Cerfontaine, Michael van der Giet, Simone van der Giet, Maren Grass, Nicole Maria Heussen, Nina Hundt, Julia Jäger, Christian Kühn, Sonja Musiol, Lisa Timmermann, Knut Wernitz, Ulf Gieseler, Audry Morrison, Volker Schöffl and Thomas Küpper ()
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Miriam Haunolder: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Christian Apel: Department of Dental Preservation, Parodontology & Preventive Dentistry, RWTH Aachen Technical University, 52074 Aachen, Germany
Daniela Bertsch: Department of Internal Medicine & Cardiology, Ilmtalklinik, 85276 Pfaffenhofen, Germany
Carina Cerfontaine: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Michael van der Giet: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Simone van der Giet: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Maren Grass: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Nicole Maria Heussen: Department of Medical Statistics, RWTH Aachen Technical University, 52074 Aachen, Germany
Nina Hundt: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Julia Jäger: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Christian Kühn: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Sonja Musiol: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Lisa Timmermann: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
Knut Wernitz: Department of Dental Preservation, Parodontology & Preventive Dentistry, RWTH Aachen Technical University, 52074 Aachen, Germany
Ulf Gieseler: Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
Audry Morrison: Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
Volker Schöffl: Department of Sport Orthopaedics, Klinikum Bamberg, 96049 Bamberg, Germany
Thomas Küpper: Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany

IJERPH, 2022, vol. 19, issue 24, 1-10

Abstract: Background: High-altitude tourist trekking continues to grow in popularity on the Everest Trek in Nepal. We examined which pre-existing cardiovascular and health conditions these global trekkers had and what health issues they encountered during the trek, be it exacerbations of pre-existing conditions, or new acute ones. Method: Trekkers ( n = 350) were recruited from guesthouses along the Everest Trek, mostly at Tengboche (3860 m). After completing a questionnaire on their health and travel preparation, they underwent a basic physical examination with an interview. Results: Almost half (45%) had pre-existing conditions, mostly orthopaedic and cardiovascular diseases. The average age was 42.7 years (range 18–76). The average BMI was 23.4 kg/m 2 , but 21% were overweight. A third were smokers (30%), and 86% had at least one major cardiovascular risk factor. A quarter (25%) were suffering from manifest acute mountain sickness (AMS), and 72% had at least one symptom of AMS. Adequate pre-travel examination, consultation, and sufficient personal preparation were rarely found. In some cases, a distinct cardiovascular risk profile was assessed. Hypertensive patients showed moderately elevated blood pressure, and cholesterol levels were favourable in most cases. No cardiovascular emergencies were found, which was fortunate as timely, sufficient care was not available during the trek. Conclusion: The results of earlier studies in the Annapurna region should be revalidated. Every trekker to the Himalayas should consult a physician prior to departure, ideally a travel medicine specialist. Preventative measures and education on AMS warrant special attention. Travellers with heart disease or with a pronounced cardiovascular risk profile should be presented to an internal medicine professional. Travel plans must be adjusted individually, especially with respect to adequate acclimatisation time and no physical overloading. With these and other precautions, trekking at high altitudes is generally safe and possible, even with significant pre-existing health conditions. Trekking can lead to invaluable personal experiences. Since organized groups are limited in their flexibility to change their itinerary, individual trekking or guided tours in small groups should be preferred.

Keywords: cardiovascular risk factors; high altitude; coronary heart disease; arrhythmia; trekking; acute mountain sickness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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