Trekking with non-cardiovascular preexisting health conditions at altitude

Authors

  • Thomas Küpper RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany; ² Royal College of Physicians and Surgeons of Glasgow, Faculty for Travel Medicine, Glasgow, UK https://orcid.org/0000-0003-0746-3254
  • Christian Apel RWTH Aachen University, Department of Operative Dentistry, Periodontology and Preventive Dentistry; Institute of Applied Medical Engineering, Aachen, Germany https://orcid.org/0000-0002-1339-1990
  • Daniela Bertsch Catholic Hospital Marienhof, Department of Cardiology, Koblenz, Germany
  • Carina Cerfontaine RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Michael van der Giet RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Simone van der Giet RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Maren Graß RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Miriam Haunolder RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Nicole M. Heussen WTH Aachen University, Institute of Medical Statistics, Aachen, Germany; ⁷ Sigmund Freud University, Faculty of Medicine, Department of Evidence Based Medicine, Vienna, Austria
  • Nina Hundt RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Julia Jäger RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Christian Kühn RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Audry Morrison Independent Researcher, London, UK
  • Lisa Timmermann RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany
  • Knut Wernitz RWTH Aachen University, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Aachen, Germany
  • Ulf Gieseler Deaconry Hospital in Speyer, Department of Internal Medicine, Speyer, Germany
  • Volker Schöffl Klinikum Bamberg, Department of Orthopaedic and Trauma Surgery, Bamberg, Germany; Friedrich Alexander University, Department of Trauma Surgery, Erlangen-Nuremberg, Germany; University of Colorado, School of Medicine Section of Wilderness Medicine, Department of Emergency Medicine, Denver, USA; Leeds Becket University, School of Health, Leeds, UK; University of Bayreuth, Department of Sport Science, Division of Exercise Physiology and Metabolism, Bayreuth, Germany https://orcid.org/0000-0002-3855-7934
  • Sonja Musiol RWTH Aachen University, Institute of Occupational and Social Medicine, Aachen, Germany

DOI:

https://doi.org/10.55225/hppa.607

Keywords:

trekking, prevention, diseases, Nepal, altitude, pre-existing diseases, travel medicine

Abstract

Aim: An epidemiological assessment of the preexisting health conditions of trekkers in the Solu-Khumbu region / Mount Everest (Nepal) to inform preventative and future pre-travel advice.

Material and methods: Adult volunteers (n = 350, 122 female, mean age 42.7 y (SD = 13.5), 35% aged 50 y+) completed a comprehensive health survey followed by a basic medical examination while trekking at 2800–5160 m. Cardiological problems were excluded.

Results: Only 51% sought some kind of medical pre-travel advice, and 150 reported one or more preexisting health conditions (predominately orthopaedic and trauma surgery n = 91). Many did not receive some, or all, of the recommended vaccinations. AMS symptoms were reported by 213, 59/350 took acetazolamide, and 53 didn’t factor in any acclimatisation days. None of the volunteers undertook specific muscular training before their trek (i.e. hiking with a rucksack the same weight as on trek), though 257/350 participated in some sport regularly back home. In those experiencing “a current pain” (n = 135), 64 had cephalgia, 28 had knee pain, 13 had shoulder pain, and more. Alcohol abuse or dependence was probable in 30/84 assessed; and 26/350 were occasional or regular users of recreational drugs. Existing or past nicotine abuse was reported by 104/350 with an average consumption of 14.8 cigarettes a day, and 25 continued to smoke during the trek with an average SpO₂ value of 90.9% (SD 3.8) vs. 90.5% (SD 4.4) in non-smokers. In 308 who provided their height and weight, 219 had a normal BMI, and 76 had pre-adiposity.

Conclusion: The preexisting health conditions of trekkers included a broad spectrum of diagnoses and fitness. Exacerbations of some of these conditions can be consequential when compounded by remote locations, AMS and limited or no access to comprehensive health care. Most would have benefited from comprehensive pre-travel medical advice. 

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Published

2025-01-20

How to Cite

Küpper, T., Apel, C., Bertsch, D., Cerfontaine, C., van der Giet, M., van der Giet, S., Graß, M., Haunolder, M., Heussen, N. M., Hundt, N., Jäger, J., Kühn, C., Morrison, A., Timmermann, L., Wernitz, K., Gieseler, U., Schöffl, V., & Musiol, S. (2025). Trekking with non-cardiovascular preexisting health conditions at altitude. Health Promotion & Physical Activity, 28(3), 29–40. https://doi.org/10.55225/hppa.607

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