Up in the mountains after a stroke, these are the rules to follow

April 9, 2019

In the mountains, the air pressure is reduced, as well as the presence of oxygen. For those who have had a stroke, these are both potentially problematic factors that must be kept under control to avoid exposing themselves to further risks, especially if you love high altitude. We talked about the rules to follow in the mountains for those who had an ischemic episode with Dr. Simona Marcheselli, Head of the Autonomous Section of Emergency Neurology and Stroke Unit of Humanitas.


After a stroke, is the mountain safe?

If you have had a stroke but you love the mountain it is important to be aware of how the body reacts at high altitude. In fact, thanks to all the treatments available today, even those who have had an ischemic episode in the past can theoretically not give up their passion and benefit from the movements that are made when you take a walk in the mountains. This is provided, however, not to underestimate the complex stages of the post-stroke and not to climb too high. This activity, when practiced, must be carried out under adequate and constant medical supervision, because if you climb above 2000 meters you may run into objective dangers.


The risks at high altitudes?

After the disease, the organism, already weakened, requires a significant effort of adaptation. Up to 1500-2000 meters, especially if it is summer and the good weather is not cold, in the mountains the risks for those who have had a stroke, however, are not significant. It is from 2000 meters onwards that there is a 20% reduction in the oxygen present in the air, to 3000 meters where a third of it is missing compared to sea level, while at 4800 meters it is about half missing. The normal compensatory mechanisms put in place by those who are healthy could be more difficult for those with acute or chronic diseases: among these there is the increase in heart and respiratory rate, the rise in blood and lung pressure, the number of red blood cells to enhance the transport of oxygen in the blood. Those who have suffered from a reduced supply of oxygen to the brain tissue should therefore not expose their bodies to these potentially dangerous “labors”.


In the first 3 months it is best not to go beyond 1500 meters

Precautionary advice from doctors is that those patients who have had a stroke should not exceed 1,500 meters above sea level in the first three months after the episode and should not exceed 2,000 between the fourth and sixth months. Much depends on the stability of the clinical picture and the cardiovascular risk factors. Pressure values, especially in the case of hypertension, should be well controlled already at low altitudes and it should be remembered that during the stay in the mountains, especially in the first days, it is necessary to monitor blood pressure, as well as blood sugar levels in diabetic patients. Cholesterol levels should be normal and no smoking should be allowed. Finally, the scrupulous adherence to the therapies prescribed by the neurologist should not be underestimated. “It is also important to remember that the mountain must be tackled slowly – added the doctor – climbing gradually and, if over 2500 meters, going down in altitude to sleep over the altitude at which you spent the day.

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