If you're planning to travel by plane during the holidays or for a winter vacation, a little extra preparation may be wise if you have (or are at risk for) heart disease. For most people, the simple precautions outlined below will suffice. But check with your doctor before booking a flight if you've recently had a heart attack or undergone any type of heart procedure.
Before takeoff
Write down the telephone numbers of your GP (and your cardiologist, if applicable) on a card or in a small notebook, in case your cell phone dies. Include your current medical conditions and a list of your prescriptions, which you will need in an emergency.
“Keep all your prescription medications easily accessible in your carry-on bag, and be sure to bring extra doses in case of travel delays,” says Dr. Yuliya Mints, a cardiologist at Harvard-affiliated Beth Israel Deaconess Hospital. . It's safest – and required in many states and countries – to leave them in the original labeled container.
Note any time difference between your home and your destination. Ideally, you should stick to a consistent schedule and take your medications (especially blood pressure medications and blood thinners) according to your time zone, says Dr. Mints. Set an alarm on your phone or watch it as a reminder, she suggests.
At the airport, body scanners commonly used for security checks are safe for people with pacemakers or implantable cardioverter defibrillators. But these devices can trigger alarms on walk-through metal detectors, which are used in certain circumstances. Carry your device's ID card with you in case you need to show it to security personnel, says Dr. Mints.
In the air
When flight attendants offer drinks, resist the temptation to order an alcoholic beverage. “Even in the field, alcohol consumption can increase the risk of atrial fibrillation and high blood pressure,” says Dr. Mints. But consuming alcohol on board may pose additional dangers, particularly for people prone to cardiovascular disease, according to a study published online June 3, 2024 by the journal Thorax.
For the study, researchers randomly assigned 48 healthy adults to spend two nights sleeping at normal atmospheric pressure or the equivalent of airplane cabin pressure. Participants stayed sober one night but drank alcohol (the equivalent of two beers or two glasses of wine) the other night. They also wore devices that measured their blood oxygen and heart rate.
Compared to people sleeping under normal atmospheric pressure, those who slept under airplane cabin pressure had lower blood oxygen levels and higher heart rates. Adding alcohol to the mix reduced oxygen levels even further and increased heart rate even more. Such changes could be dangerous for older people at risk of heart problems, says Dr. Mints.
But drink plenty of water, which has the added benefit of forcing you to get up to go to the bathroom. On a long flight, walking a little every hour or so will help improve circulation in your legs; the same goes for flexing your feet and circling your ankles. This may reduce the risk of developing a blood clot, although the overall risk of one (known as deep vein thrombosis or DVT) is quite low. Doctors often recommend that people with a history of DVT wear compression stockings (elastic socks below the knee that gently hug your calves) when flying.
To your destination
If your vacation involves more activities than you're used to doing regularly, take it easy for the first day or so. This is especially important if you are traveling to a higher altitude destination, such as a ski resort. The higher the altitude, the lower the concentration of oxygen in the air (see “Oxygen Levels in High-Altitude Destinations in America”). In response, your heart rate and blood pressure temporarily increase until your body adapts to the lower oxygen level, usually within a few days. As a general rule, don't exceed 8,000 feet on the first day and give your body time to adapt before climbing higher or doing strenuous exercise. Climbing up to 12,000 feet is considered a good thing for most people with stable heart disease.
In case you need medical attention while you are away from home, the CDC offers helpful information, including resources on locating medical services abroad.
Oxygen Levels in High Altitude Destinations in America
If you live near sea level and travel up to Denver (5,279 feet), you may not notice the change in altitude, even if you exercise vigorously. The average drop in VO2 max (the maximum amount of oxygen you can use during intense exercise) is only 1%. In Park City, Utah (7,001 feet), the reduction is 9%. But if you ride North America's highest chairlift in Breckenridge, Colorado (12,840 feet), you'll definitely notice the difference. At this altitude, the reduction in VO2 the maximum is around 25%.
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