Travel Reference
In-Depth Information
Individuals with moderately high blood pressure are at higher risk for heart attack and
heart failure. These complications include cardiac dyspnea, angina pectoris, stroke, and
severe headache, any of which is an indication for prompt evacuation.
Some persons with only moderate hypertension have periodic episodes of severe blood
pressureelevation.Suchepisodesaretypicallyassociatedwithsevereheadache,confusion,
forgetfulness,visualimpairment,slurredspeech,andotherneurologicsignsandsymptoms.
The blood pressure should be measured if such symptoms appear. If the systolic pressure
exceeds 200 mm Hg, the individual should be forced to rest and nitroglycerine should be
given every hour to reduce the pressure. Evacuation should be arranged after six to twelve
hours.
Somehypertensivepersonsexperienceanincreaseinpressureathighaltitudes.Therise
in pressure, which usually is not detectable unless the blood pressure is measured, is usu-
ally evident within one to two days at altitudes at and above 6000 feet (1800 m). It typic-
ally returns to its previous level in a few days ( Chapter 25: Altitude and Common Med-
ical Conditions ). Individuals who have a major rise in pressure at such moderate altitudes
should consult their physicians, who may increase medication dosage when at high alti-
tudes or may advise not going to high elevations at all.
Individuals taking certain types of medication for high blood pressure (such as propran-
olol, a beta blocker) may not experience the normal increase in heart rate at high altitude.
Some develop orthostatic hypotension. Individuals on a diuretic must continue to take po-
tassium supplements if recommended by their physicians. Diuretic-induced potassium de-
pletion can result in muscular weakness but is relieved by potassium-rich foods such as
dried fruits, nuts, soups, and fruit juices.
VASCULAR DISEASE
Claudication
Older individuals with arteriosclerosis of the arteries in their legs may experience pain
or burning in their calves, hips, buttocks, or thighs while walking uphill, particularly when
carrying aheavyload.Thepainoccurs duringeffort,becomes moresevere aseffortiscon-
tinued, and is relieved by rest. The medical term for this condition is claudication. When
severe, it can appear while strolling on level terrain.
Claudication should be distinguished from common leg cramps, which occur at rest
or during the night, are characterized by painful contraction of the muscles—not just
pain—and usually involve the calf or foot.
Ifclaudicationismild,aslowerpaceandalighterloadmaypermittheindividualtocon-
tinue.Smokingincreasestheseverityofclaudicationandshouldbeavoided.Ifclaudication
suddenly becomes severe or appears for the first time in the wilderness, the person should
be evacuated and allowed to exert only minimal effort.
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