Cardiovascular risk during physical activity in the mountains.

OBJECTIVE: Several previous studies evaluated the cardiovascular risk associated with exercise, but only a few papers considered this risk during physical activity in the mountains. The aim of this study was to assess the cardiovascular risk in a population practising physical activity in the mountains. METHODS: We used an observational study design. We estimated the population by integrating the data of presences in the accommodation establishments with data from telephone and on-field interviews. As survey sources of cardiovascular events we used the reports of the Mountain Rescue teams and of the emergency physicians and pathologists operating in the hospitals of the considered mountain area. RESULTS: We estimated that the duration of exposure to risk for the study population was, averagely per year, 12 449 877 person-days. During the study period, we recorded 117 cardiovascular events, namely 38 sudden cardiac deaths, 13 acute coronary syndromes, and five strokes. The remaining 61 events were non-traumatic events with a probable cardiovascular origin. We calculated one cardiovascular event per 319 000 person-days of physical activity in the mountains, one sudden cardiac death per 980 000 and one acute coronary syndrome per 2 895 000 person-days. CONCLUSIONS: The risk of cardiovascular events in the population practising physical activity in the mountains is very low and essentially limited to men over the age of 40, particularly if they do not practise regularly physical activity. For these subjects the risk seems to be associated with physical activity, but not with altitude and other typical aspects of mountains, such as low temperature and difficulties of terrain.