How to Protect Your Heart While Hiking

Cardiac arrest is the number three killer in the outdoors. Learn how to prevent, recognize, and treat trail-side heart issues.

If you think hikers are immune to heart attacks, you could be dead wrong. Cardiac arrest is the number three killer in the outdoors, and it’s responsible for half of all mountain-climbing fatalities. What’s more, the typical victim isn’t collecting Social Security: He’s a 45-year-old weekend warrior bent on matching his youthful pace. Backpackers of all ages should pay close attention to their pump, says Dr. James Ehrlich, assistant professor at the University of Colorado School of Medicine. That’s because intense exertion, cold weather, and altitude increase stress on the heart, exacerbating key factors like family history, obesity, and smoking. The good news: Studies have concluded that regular hiking significantly lowers the likelihood of heart attack in men. (While studies haven’t tested it, women can probably reap the benefits too.) Here’s how to reduce your risk factors before and during your next adventure.


  • Check your family tree: Ancestry is the #1 predictor of heart attacks, meaning that even active non-smokers can be at risk.
  • High cholesterol raises heart attack risk in men threefold. A healthy blood pressure is 120/80 mm Hg, and total cholesterol should be under 200 mg/dL.
  • At-risk individuals should get a heart image scan or exercise stress test before attempting a strenuous hike.


  • At home, keep bad cholesterol in check with a low-fat diet. Talk to your doctor about medication if food and exercise aren’t enough.
  • Adjust your mileage goals to your age and fitness level–under-fit hikers were 27% more likely to suffer sudden cardiac arrest, according to the study.
  • Heart attacks occur most often in the morning, says Dr. Erhlich. Ease into your hiking day with frequent rests, especially if you’re gaining elevation.
  • Vulnerable hikers should consult their doctor about medications like nitroglycerin to widen blood vessels in case of an attack.


  • Watch for shortness of breath and intermittent pain, pressure, or squeezing in the center of the chest. This discomfort can migrate to the upper body, including arms, shoulders, back, neck, jaw, or stomach. Women often experience nausea, fatigue and painful breathing.
  • Denial can be deadly. Victims often dismiss early symptoms because they resemble heartburn, indigestion, or aches.


  • Evacuate to the nearest road and summon medical care as soon as possible.
  • Chewing aspirin tablets may help dissolve blood clots to give you more time.
  • Initiate CPR if the victim stops breathing or has no pulse: begin with 30 chest compressions followed by 2 breaths.