The coronary stress of skiing at high altitude

Skiing, which may involve strenuous exercise in the cold at high altitude, could place considerable stress on the coronary circulation. To explore this possibility, we obtained by telemetry electrocardiograms on 149 men during recreational skiing at altitudes above 3100 m (10 150 ft). Tachycardia was impressive; heart rate exceeded 80% of predicted maximum in two thirds of the subjects. Five men developed abnormal ST-segment depression during or immediately after exercise. All five were older than 40 years, so in this age group the incidence of ST abnormalities was 5.6%. This is not greater than the incidence among asymptomatic men during submaximal exercise at low altitude. The high level of physical fitness of men who ski may have offset the added stress of cold and hypoxia. Hence, for physically fit older men, mountain skiing does not appear to pose a greater coronary stress than does comparable exercise at low altitude among men of only average physical fitness without known heart disease.