Frankfurt a. M. – 14. August 2023
How to perfectly prepare for a holiday in an unfamiliar environment – expert tips for medication, readings, nutrition and exercise
Cardiac patients should not underestimate warmer temperatures even on holiday trips and protect themselves from excessive circulatory reactions and cardiac arrhythmias. “From a scientific point of view, we take the increasing heat waves very seriously and advise people with heart disease to adapt to the conditions that are challenging for their bodies – especially when there are other risk factors such as fine dust in addition to the high temperatures,” warns Professor Dr. Heribert Schunkert, Deputy Chairman of the Board of Directors of the German Heart Foundation and Director of the Clinic for Adult Cardiology at the German Heart Center in Munich. “After inhaling, the fine dust enters the bloodstream through the alveoli and also puts a strain on the heart. Particulate matter triggers inflammatory reactions and is therefore considered a risk factor for cardiovascular diseases. However, patients often do not even realize that they are exposing themselves to increased fine dust pollution. Many only associate particulate matter with road traffic. But it could also be caused, for example, by large forest fires or intensive agricultural use, according to the Heart Foundation expert. “In this respect, you can be more stressed than you think even in the supposedly fresh air and in nature,” reports Schunkert. The Heart Foundation offers helpful information for people with heart disease, including a free travel kit at
Cardiac patients are already under greater stress at temperatures of around 30 degrees
In general, temperatures of around 30 degrees and more become a physical strain – especially for people with heart problems. “Many people find a warm climate pleasant, and we also know from southern countries that, statistically speaking, their inhabitants are less likely to suffer from heart disease than their northern neighbors. But the tables turn when there are major heat waves: heart patients should then be particularly careful,” Schunkert emphasizes, and explains the physiological context: “On the one hand, a lot of fluid is lost through the skin, which is a particular problem for patients with an already limited amount of fluids to drink. You are threatened with an acute lack of fluids. And on the other hand, the circulatory system is challenged more by the increased blood flow to the skin. Both factors can easily lead to excessive circulatory reactions. These can have a negative effect, especially for people with a previously damaged heart.”
Keep an eye on medications for blood pressure fluctuations
In addition, heart patients should always keep an eye on their medication in warmer temperatures. This applies in particular to blood pressure drugs. The medical background: Patients with cardiac insufficiency in particular usually take medication to relieve their heart. This happens in part by lowering blood pressure, for example with dehydrating drugs such as diuretics. “If the effects of the medication are accompanied by extreme heat and the associated loss of fluids, then it may be that the blood pressure drops too much. The combination of these factors can lead to an excessive reaction in the circulatory system,” says the cardiologist and hypertensiologist. His tip: measure and check your blood pressure more often, especially when it’s hot. If blood pressure falls below 100 mmHg (systolic), it is advisable to consult a doctor. Conversely, blood pressure can also rise sharply because the body is under great stress from the heat. Info below
Do not compensate for dehydration with alcoholic beverages
By the way: The deputy chairman of the Heart Foundation reminds us that the effect of alcohol in hot weather is still often underestimated. “Drinking beer or wine to quench your thirst is the wrong approach. If you try to compensate for the lack of fluids in this way, you also risk an excessive reaction of the circulatory system – especially if the alcohol comes together with other risk factors for cardiovascular patients,” warns Schunkert.
Caution at altitudes over 2500 meters and in extreme climates
In addition to the heat, high altitude can also put the body under stress – not only when hiking in the mountains, but also during stays and, for example, cultural trips to high-altitude regions. For light physical activity, a height of 2500 meters is considered the critical limit, but for intensive exertion (mountain climb) it is significantly lower (for comparison: the Zugspitze is 2962 meters high, the Klein-Matterhorn near Zermatt, which can also be reached by cable car, is 3883 meters , and the Bolivian capital La Paz is at 3869 meters). As the altitude increases, the air gets thinner and less oxygen gets into the arteries. This increases the heart rate. The high heart rate can be extremely stressful, especially for people with cardiac insufficiency. At the same time, more CO2 is exhaled due to more intensive breathing, which upsets the acid-base balance in the blood. Slow acclimatization can in turn have a positive effect on this. Extreme climates can also be particularly harmful to these patients. “Therefore, high altitudes and tropical and arctic regions of the world are not recommended for heart patients. The climate there simply puts too much strain on the cardiovascular system,” emphasizes Professor Dr. Thomas Meinertz, former Chairman of the Heart Foundation and Editor-in-Chief of the Heart Foundation magazine “Herz heute”. It makes more sense to travel to a holiday destination with a familiar climate. The renowned cardiologist and pharmacologist suggests autumn and spring as the best travel times for heart patients.
Thorough planning with the Herzstiftung holiday package as a safety plus
Thorough planning makes sense. What is important is also evident from the large holiday information package of the German Heart Foundation. In addition to many practical general tips, it also contains a travel checklist and a travel set for cardiac patients. The information package can be ordered at or by telephone on 069 955128-400. Good preparation also includes finding out about the air quality at your holiday destination, especially on city trips. Because pollutants in the air, in addition to fine dust, for example carbon monoxide and nitrogen oxides – can promote inflammation and also fuel vascular diseases such as deposits in the walls of the arteries (arteriosclerosis). Patients with coronary artery disease (CHD), cardiac arrhythmias or high blood pressure are at risk. “Depending on the type of heart or circulatory disease, air pollution at the travel destination can have an unfavorable effect on the course of the disease within a short period of time, in the worst case it can trigger a complication such as a heart or cerebral infarction or lead to hospitalization for heart failure patients,” reports Meinertz . Interested parties can find information on air quality at holiday destinations worldwide at
After the stress of arriving, start your holiday program with a sense of proportion
With all the planning, however, you should also make sure not to pack the holiday program too full. Especially after the stress of arriving, the body needs some rest and a certain amount of time to adjust at the holiday destination. In concrete terms, this means: Activity yes – but please use a sense of proportion, advises the Heart Foundation. In the first few days of your holiday, do without strenuous mountain tours, long bike rides or extensive sunbathing. Moderate exercise is better, and you should avoid the midday sun if possible. Some caution is also required for heart patients when bathing, especially in cold waters – both when entering and exiting the water. “This can lead to circulatory problems,” says Heart Foundation expert Meinertz.
Unfamiliar diet can affect the effects of medication
Because everyday life on vacation is often different than at home, heart patients should not forget to take their medication. Incidentally, eating habits also play a role in their effect. Affected are, for example, patients who have to take the anticoagulant drug Marcumar due to atrial fibrillation or an artificial heart valve. Fatty food and many foods with a high vitamin K content (e.g. spinach, onions, garlic, chard or lentils) can affect the effect of Marcumar. Therefore, these patients should check their blood coagulation values at shorter intervals.
Don’t forget your card for a pacemaker or defibrillator
The best message for the holiday season: Even most heart patients can pack their bags full of anticipation and travel safely. However, if you have a pacemaker or defibrillator in your chest, you should not forget the ID card for the device and show it, for example, at security checks at the airport. You can go through the control barriers (the ones that look like door frames) with a clear conscience, but an examination with a manual metal detector is rather unfavorable. More information is available at
In the case of the following illnesses, it is better to forgo a holiday trip
In some cases, heart patients should refrain from going on vacation – for example, if they suffer from the following diseases or symptoms:
Angina pectoris (chest tightness) with low loads, such as e.g. angina pectoris (chest tightness) that occurs with increasing severity, shortness of breath with low exertion such as walking on level ground or climbing stairs, increasing shortness of breath or increasing edema (water retention), repeated dizziness and sudden loss of consciousness (syncope)
– then you should definitely see a doctor.
Service Tips
Checklist for more security
The German Heart Foundation offers a travel checklist on the most important points of good travel preparation and the option of ordering a travel set for people with heart disease free of charge at or by telephone at 069 955128-400
From the imPULS podcast series on the subject of travel
Heat, altitude & hustle and bustle – travel safely despite heart failure
In the current episode of imPULS, cardiologist Prof. Stephan von Haehling explains which travel preparations are recommended, why breaks on the journey are particularly important and how the climate, air pollution and altitude at the holiday destination can worsen heart failure. Listen in below
Heart tip for implantable defibrillators/pacemakers
Some pacemaker systems have the ability to program a circadian rhythm. When changing time zones, this function should be deactivated beforehand. The walk-in detectors can be used with pacemakers/defibrillators as part of safety checks. However, manual metal detectors should not be guided directly over the unit if possible (show pacemaker ID). More information at:
Information about swimming, hiking and cycling:
Photographic material is available from [email protected] or by phone on 069 955128-114