Despite a barrage of criticism from medical experts over the last couple of years, doctors on Aconcagua still continue to take blood pressure measurements from all climbers on the mountain - sometimes leading to treatment or climbers being banned. Jeremy Windor thinks it's high time this changed.
During the 2009-10 climbing season I had the pleasure to work as a guide and doctor for a group of mountaineers during a safe and successful ascent of Aconcagua. In this capacity I was able to gain at first hand an impression of the medical facilities, personnel and procedures that are in place on the mountain.
I should first say that I believe the doctors employed by the park authorities on Aconcagua are doing their utmost to provide the best possible care for their patients. Their work should be applauded. However their efforts in one key area are misguided.
Despite a barrage of criticism from medical experts over the last couple of years, doctors on Aconcagua still continue to take blood pressure measurements from all those who wish to climb the mountain. In many cases this has led to fit and healthy individuals being diagnosed with high blood pressure and a course of treatment being given. If this wasn’t bad enough, those who fail to improve with treatment often find themselves banned from climbing any higher on the mountain.
On returning to the UK I have been in touch with several climbers who were sent home without even setting foot on the mountain! Unfortunately, there is no evidence whatsoever to suggest that a high blood pressure measurement is a good way of predicting the development of medical problems at altitude. Whilst a long history of high blood pressure is associated with heart problems at any height, this is unlikely to be the case in mountaineers who have normal blood pressure at sea level and are otherwise fit and healthy.
The actions of doctors on Aconcagua are made worse by a huge amount of variation in the measurement and interpretation of blood pressure recordings. I noticed several doctors choosing to ignore high blood pressure measurements, whilst others looked carefully for even the smallest changes that occurred in my group. Surprisingly, I encountered some doctors who couldn’t agree on what was meant by high blood pressure, whilst others disagreed on the number of measurements that were needed before a diagnosis could be made!
It was very clear that guidelines on the management of blood pressure are simply not in place on Aconcagua. Doctors are instead left to follow their instincts and climbers are faced with a situation that can lead to two mountaineers sharing the same blood pressure, yet one is sent home and another is allowed to climb to the summit! Given all these issues isn’t it time that this practice was stopped on Aconcagua?
Wouldn’t it be better to adopt the approach of the Himalayan Rescue Association (HRA) and focus more upon improving education and treating medical problems as they arise? In the meantime, those with a history of high blood pressure would be well advised to visit their doctor and come up with a clear plan in order to deal with any increase in blood pressure that might occur on the mountain.
Until this haphazard approach is stopped, a significant number of mountaineers will return home disappointed, not defeated by the mountain but by well meaning doctors instead.
UIAA Medical Commission advice
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