Dr. Simon Gibbs,
Forty million skiers and hikers visit the Alps each year and about 300 die during their visit. Thirty percent of these deaths are sudden. One sudden death occurs every 400 000 hours of exposure to skiing (including both cross-country and downhill) and every 800 000 hours exposure to hiking. The greatest risk occurs on the first day of the visit but other triggers also include going too long without food and drink and exercising in the late morning. Acute altitude exposure with consequent hypoxia and sympathetic nervous system activation may play a role in these risks. The need for pre-visit cardiovascular risk factor control was stressed, especially one including blood pressure and an exercise training regime with aerobic exercise with high intensity interval training and strength training. On the first day of the holiday, it is important to rest or take only low intensity exercise. He recommended that food and fluid should be taken every 30 to 60 minutes during the period of exercise. In a comparison of various ball games, football caused the most cardiac stress reaching 98% of peak heart rate during training, tennis was moderate with a peak heart rate of 80% and golf considerably less. The benefit of these sports in improving cardiovascular risk factors was not clear although published studies are limited.
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