Travelling to Colder Places with Pre-existing Medical Conditions

Posted on December 11, 2018 by Dr. Claudia Pastides
Couple-overlooking-cold-weather

Having a pre-existing medical condition needn’t put you off travelling during winter or venturing to colder climates.

Although there are certain conditions more affected by the cold than others, the good news is that these pre-existing medical conditions don’t always have to prohibit your travel plans.

Ultimately it is not the cold weather itself, but how you prepare for it that counts.

Heart and vascular disease

There is no easy answer to the question of whether cold weather is bad for people with pre-existing heart and cardiovascular conditions (i.e. angina, stroke, arrhythmia).

Research has shown us that there is indeed seasonal variation in the UK when it comes to the incidence of cardiovascular disease (1), with significantly more admissions to hospital with heart problems in the colder winter months, than in the summer.

Reasons for this appear to include more than just low temperatures. Changes to lifestyle factors (such as diet, obesity and exercise), reduced exposure to sunlight and increased exposure to infections are all said to affect this increased risk.

In some people angina is known to be precipitated by exposure to cold weather. Lower environmental temperature may exert a direct effect on the heart or have an indirect effect via changes in blood pressure, as the cold is known to be associated with higher blood pressure. (2)

Of course, however, people with cardiovascular disease live all over the world, in all sorts of freezing cold climates and they do not have a permanent higher risk of heart attacks or strokes.

In a study comparing six regions in Europe, cardiovascular mortality in winter was independently associated with low living-room temperatures, limited bedroom heating, a low proportion of people wearing hats, gloves and anoraks, and inactivity (2).  These findings suggest that some of the impact of cold weather on cardiovascular disease can be reduced through taking a few simple measures.

DOCTOR’S TIPS

  • Make sure you are staying and sleeping somewhere warm and wear appropriate clothing (especially outdoor protection of the face).
  • Remain active but be sensible and don’t take up unaccustomed strenuous exercise.
  • If you are travelling to high altitudes, it is important to discuss this with your doctor as certain heart conditions can be affected by rapid ascents to altitude

Asthma

Cold weather is well known to be a trigger of asthma symptoms for many asthma sufferers. The airways can narrow and tighten up when cold air is breathed in, with some asthma attacks triggered by the cold air more than others.

DOCTOR’S TIPS

  • Plan ahead and speak to your GP/asthma nurse about your upcoming holiday plans. Make sure you have enough inhalers to cover you, should you need to use more of your bronchodilator (reliever) than usual and of course, continue taking your preventer regularly.
  • Some find that taking their bronchodilator 30 minutes before heading out into the cold can help. Make sure you have a bronchodilator with you when out and about.
  • Wrap a scarf loosely over your nose and mouth.
  • Make sure you have had the annual flu vaccine.

Chronic Obstructive Pulmonary Disease (COPD)

The cold makes people more susceptible to infections and interestingly a study has found cold temperatures alone can increase exacerbations of COPD (3) The study showed that people of older age and those who didn’t use their inhalers, were more at risk of being affected by lower temperatures.

DOCTOR’S TIPS

  • It is best to discuss your COPD management regularly with your GP/COPD nurse and providing you have a good treatment plan, keep warm and stay alert for symptoms of an exacerbation, so that it can be treated early, you’ll be well prepared.
  • Make sure you always take your COPD rescue pack with you.

Diabetes

Although some studies have shown blood sugar readings fluctuate in diabetics when it is cold, the exact reasons proposed are varied.

From postulating about diet and increased consumption of food during the winter months, to physiological changes in how the body responds in cold weather and that affecting the ways in which the body processes blood sugar, the theories are many.

What it boils down to is that no matter whether it is cold or warm, the aim should be to eat well, exercise as best you can and aim for good blood sugar control.

DOCTORS TIP

Arthritis

The evidence to support the common belief and observation that cold climate worsens arthritic symptoms is weak. However, some studies and experiments have shown that people with arthritic symptoms do experience a trend of worsening in pain and stiffness in cold and damp weather. (4)

This could be due to reduced activity as people spend less time out and about when it is cold but the scientific research out there doesn’t give any clear answers.

DOCTOR’S TIP

– The best advice it to keep warm and stay active. If you’re going for a walk, wear non-slip footwear and take a thermos flask with your favourite warm drink.
– Discuss appropriate pain management with your doctor should your joint pain worsen while you’re away.

Catching a cold

People with pre-existing chronic health conditions are at higher risk of becoming unwell when exposed to colds and the flu.

The cold weather leads to more people huddling indoors causing increased transmission of respiratory infections. But, did you know that scientists have proven the old wives’ tale – ‘cold weather can make you sick’?

Cold weather itself cannot cause an infection (it is bacteria and viruses that do this) but recent research has shown that the immune response to bacteria and viruses found in the nose is reduced by cold weather. As our nose is often the first port of entry for many colds, we now have some evidence to back up the concern that cold weather makes us more susceptible to illness. (5)

DOCTOR’S TIP

  • It is highly recommended that those offered the flu vaccine take it up as it will help protect you against flu when travelling in winter, a time where influenza peaks world-wide.
  • Keep your neck, mouth and face warm with a scarf.
  • Wash your hands well and try not to touch your nose or mouth when out and about as you can introduce infections that way.

Important Information:

These travel tips are intended to provide general information for those travelling to a cold climate and do not replace a visit to your doctor if you have existing medical conditions.

If you are planning a holiday you should consult your doctor to ensure that you are fit to travel and discuss any specific health requirements you may have.

Dr Claudia Pastides

Dr Claudia Pastides

Dr Claudia (Carmaciu) Pastides

MRCGP MBBS iBSc

Dr Claudia (Carmaciu) Pastides works as a GP in Marylebone. She graduated from University College of London Medical School in 2009 and is a London trained General Practitioner with a special interest in health promotion and health writing. Website – www.DrMummykins.com Twitter- @DrClaudiaPastides