What are the Heart Benefits of Altitude Training?

More and more people are practicing altitude training in the mountains. It's become a growing trend for different age groups and even among people with heart problems.
What are the Heart Benefits of Altitude Training?

Last update: 19 March, 2020

Altitude training has gained a lot of supporters over time. Gradually, it became a viable activity for everyone, not just for mountain fans who go out for runs in any weather condition.

We could say that mountains have opened up a world of possibilities for different ages and physical conditions. Even altitude training modalities have diversified enough to increase their popularity.

This is partly because altitude training offers rewarding landscapes and scenic views along with the workouts. For many people who wouldn’t run or walk at sea level or on flat terrains, the possibility of encountering valleys and mountains is a powerful incentive.

But apart from that, the increase in popularity of this modality has also raised numerous questions. Is it beneficial for anyone? What about chronic disease patients? Can a cardiac patient be a mountain runner? Let’s take a closer look at the situation.

Altitude training and red blood cells

By training at high altitudes, we demand more from our bodies. The immediate effect is a decrease in oxygen concentration; the higher we are with respect to sea level, the less oxygen is available for our respiratory system.

That first session of altitude training can be exhausting for the people who practice it. This is especially true if the person has never worked out on an altitude higher than sea level, or if they don’t do it very often.

A man doing bike altitude training through a mountain

However, if altitude training becomes repetitive and constant, then the body seeks to adapt. One of the first measures it takes to make up for the lack of oxygen is to produce more red blood cells. People who train regularly can have up to 20 percent more red blood cells than a normal person.

Mountain exercise also increases the efficiency of a protein called myoglobin. Myoglobin is the oxygen carrier between myocytes, which are the muscle cells. That’s why we can find this protein inside our muscles.

All of these changes can affect the metabolism of exercising. The high altitude athlete begins their first workout by performing aerobic metabolism; in other words, they consume a lot of oxygen for their muscles to work.

As the workout progresses and erythropoietin (EPO) increases, the amount of red blood cells also goes up and the metabolism changes to anaerobic. The muscle becomes more efficient, consumes less oxygen and its available for whenever our body requires it.

Altitude training for patients with mild heart conditions

The heart of a healthy person clearly benefits from altitude training. Their use of oxygen becomes more effective and their endurance increases. Also, the metabolism changes from aerobic to anaerobic.

For patients with mild heart conditions, this training modality also has a lot of benefits. Of course, the patient must maintain a normal ejection fraction. In other words, the amount of blood exiting through the left ventricle into the circulation must be within a normal range.

If the patient meets these safety requirements, then they can train in altitudes up to 8,200 ft (2.5 km) meters above sea level. However, it also depends on their particular tolerance to exercise. Either way, training between 3,200 and 6,500 feet (ca. 2 km) above sea level has obvious benefits for someone who’s had a heart attack.

Heart attack victims can practice altitude training as long as they maintain a normal ejection fraction and are under medical supervision. Of course, they won’t reach professional athlete levels, but they will increase their oxygenation capacity, with clear benefits for their condition.

The risks exist

We want to emphasize again that this information only applies to patients who meet certain safety conditions. For example, a normal ejection fraction and a proven tolerance to exercise.

A woman trekkking and enjoying the view from the top of a cannyon

It would be risky to train in the mountains for someone with cardiac insufficiency. In those cases, the increase in red blood cells isn’t enough since blood circulations in general fail. It’s also risky if the heart pathology involves hypercoagulation problems. This is because as the number of red blood cells increases, the blood starts to thicken.

Altitude sickness is also a factor to consider. It’s quite noticeable at more than 9,800 ft. (ca. 3 km) above sea level, but some people can present symptoms at around 8,200 ft. (2.5 km). Cardiac patients must start their descent as soon as they perceive the first symptoms.

Temperature is another key issue. Mountains have a colder climate, with lower degrees of thermal sensation, and this causes vasoconstriction. Climate isn’t a contraindication, but it’s important to wear appropriate garments and have greater precautions in this regard.

In conclusion

Altitude training for heart patients is an interesting option if they enjoy the mountains. They can combine their passion with an improvement in their quality of life after a cardiac diagnosis.

These athletes should also consult a health professional who controls their general health condition. If they meet the minimum requirements, there should be no risks or drawbacks.


All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.


  • Tapia Pruna, Ramiro Xavier. El entrenamiento en altura para mejorar la capacidad anaeróbica en los deportistas de fondo de la Federación Deportiva de Cotopaxi en el año 2015. BS thesis. LATACUNGA/UTC/2015, 2015.
  • Martinez Ferrer, J. “Alteraciones cardíacas del sujeto sano en la altitud.” Manual Básico de Medicina de Montaña. INO Reproducciones, Zaragoza, España (1996): 123-130.
  • Velarde, Ariel, et al. “Fisiología del corazón de atleta: estudio ecocardiográfico en atletas de resistencia y fuerza nativos de la altura.” Revista Scientifica 12 (2014): 19.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.