Air Travel and Cardiovascular Disease

Stephen E. Possick, MD; Michèle Barry, MD, FACP


J Travel Med. 2004;11(4) 

In This Article

General Concerns

Dehydration has been a major concern with long-haul air travel, due to the 10% humidity of circulating air on commercial aircraft. Theoretically, dehydration could be expected to contribute to the deleterious effect of air travel on cardiac patients by effectively decreasing preload and therefore cardiac output. Whereas low humidity may lead to dry skin and eye irritation, it has not been proven to result in significant intravascular dehydration. Skjenna et al. cite data demonstrating that most patients actually gain weight secondary to increased fluid intake during air travel.[14] Landgraf et al. simulated flight conditions in 12 healthy volunteers and found an average surplus in fluid balance of 1,100 to 1,200mL. This cor-responded to an average weight gain of approximately 1kg.[15] Nevertheless, dehydrating alcohol and caffeinated beverages should be avoided, and care should be taken to consume adequate fluids. Airline food is often quite high in sodium. The increased sodium load can present problems for travelers with congestive heart failure, who may be more sensitive to volume shifts than other cardiac patients. Mental stress may lead to cardiac ischemia in those with known coronary artery disease.[16] Flying can be a significant stressor in many travelers, and represents a potential risk factor for in-flight ischemia as well. General recommendations for air travelers with cardiac disease are presented in Table 2 .


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