High altitude takes your breath away, and not always in a good way.
As you climb higher into the mountains, be it Kilimanjaro, the Himalayas, or the Andes, your heart starts working harder. And sometimes, that pounding in your chest isn’t just excitement or exertion. It’s your body telling you it’s struggling.
If you’ve ever noticed your heart racing at altitude, you’re far from alone. Understanding what’s happening inside your body can help you manage it, and keep you safe on the trail.
Why does your heart rate increase at high altitude?
Before we explore how to lower the heart rate at high altitude, it helps to know what causes it in the first place.
At elevation, oxygen levels drop. This condition (hypoxia) means there’s less oxygen in every breath. Your body, sensing the deficit, works overtime to compensate.
Here’s what happens:
- Your heart beats faster, pumping more blood to carry what little oxygen is available.
- You start breathing quicker, often without realising.
- Your body releases adrenaline, adding even more strain to your system.
This is part of a normal process called acclimatisation. It's your body’s way of adapting to the new environment, but it can leave you feeling drained, dizzy, or on edge, especially in the first few days.
Is it normal to have a high heart rate at altitude?
Yes, to an extent. A faster resting heart rate is completely expected as your body adjusts. But it’s important to recognise when things aren’t normal.
If you’re sitting still and your heart’s racing, or you feel faint, breathless, or nauseous with minimal effort, that’s cause for concern.
Keep an eye out for:
- Persistent heart palpitations or a fluttering sensation
- Chest tightness that doesn’t improve with rest
- Feeling light-headed or dizzy, even when seated
- Fainting spells or extreme fatigue
These could be signs of high-altitude heart palpitations or early warning symptoms of altitude-related heart problems. The American Heart Association reiterates that if you already have a heart condition, you should speak to a medical professional before your trip; don’t assume it’ll be fine just because you’re fit.
Can high altitude cause a heart attack?
In healthy individuals, it’s highly unlikely. But if you have a pre-existing cardiac condition, the answer changes.
At extreme elevations(above 3,500 to 4,000 meters), your heart is under more strain. The oxygen is thin, the blood vessels constrict, and the workload on your heart increases. In some cases, this can raise the risk of:
- Cardiac arrhythmias
- Angina
- In very rare cases, a heart attack
That doesn’t mean you shouldn’t go. It just means that managing heart rate in the mountains becomes even more important, especially for those with hypertension, past cardiac issues, or who are over 50.
How to lower heart rate at high altitude
Practical ways to slow your pulse when the air gets thin
That pounding in your chest as you gain altitude? It’s not just excitement. As oxygen thins out, your heart works overtime to keep blood flowing. And while that’s completely normal, there are smart ways to help your body cope.
Here’s how to manage it safely, especially if you’re dealing with heart racing at altitude or just want to feel a bit steadier on your feet.
1. Take it slow.
There’s no medal for racing to the summit. The best way to stop your heart from overworking is to give it fewer surprises.
- Keep your daily gain under 500 meters once you're above 2,500.
- Build in rest days every 1,000 meters
This pacing gives your system time to adapt naturally and helps prevent high-altitude heart palpitations from catching you off guard.
2. Keep your water bottle close.
Even slight dehydration can push your heart rate higher. That’s because thickened blood makes the heart pump harder, especially up here.
- Aim for 3–4 litres of water a day.
- Check that your urine is light yellow (the darker it is, the more you need to drink).
Hydration helps oxygen circulate and supports overall acclimatisation.
3. Don’t overdo it early on.
Your sea-level strength doesn't count for much when the air thins. Give your body time to adjust before pushing it.
- Avoid heavy exercise or fast-paced hiking in your first 48 hours.
- Let your breathing guide your pace.
This is key to managing heart rate in the mountains, especially on treks with quick elevation gain like Kilimanjaro or Annapurna.
4. Prioritise proper rest.
Sleep is more than recovery—it’s when your heart rate naturally settles.
- Try to get 7–9 hours of solid rest.
- Avoid caffeine or alcohol before bed.
Good sleep will help your heart cope with the reduced oxygen and support your body’s overall acclimatisation process. For more info on the importance of sleep, check out the CDC’s in-depth look at the importance of sleep for your heart health.
5. Use your breath to your advantage.
Intentional breathing can lower your heart rate and calm your system, particularly when anxiety or altitude stress kicks in.
- Breathe in for 4 seconds
- Hold for 7
- Exhale for 8
Do a few rounds whenever you feel light-headed or tense. It’s simple, free, and surprisingly effective.
6. Be smart about supplements.
Some trekkers swear by natural boosters, but they’re not one-size-fits-all.
- Beetroot juice is thought to help with circulation.
- Ginkgo biloba may support altitude adjustment.
If you’re taking heart medication or have concerns, check with your doctor before adding anything new. Heart problems at elevation are rare but serious.
7. Skip the stimulants.
Your nervous system’s already doing overtime. Adding an extra kick can make things worse.
- Steer clear of energy drinks and high doses of caffeine.
- Opt for slow-burning foods like oats, bananas, or trail mix.
These small choices help keep your pulse steady and your energy up without overloading your heart.
Who’s most at risk of heart issues at altitude?
It’s not just older trekkers who need to be careful.
Anyone can feel their heart race at altitude, but some people are more prone to heart problems at elevation than others. If you're heading into the mountains, it’s worth knowing who should take extra care.
A faster heart rate is a normal part of acclimatising, but it can become risky depending on your health history. These are the groups most likely to struggle with high altitude and heart rate changes:
- People with known heart conditions (like arrhythmias or coronary artery disease)
- Those over 50, especially if not very active
- Smokers
- Anyone with high blood pressure or diabetes
- Travellers with a family history of heart disease or sudden cardiac events
You don’t have to be unwell to experience heart palpitations at altitude. Even fit trekkers can feel the effects. That’s why it’s smart to get a pre-trek check-up before heading off to places like Mount Meru, Everest Base Camp, or the Annapurna Circuit, particularly if you’re planning rapid elevation gain.
Managing heart rate in the mountains: when to worry and what to do
It’s normal for your heart to work harder at altitude. After all, it’s trying to push oxygen through your system with less fuel in the tank. But there’s a line between natural adjustment and something that needs urgent attention.
If your pulse feels uncomfortably fast, won’t settle at rest, or comes with other symptoms, it could be more than just tired legs. Here’s what to watch for.
When a racing heart becomes a red flag
A quickened heartbeat is part of the process, but it shouldn’t feel alarming or persist when you’re lying down. Keep an eye out for:
- Heart palpitations that won’t ease
- Chest tightness or pain
- Dizziness or near-fainting
- Breathlessness even while resting
- Fatigue that feels extreme or out of place
- A resting heart rate over 120 bpm with no sign of slowing
These could be signs that your body isn’t acclimating well—or worse, that your heart is under too much strain.
Altitude-related conditions linked to a high heart rate
Some common illnesses at elevation directly impact the heart.
1. (AMS)
Headaches, nausea, dizziness, and a raised heart rate are the most frequent signs that you’re not adapting quickly enough.
2. (HAPE)
A serious and potentially fatal condition where fluid fills the lungs. Breathing becomes laboured, lips or fingertips may turn blue, and the heart races to compensate for the lack of oxygen.
3. (HACE)
This one affects the brain. It may include confusion, slurred speech, trouble walking, and a dangerously elevated pulse.
4.
Rare, but possible, especially if you already have a heart condition. The combination of low oxygen and dehydration can cause the heart to skip, flutter, or beat irregularly.
How to monitor your heart rate at altitude
You don’t need to guess, track it.
Keeping tabs on your heart rate helps you spot patterns early and make better decisions in the mountains. You don’t need hospital-grade equipment—just a bit of preparation.
Best tools for the job
- Pulse oximeter: These fingertip devices measure oxygen saturation and pulse rate. Use it at rest, ideally around the same time each morning. A normal resting heart rate at elevation is often 80–100 bpm. Anything over 120 bpm at rest, especially with other symptoms, is a cause for concern.
- Smartwatches or fitness trackers: Devices from Garmin, Suunto, and Apple offer real-time heart rate monitoring, plus data on sleep and stress. They’re useful for catching changes over a few days.
Emergency steps if your heart rate won’t come down
Act early, don’t try to “push through.”
When your chest is pounding and rest doesn’t help, it’s time to act. The key is not to ignore your symptoms or chalk them up to tiredness.
- Stop ascending immediately: Gaining more height will only increase the risk.
- Hydrate and rest: Find somewhere warm and still. Sip water regularly. Avoid anything that raises your heart rate, like caffeine or alcohol.
- Descend if things don’t improve: Even a few hundred meters can help. If you suspect altitude sickness, HAPE, or HACE, you need to get lower as soon as possible.
- Use oxygen if it’s available: Supplemental oxygen can give your body breathing room while you prepare to descend.
- Tell someone: Let your guide or group know. Most trained leaders are equipped to recognise and treat serious heart problems at elevation.
Best practices for keeping your heart in check on long treks
Prevention really is the best medicine.
If you’re trekking routes like the Manaslu Circuit, Inca Trail, or Kilimanjaro, your preparation matters just as much as your gear.
- Choose itineraries with acclimatisation built in.
- Avoid pushing for speed; it’s not a race.
- Train in advance with cardio and hill walking
- Eat iron-rich foods to support oxygen transport.
- Always consult a doctor if you have a heart or lung condition.
Bringing medication? Make sure it’s cleared for high altitude and doesn’t affect blood pressure or pulse in risky ways.
Can you train your heart for altitude?
You can improve your chances, but not cheat altitude.
You can't fully replicate thin air unless you live at high elevation, but you can get your body into a better state to handle it.
Start training 6–8 weeks before your trip with:
- Hiking or trail walking
- Cardio like cycling or swimming
- Breathing exercises and stretching
- Sleeping in a semi-upright position if you’re prone to fluid buildup
A stronger heart won’t prevent your heart from racing at altitude, but it will likely recover faster and help you acclimatise more comfortably.
Final word on managing heart rate in the mountains
Trek smart, listen to your body, and don’t push past warning signs.
Most travellers experience a raised heart rate when heading into high-altitude zones. That’s normal. But if your symptoms escalate or don’t settle with rest, it’s a signal worth taking seriously.
Understanding how to lower heart rate at high altitude, spotting the warning signs of AMS, and being prepared for the possibility of heart palpitations or even cardiac stress is what keeps a memorable trek from turning dangerous.
So take your time. Breathe. Hydrate. And remember, adapting to altitude isn’t a test of strength. It’s a process of patience.
