Are hiking recommendations one-size-fits-all? Insights into cardiovascular safety and trail demands.

INTRODUCTION: Hiking is an outdoor activity with not only significant health benefits but also associated risks, especially for individuals with cardiovascular conditions. Current trail recommendations lack personalization, potentially increasing the risk of adverse events during hiking. SOURCES OF DATA: Prospective, cross-sectional study combining outpatient cardiopulmonary exercise testing with monitored outdoor hiking. Data were collected via portable gas analysis, heart rate monitors, and an official meteorological station. AREAS OF AGREEMENT: Hiking intensity and cardiorespiratory responses vary widely. Cardiovascular risk and trail slope were found to influence the exertion required to complete the hike. AREAS OF CONTROVERSY: There is no consensus on how to standardize trail recommendations to account for individual variability. GROWING POINTS: Personalized hiking advice integrating individual fitness, cardiovascular risk, and trail features may enhance safety. Wearable technologies enable real-time adjustment of exertion levels. AREAS FOR DEVELOPING RESEARCH: New tools combining personal health data and environmental features to optimize hiking safety and accessibility should be implemented.