Ready to go to up North to play in the new snow? Pack some extra precautions along with your ski poles: heart problems can become more serious in higher altitudes, especially when exercising at altitude.

And even people who don’t have any cardiac problems can face nausea and increased heart rates when going into higher elevations, says Michael Kim, MD, an interventional cardiologist at North Colorado Medical Center.

The thin air, which has less oxygen, is harder to breathe and that puts an extra strain on the cardiovascular system, Kim said.

“The most common reaction of your heart to higher altitudes is an increase in heart rate to help maintain cardiac output and maintain oxygen delivery to the tissues,’’ he said.

Kim offers these tips on how to prevent high-altitude sickness from ruining your winter playtime:

• People should try to acclimate to the area before engaging in very strenuous exercise

• Understand it may take a couple days to get adjusted for the altitude.

• Practice “aggressive hydration.’’