Warm, Cool or Mountain: Climate and Altitude at 75
She spent a week in Quito and loved it.
Picture a woman named Minerva, 72, who has treated coronary heart disease for years and feels well on her medicine. She spent a week in Quito and loved it. Every afternoon was about 21 degrees Celsius, with a cool evening and a light sweater. Her son Callum asked one question over the phone. "Did you ask your cardiologist about 2,850 metres?"
She had not. She had looked at the temperature, and not at the height.
Two questions to ask of a city
The first is how hot it gets, the second how high the city sits. The table shows both, using monthly averages from national weather services, collected by the World Meteorological Organization. The averages cover different periods, from 1951 to 2010, and older ones may understate today's heat. Elevations are approximate, from Wikipedia.
| City | Elevation (m) | Average daily high through the year (C) | Average night low through the year (C) |
|---|---|---|---|
| Quito | 2,850 | 20.8 to 22.3 | 9.4 to 10.2 |
| Bogota | 2,640 | 14.9 to 16.7 | 5.6 to 8.7 |
| Cuenca, Ecuador | 2,560 | 18.6 to 22.2 | 9.0 to 11.4 |
| Mexico City | 2,240 | 20.8 to 26.6 | 5.8 to 12.2 |
| San Miguel de Allende* | 1,900 | 23.5 to 31.3 | 7.3 to 16.2 |
| Medellin | 1,495 | 26.9 to 28.3 | 16.7 to 17.5 |
| Madrid | 660 | 9.8 to 32.1 | 2.7 to 19.0 |
| Lisbon | near sea level, with hills | 14.5 to 27.9 | 8.2 to 17.7 |
*San Miguel is not in the weather service list. The figures are from Leon, a similar high plateau, and are approximations. Boquete is left out.
Quito barely changes through the year. Mexico City is wet from June to September. Bogota's average January night low is 5.6 degrees.
What the research says about height
The British health service says altitude sickness can happen above about 2,500 metres. Symptoms such as headache, nausea and poor sleep usually start 6 to 10 hours after arrival and ease within 1 to 3 days. Confusion, breathlessness at rest or a frothy cough need urgent help.
A 2015 review of heart disease at altitude found that problems are most common in older, unfit men in the first few days. It advised at least five days to adjust, with treatment tuned first, and found that most older people with coronary disease tolerate altitude with little added risk. Other studies describe extra strain in sleep apnoea above about 1,600 metres, and in some lung disease.
One limit matters. These studies follow visitors on short stays, and nothing we read covered long-term residents over 70.
Heat
The World Health Organization reports that heat-related deaths among people over 65 rose about 85% between 2000-2004 and 2017-2021. It notes there is little research on long exposure to heat and humidity. The Centers for Disease Control and Prevention says older adults adjust less well to sudden changes in temperature, and advises air conditioning in hot weather rather than a fan alone (we read a copy of the page, so this is as reported).
The same weather service lists average daily highs of 32.1 degrees for Madrid in July, 33.5 for Athens, 36.1 for Merida in Mexico in May, and 35.4 for Panama City in April, with 21-degree nights. Quito, Bogota, Cuenca and Medellin stay below 29 degrees on average. The first three raise the altitude question.
Minerva and Callum looked at the table together.
"Maybe a few days somewhere lower first," Callum said.
"I wanted the sweater weather," said Minerva. "I had not thought about the air."
You could…
- Ask your own doctor, before choosing a city above 2,500 metres, how your conditions might respond and what a first week should look like.
- Ask the doctor whether a first stay in a lower city, such as Medellin at 1,495 metres, and then a step up, would suit your health.
- Ask a landlord in a hot city whether the flat has air conditioning that works.
If you have lived at altitude or through a hot summer, what did you wish you had known? Write to us below for the next reader.
Figures are estimates for planning, based on public data. Rules change, so each figure shows the year it applies to; ask the official office before you act.
Sources: World Meteorological Organization, World Weather Information Service (national weather services, normals 1951 to 2010); Wikipedia city pages for approximate elevations; British National Health Service altitude sickness page; High Altitude Medicine and Biology reviews (2015, 2023, 2025) via PubMed; World Health Organization heat and health fact sheet; Centers for Disease Control and Prevention heat and older adults page.
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