Blood Pressure and Altitude: An Observational Cohort Study of Hypertensive and Nonhypertensive Himalayan Trekkers in Nepal

Keyes, Linda E.; Sallade, T. Douglas; Duke, C. B.; Starling, Jennifer; Sheets, Alison; Pant, Sagun Ballav; Young, David; Twillman, David; Regmi, Nirajan; Phelan, Benoit; Paudel, Purshotam; McElwee, Matthew K.; Mather, Luke; Cole, Donald R.; McConnell, Theodore; Basnyat, Buddha

doi:10.1089/ham.2017.0001

Cited by 13 publications

(15 citation statements)

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“…29 On the other hand, Schmid et al 47 did not reveal significant risks in revascularized patients with coronary disease who performed exercise at HA, and the limited data in hypertensive individuals during altitude exposure do not indicate significant immediate risks. 10,48 Regarding drug therapy, several studies tested the efficacy of different antihypertensive drugs in controlling BP during HA stay, and more generally, their effects on altitude pathophysiology. In fact, acclimatization mechanisms affect many biological pathways targeted by antihypertensive drugs.…”

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confidence: 99%

Blood pressure at high altitude: physiology and clinical implications

Bilo¹,

Caravita²,

Torlasco³

et al. 2019

Kardiologia Polska

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High altitude is a fascinating model of hypoxia effects on the human body, but it is also an extreme environment that directly influences millions of people who either travel to high altitude locations or live there permanently. A significant progress has been made over the past decades in the understanding of physiological background of responses to altitude, and recently, a number of studies regarding clinical aspects of high-altitude exposure have been published. In particular, more is known about the changes in systemic blood pressure (BP) in individuals exposed to high altitude as well as on the effects of antihypertensive drugs in this setting. The present article provides an overview of principal physiological and clinical aspects related to systemic BP control and its changes at high altitude, mainly during the acute exposure. The evidence on BP changes at rest and during exercise is discussed, as well as the underlying mechanisms and possible clinical implications.

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confidence: 99%

Blood pressure at high altitude: physiology and clinical implications

Bilo¹,

Caravita²,

Torlasco³

et al. 2019

Kardiologia Polska

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“…A study evaluating trekkers with and without hypertension shows that both systolic and diastolic blood pressures remain stable with exposure to high altitude. However, there are participants in both groups that experienced severe, asymptomatic hypertension with an unclear consequence (Keyes et al, 2017). A major limitation of this study is that blood pressure measurements began once the participants had reached 2860 m with no sea level blood pressures available for comparison.…”

Section: The Tradeoffsmentioning

confidence: 98%

The Effect of Hypoxia on Cardiovascular Disease: Friend or Foe?

Savla

Levine

Sadek

2018

High Altitude Medicine & Biology

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Savla, Jainy J., Benjamin D. Levine, and Hesham A. Sadek. The effect of hypoxia on cardiovascular disease: Friend or foe? High Alt Med Biol. 19:124-130, 2018.-Over 140 million people reside at altitudes exceeding 2500 m across the world, resulting in exposure to atmospheric (hypobaric) hypoxia. Whether this chronic exposure is beneficial or detrimental to the cardiovascular system, however, is uncertain. On one hand, multiple studies have suggested a protective effect of living at moderate and high altitudes for cardiovascular risk factors and cardiovascular disease (CVD) events. Conversely, residence at high altitude comes at the tradeoff of developing diseases such as chronic mountain sickness and high-altitude pulmonary hypertension and worsens outcomes for diseases such as chronic obstructive pulmonary disease. Interestingly, recently published data show a potential role for severe hypoxia as a unique and unexpected therapy after myocardial infarction. In this review, we will discuss the current literature evaluating the effects of altitude exposure and the accompanying hypoxia on health and the potential therapeutic applications of hypoxia on CVD.

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“…High-altitude ABP was measured in the Khumbu valley, Nepal when the participant enrolled as a participant in a prospective observational cohort study on BP, hypertension and high altitude in October 2014 (Keyes, Sallade et al 2017). Because of the limited information on kidney transplant patients at high altitude, we solicited the participant's consent to perform additional 24 ABPM at sea level for this report, and to share this data with his physicians.…”

Section: Case Presentationmentioning

confidence: 99%

“…Welch-Allyn ABPM 6100 monitor was used to collect heart rate (HR), systolic BP (SBP), and diastolic BP (DBP) every 30 min 07:00-22:00, and hourly 22:00-07:00. Summary high-altitude data has been partially reported separately (Keyes, Sallade et al 2017). Here, we compare detailed ABP measurements during ascent from 2860m to 4300m with ABP measured at sea level in the south of Spain in January 2016.…”

Section: Case Presentationmentioning

confidence: 99%

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Ambulatory Blood Pressure at Sea Level and High Altitude in a Climber with a Kidney Transplant and Hypertension

Phelan

Mather

Regmi

et al. 2019

High Altitude Medicine & Biology

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Background and Objectives: High altitude may increase blood pressure (BP) and the kidney plays an important role in acclimatization. Little is known about how transplanted kidneys respond to the hypoxic stress of high altitude. We compared 24h ambulatory blood pressure (24 ABP) in a climber with a kidney transplant and hypertension at sea level and high altitude (2800-4300m).Methods: Welch-Allyn ABPM 6100 monitor was used to collect heart rate (HR), systolic BP (SBP), and diastolic BP (DBP) every 30 min while awake, and hourly while asleep.The kidney transplant participant was monitored for 49h at sea level and for 53 h at 2800-4300m.Results: Overall mean SBP did not differ between altitudes. At high altitude the participant's mean nocturnal BP decreased, but this "reverse dipping" pattern was not observed at sea level. The participant had no evidence of altitude illness or infectious complication at high altitude.Conclusions: This case builds on previous reports that kidney transplant recipients may safely travel to high altitude Further study is required to determine the generalizability to other travelers with kidney transplant and/or underlying hypertension and the clinical significance of short-term elevated nocturnal blood pressure at high altitude.

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Blood Pressure and Altitude: An Observational Cohort Study of Hypertensive and Nonhypertensive Himalayan Trekkers in Nepal

Cited by 13 publications

References 30 publications

Blood pressure at high altitude: physiology and clinical implications

Blood pressure at high altitude: physiology and clinical implications

The Effect of Hypoxia on Cardiovascular Disease: Friend or Foe?

Ambulatory Blood Pressure at Sea Level and High Altitude in a Climber with a Kidney Transplant and Hypertension

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