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Boxer DJM, Sung YH, Nunez NA, Fitzgerald CE, Renshaw PF, Kondo DG. Exploring the Link between Altitude of Residence and Smoking Patterns in the United States. Int J Environ Res Public Health 2024; 21:226. [PMID: 38397715 PMCID: PMC10887906 DOI: 10.3390/ijerph21020226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Smoking-related diseases affect 16 million Americans, causing approximately 480,000 deaths annually. The prevalence of cigarette smoking varies regionally across the United States, and previous research indicates that regional rates of smoking-related diseases demonstrate a negative association with altitude. The purpose of this study was to determine the relationship between altitude and the prevalence of cigarette smoking by county (N = 3106) in the United States. We hypothesized that smoking prevalence among adults would be negatively associated with mean county altitude. METHODS A multivariate linear regression was performed to examine the relationship between county-level mean altitude and county smoking rate. Covariates were individually correlated with 2020 smoking data, and significant associations were included in the final model. RESULTS The multivariate linear regression indicated that the county-level smoking rates are significantly reduced at high altitudes (p < 0.001). The model accounted for 89.5% of the variance in smoking prevalence, and for each 1000-foot increase in altitude above sea level, smoking rates decreased by 0.143%. Based on multivariate linear regression, the following variables remained independently and significantly associated: race, sex, educational attainment, socioeconomic status, unemployment, physical inactivity, drinking behavior, mental distress, and tobacco taxation. CONCLUSIONS Our results indicate that smoking rates are negatively associated with altitude, which may suggest that altitude affects the pharmacokinetics, pharmacodynamics, and mechanistic pathways involved in cigarette use. Further research is needed to explore the relationship between altitude and smoking and how altitude may serve as a protective factor in the acquisition and maintenance of tobacco use disorders.
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Affiliation(s)
- Danielle Jeanne-Marie Boxer
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (Y.-H.S.); (N.A.N.); (C.E.F.); (P.F.R.); (D.G.K.)
| | - Young-Hoon Sung
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (Y.-H.S.); (N.A.N.); (C.E.F.); (P.F.R.); (D.G.K.)
| | - Nicolas A. Nunez
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (Y.-H.S.); (N.A.N.); (C.E.F.); (P.F.R.); (D.G.K.)
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Colleen Elizabeth Fitzgerald
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (Y.-H.S.); (N.A.N.); (C.E.F.); (P.F.R.); (D.G.K.)
- Intermountain Health, Oncology Clinical Trials, Intermountain Health, Salt Lake City, UT 84107, USA
| | - Perry Franklin Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (Y.-H.S.); (N.A.N.); (C.E.F.); (P.F.R.); (D.G.K.)
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), George E. Whalen Department of Veterans Affairs (VA) Medical Center, Salt Lake City, UT 84148, USA
| | - Douglas Gavin Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (Y.-H.S.); (N.A.N.); (C.E.F.); (P.F.R.); (D.G.K.)
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), George E. Whalen Department of Veterans Affairs (VA) Medical Center, Salt Lake City, UT 84148, USA
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Small E, Juul N, Pomeranz D, Burns P, Phillips C, Cheffers M, Lipman GS. Predictive Capacity of Pulmonary Function Tests for Acute Mountain Sickness. High Alt Med Biol 2021; 22:193-200. [PMID: 33601996 DOI: 10.1089/ham.2020.0150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Small, Elan, Nicholas Juul, David Pomeranz, Patrick Burns, Caleb Phillips, Mary Cheffers, and Grant S. Lipman. Predictive capacity of pulmonary function tests for acute mountain sickness. High Alt Med Biol. 22: 193-200, 2021. Background: Pulmonary function as measured by spirometry has been investigated at altitude with heterogenous results, though data focused on spirometry and acute mountain sickness (AMS) are limited. The objective of this study was to investigate the capacity of pulmonary function tests (PFTs) to predict the development of AMS. Materials and Methods: This study was a blinded prospective observational study run during a randomized controlled trial comparing acetazolamide, budesonide, and placebo for AMS prevention on White Mountain, CA. Spirometry measurements of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow were taken at a baseline altitude of 1,250 m, and the evening of and morning after ascent to 3,810 m. Measurements were assessed for correlation with AMS. Results: One hundred three participants were analyzed with well-matched baseline demographics and AMS incidence of 75 (73%) and severe AMS of 48 (47%). There were no statistically significant associations between changes in mean spirometry values on ascent to high altitude with incidence of AMS or severe AMS. Lake Louise Questionnaire scores were negatively correlated with FVC (r = -0.31) and FEV1 (r = -0.29) the night of ascent. Baseline PFT had a predictive accuracy of 65%-73% for AMS, with a receiver operating characteristic of 0.51-0.65. Conclusions: Spirometry did not demonstrate statistically significant changes on ascent to high altitude, nor were there significant associations with incidence of AMS or severe AMS. Low-altitude spirometry did not accurately predict development of AMS, and it should not be recommended for risk stratification.
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Affiliation(s)
- Elan Small
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Nicholas Juul
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | | | - Patrick Burns
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Caleb Phillips
- Department of Computational Science, University of Colorado, Boulder, Colorado, USA
| | - Mary Cheffers
- Department of Emergency Medicine, Keck School of Medicine, Los Angeles, California, USA
| | - Grant S Lipman
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
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Hwang J, DeLisi LE, Öngür D, Riley C, Zuo C, Shi X, Sung YH, Kondo D, Kim TS, Villafuerte R, Smedberg D, Yurgelun-Todd D, Renshaw PF. Cerebral bioenergetic differences measured by phosphorus-31 magnetic resonance spectroscopy between bipolar disorder and healthy subjects living in two different regions suggesting possible effects of altitude. Psychiatry Clin Neurosci 2019; 73:581-589. [PMID: 31125152 PMCID: PMC6771782 DOI: 10.1111/pcn.12893] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 05/17/2019] [Accepted: 05/22/2019] [Indexed: 12/26/2022]
Abstract
AIM Increased oxidative stress in cerebral mitochondria may follow exposure to the systemic hypobaric hypoxia associated with residing at higher altitudes. Because mitochondrial dysfunction is implicated in bipolar disorder (BD) pathophysiology, this may impact the cerebral bioenergetics in BD. In this study, we evaluated the cerebral bioenergetics of BD and healthy control (HC) subjects at two sites, located at sea level and at moderate altitude. METHODS Forty-three veterans with BD and 33 HC veterans were recruited in Boston (n = 22) and Salt Lake City (SLC; n = 54). Levels of phosphocreatine, β nucleoside triphosphate (βNTP), inorganic phosphate, and pH over total phosphate (TP) were measured using phosphorus-31 magnetic resonance spectroscopy in the following brain regions: anterior cingulate cortex and posterior occipital cortex, as well as bilateral prefrontal and occipitoparietal (OP) white matter (WM). RESULTS A significant main effect of site was found in βNTP/TP (Boston > SLC) and phosphocreatine/TP (Boston < SLC) in most cortical and WM regions, and inorganic phosphate/TP (Boston < SLC) in OP regions. A main effect analysis of BD diagnosis demonstrated a lower pH in posterior occipital cortex and right OP WM and a lower βNTP/TP in right prefrontal WM in BD subjects, compared to HC subjects. CONCLUSION The study showed that there were cerebral bioenergetic differences in both BD and HC veteran participants at two different sites, which may be partly explained by altitude difference. Future studies are needed to replicate these results in order to elucidate the dysfunctional mitochondrial changes that occur in response to hypobaric hypoxia.
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Affiliation(s)
- Jaeuk Hwang
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Department of Psychiatry, Soonchunhyang University Hospital, Seoul, South Korea
| | - Lynn E DeLisi
- US Department of Veterans Affairs Boston Healthcare System, Brockton, USA
| | - Dost Öngür
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, USA
| | - Colin Riley
- Department of Psychiatry, University of Utah, Salt Lake City, USA
| | - Chun Zuo
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, USA
| | - Xianfeng Shi
- Department of Psychiatry, University of Utah, Salt Lake City, USA
| | - Young-Hoon Sung
- Department of Psychiatry, University of Utah, Salt Lake City, USA
| | - Douglas Kondo
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Rocky Mountain Mental Illness Research, Education and Clinical Center, US Department of Veterans Affairs Healthcare System, Salt Lake City, USA
| | - Tae-Suk Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea
| | - Rosemond Villafuerte
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, USA
| | - Diane Smedberg
- US Department of Veterans Affairs Boston Healthcare System, Brockton, USA
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Rocky Mountain Mental Illness Research, Education and Clinical Center, US Department of Veterans Affairs Healthcare System, Salt Lake City, USA
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Rocky Mountain Mental Illness Research, Education and Clinical Center, US Department of Veterans Affairs Healthcare System, Salt Lake City, USA
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Dhar P, Sharma VK, Das SK, Barhwal K, Hota SK, Singh SB. Differential responses of autonomic function in sea level residents, acclimatized lowlanders at >3500 m and Himalayan high altitude natives at >3500 m: A cross-sectional study. Respir Physiol Neurobiol 2018; 254:40-8. [DOI: 10.1016/j.resp.2018.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 04/03/2018] [Accepted: 04/07/2018] [Indexed: 11/22/2022]
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Cross TJ, Wheatley C, Stewart GM, Coffman K, Carlson A, Stepanek J, Morris NR, Johnson BD. The influence of thoracic gas compression and airflow density dependence on the assessment of pulmonary function at high altitude. Physiol Rep 2018; 6:e13576. [PMID: 29595881 PMCID: PMC5875542 DOI: 10.14814/phy2.13576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 12/14/2017] [Accepted: 12/17/2017] [Indexed: 11/27/2022] Open
Abstract
The purpose of this report was to illustrate how thoracic gas compression (TGC) artifact, and differences in air density, may together conflate the interpretation of changes in the forced expiratory flows (FEFs) at high altitude (>2400 m). Twenty-four adults (10 women; 44 ± 15 year) with normal baseline pulmonary function (>90% predicted) completed a 12-day sojourn at Mt. Kilimanjaro. Participants were assessed at Moshi (Day 0, 853 m) and at Barafu Camp (Day 9, 4837 m). Typical maximal expiratory flow-volume (MEFV) curves were obtained in accordance with ATS/ERS guidelines, and were either: (1) left unadjusted; (2) adjusted for TGC by constructing a "maximal perimeter" MEFV curve; or (3) adjusted for both TGC and differences in air density between altitudes. Forced vital capacity (FVC) was lower at Barafu compared with Moshi camp (5.19 ± 1.29 L vs. 5.40 ± 1.45 L, P < 0.05). Unadjusted data indicated no difference in the mid-expiratory flows (FEF25-75% ) between altitudes (∆ + 0.03 ± 0.53 L sec-1 ; ∆ + 1.2 ± 11.9%). Conversely, TGC-adjusted data revealed that FEF25-75% was significantly improved by sojourning at high altitude (∆ + 0.58 ± 0.78 L sec-1 ; ∆ + 12.9 ± 16.5%, P < 0.05). Finally, when data were adjusted for TGC and air density, FEFs were "less than expected" due to the lower air density at Barafu compared with Moshi camp (∆-0.54 ± 0.68 L sec-1 ; ∆-10.9 ± 13.0%, P < 0.05), indicating a mild obstructive defect had developed on ascent to high altitude. These findings clearly demonstrate the influence that TGC artifact, and differences in air density, bear on flow-volume data; consequently, it is imperative that future investigators adjust for, or at least acknowledge, these confounding factors when comparing FEFs between altitudes.
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Affiliation(s)
- Troy J. Cross
- Division of Cardiovascular DiseasesMayo ClinicRochesterMinnesota
- Menzies Health Institute QueenslandGriffith UniversitySouthportQueenslandAustralia
| | | | - Glenn M. Stewart
- Division of Cardiovascular DiseasesMayo ClinicRochesterMinnesota
- Menzies Health Institute QueenslandGriffith UniversitySouthportQueenslandAustralia
| | - Kirsten Coffman
- Division of Cardiovascular DiseasesMayo ClinicRochesterMinnesota
| | - Alex Carlson
- Division of Cardiovascular DiseasesMayo ClinicRochesterMinnesota
| | - Jan Stepanek
- Preventive, Occupational and Aerospace MedicineMayo ClinicScottsdaleArizona
| | - Norman R. Morris
- Menzies Health Institute QueenslandGriffith UniversitySouthportQueenslandAustralia
- Allied Health Research CollaborativeThe Prince Charles HospitalBrisbaneQueenslandAustralia
| | - Bruce D. Johnson
- Division of Cardiovascular DiseasesMayo ClinicRochesterMinnesota
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Berger MM, Macholz F, Schmidt P, Fried S, Perz T, Dankl D, Niebauer J, Bärtsch P, Mairbäurl H, Sareban M. Inhaled Budesonide Does Not Affect Hypoxic Pulmonary Vasoconstriction at 4559 Meters of Altitude. High Alt Med Biol 2018; 19:52-59. [PMID: 29298124 DOI: 10.1089/ham.2017.0113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Berger, Marc Moritz, Franziska Macholz, Peter Schmidt, Sebastian Fried, Tabea Perz, Daniel Dankl, Josef Niebauer, Peter Bärtsch, Heimo Mairbäurl, and Mahdi Sareban. Inhaled budesonide does not affect hypoxic pulmonary vasoconstriction at 4559 meters of altitude. High Alt Med Biol 19:52-59, 2018.-Oral intake of the corticosteroid dexamethasone has been shown to lower pulmonary artery pressure (PAP) and to prevent high-altitude pulmonary edema. This study tested whether inhalation of the corticosteroid budesonide attenuates PAP and right ventricular (RV) function after rapid ascent to 4559 m. In this prospective, randomized, double-blind, and placebo-controlled trial, 50 subjects were randomized into three groups to receive budesonide at 200 or 800 μg twice/day (n = 16 and 17, respectively) or placebo (n = 17). Inhalation was started 1 day before ascending from 1130 to 4559 m within 20 hours. Systolic PAP (SPAP) and RV function were assessed by transthoracic echocardiography at low altitude (423 m) and after 7, 20, 32, and 44 hours at 4559 m. Ascent to high altitude increased SPAP about 1.7-fold (p < 0.001), whereas RV function was preserved. There was no difference in SPAP and RV function between groups at low and high altitude (all p values >0.10). Capillary partial pressure of oxygen (PO2) and carbon dioxide as well as the alveolar to arterial PO2 difference were decreased at high altitude but not affected by budesonide. Prophylactic inhalation of budesonide does not attenuate high-altitude-induced pulmonary vasoconstriction and RV function after rapid ascent to 4559 m.
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Affiliation(s)
- Marc Moritz Berger
- 1 Department of Anesthesiology, Perioperative and General Critical Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg, Austria .,2 Department of Anesthesiology, University Hospital Heidelberg , Heidelberg, Germany
| | - Franziska Macholz
- 1 Department of Anesthesiology, Perioperative and General Critical Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg, Austria
| | - Peter Schmidt
- 1 Department of Anesthesiology, Perioperative and General Critical Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg, Austria
| | - Sebastian Fried
- 3 Division of Sports Medicine, Department of Internal Medicine VII, University Hospital Heidelberg , Heidelberg, Germany
| | - Tabea Perz
- 4 University Institute of Sports Medicine, Prevention and Rehabilitation; Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University , Salzburg, Austria
| | - Daniel Dankl
- 1 Department of Anesthesiology, Perioperative and General Critical Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg, Austria
| | - Josef Niebauer
- 4 University Institute of Sports Medicine, Prevention and Rehabilitation; Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University , Salzburg, Austria
| | - Peter Bärtsch
- 3 Division of Sports Medicine, Department of Internal Medicine VII, University Hospital Heidelberg , Heidelberg, Germany
| | - Heimo Mairbäurl
- 3 Division of Sports Medicine, Department of Internal Medicine VII, University Hospital Heidelberg , Heidelberg, Germany .,5 Translational Lung Research Center (TLRC), German Center for Lung Research (DZL) , Heidelberg, Germany
| | - Mahdi Sareban
- 4 University Institute of Sports Medicine, Prevention and Rehabilitation; Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University , Salzburg, Austria
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Rębacz-Maron E. The multi-ethnic global lung initiative 2012 and Third National Health and Nutrition Examination Survey reference values do not reflect spirometric measurements in Black boys and men from Tanzania. Clin Physiol Funct Imaging 2016; 38:76-86. [DOI: 10.1111/cpf.12386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ewa Rębacz-Maron
- Department of Vertebrate Zoology and Anthropology; University of Szczecin; Szczecin Poland
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8
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Dhar P, Sharma VK, Hota KB, Das SK, Hota SK, Srivastava RB, Singh SB. Autonomic cardiovascular responses in acclimatized lowlanders on prolonged stay at high altitude: a longitudinal follow up study. PLoS One 2014; 9:e84274. [PMID: 24404157 PMCID: PMC3880292 DOI: 10.1371/journal.pone.0084274] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/13/2013] [Indexed: 11/19/2022] Open
Abstract
Acute exposure to hypobaric hypoxia at high altitude is reported to cause sympathetic dominance that may contribute to the pathophysiology of high altitude illnesses. The effect of prolonged stay at high altitude on autonomic functions, however, remains to be explored. Thus, the present study aimed at investigating the effect of high altitude on autonomic neural control of cardiovascular responses by monitoring heart rate variability (HRV) during chronic hypobaric hypoxia. Baseline electrocardiography (ECG) data was acquired from the volunteers at mean sea level (MSL) (<250 m) in Rajasthan. Following induction of the study population to high altitude (4500–4800 m) in Ladakh region, ECG data was acquired from the volunteers after 6 months (ALL 6) and 18 months of induction (ALL 18). Out of 159 volunteers who underwent complete investigation during acquisition of baseline data, we have only included the data of 104 volunteers who constantly stayed at high altitude for 18 months to complete the final follow up after 18 months. HRV parameters, physiological indices and biochemical changes in serum were investigated. Our results show sympathetic hyperactivation along with compromise in parasympathetic activity in ALL 6 and ALL 18 when compared to baseline data. Reduction of sympathetic activity and increased parasympathetic response was however observed in ALL 18 when compared to ALL 6. Our findings suggest that autonomic response is regulated by two distinct mechanisms in the ALL 6 and ALL 18. While the autonomic alterations in the ALL 6 group could be attributed to increased sympathetic activity resulting from increased plasma catecholamine concentration, the sympathetic activity in ALL 18 group is associated with increased concentration of serum coronary risk factors and elevated homocysteine. These findings have important clinical implications in assessment of susceptibility to cardio-vascular risks in acclimatized lowlanders staying for prolonged duration at high altitude.
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Affiliation(s)
- Priyanka Dhar
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Vijay K. Sharma
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Kalpana B. Hota
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Saroj K. Das
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Sunil K. Hota
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Ravi B. Srivastava
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Shashi B. Singh
- Defence Institute of Physiology and Allied Sciences, Defence Research & Development Organisation, Lucknow Road, Timarpur, Delhi, India
- * E-mail:
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Affiliation(s)
- Josef Finsterer
- Krankenanstalt Rudolfstiftung, Postfach 20, 1180 Vienna , Austria
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10
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Orhan O, Bilgin U, Cetin E, Oz E, Dolek BE. The effect of moderate altitude on some respiratory parameters of physical education and sports' students. J Asthma 2010; 47:609-13. [PMID: 20653497 DOI: 10.3109/02770901003725676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Analysis of the effects of moderate altitude on some respiratory functions of students enrolled in School of Physical Education and Sports. METHODS The study group comprised of 9 female and 10 male volunteers who were attending a 5-day skiing training camp. All participants were enrolled in School of Physical Education and Sports at Gazi University. The male students had an age range of 22.2 +/- 1.7 years, height of 175.0 +/- 4.3 cm, and body weight of 71.0 +/- 10.4 kg; the female students had an age range of 21.2 +/- 1.7 years, height of 167.1 +/- 4.9 cm, and body weight of 53.7 +/- 4.8 kg. Respiratory tests were performed on the 1st and 5th days (the first and second measurements) at an altitude of 1880 m (in Ilgaz Mountain); 10 days after being exposed to high altitude, further tests were performed at an altitude of 856 m (in Ankara) (the third measurement). Data were analyzed using SPSS software (version 10.0). Intragroup differences were analyzed using repeated measures analysis of variance (ANOVA). According to the results of normality test results, an independent-sample t test was used in comparisons between the groups. A significance level of p < .05 was used in analysis. RESULTS Statistical analysis indicated that there was no significant difference between the intragroup comparisons of female and male students. Intergroup comparisons showed significant differences in forced vital capacity (FVC), forced expiratory volume (FEV), peak expiratory flow (PEF), maximal voluntary ventilation (MVV), and VC parameters (p < .05). CONCLUSION The authors conclude that moderate altitude does not have any effect on some respiratory parameters after 5 days of skiing camp.
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Affiliation(s)
- O Orhan
- Gazi University, School of Physical Education and Sports, Ankara, Turkey.
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Napoli AM, Milzman DP, Damergis JA, Machan J. Physiologic affects of altitude on recreational climbers. Am J Emerg Med 2009; 27:1081-4. [DOI: 10.1016/j.ajem.2008.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Revised: 09/11/2008] [Accepted: 09/13/2008] [Indexed: 10/20/2022] Open
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Abstract
Alteration in lung function at high altitude influences exercise capacity, worsens hypoxia, and may predispose to high-altitude illness. The effect of high altitude on lung function and mechanisms responsible for these alterations remain unclear. Seven adult male mountaineers were followed prospectively during a climbing expedition to Mount Everest, Nepal. Measurements of spirometry and respiratory muscle function were performed for the duration of the expedition, during changes in altitude between 3450 and 7200 meters (m). Measurements included the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), maximal voluntary ventilation (MVV) in 12 seconds, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and respiratory muscle endurance (Tlim). At an altitude of 3450 m, the FVC initially increased (9%) over 24 h, followed by a significant decline; the FEV(1), MVV, MIP, and MEP showed similar progressive decline. At 5350 m, FVC increased by 21% over the first 48 h, then decreased. The FVC, FEV(1), MVV, MIP, and MEP initially increased and then gradually diminished over time. Respiratory muscle endurance (Tlim) decreased over the first three days at 3450 m but then remained unchanged. MVV decreased at lower altitude followed by a slight increase and then a significant decline. Compared with baseline, we observed a fluctuating course for spirometric measurements, respiratory muscle strength, and endurance at high altitude. Initial transient increases in parameters occurred on ascent to each new altitude followed by a gradual decline during prolonged stay.
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Affiliation(s)
- Sat Sharma
- Sections of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
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Senn O, Clarenbach CF, Fischler M, Thalmann R, Brunner-La Rocca H, Egger P, Maggiorini M, Bloch KE. Do Changes in Lung Function Predict High-Altitude Pulmonary Edema at an Early Stage? Med Sci Sports Exerc 2006; 38:1565-70. [PMID: 16960516 DOI: 10.1249/01.mss.0000229102.37359.af] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Ascent to high altitude is associated with alterations in lung function. The mechanisms of these changes and whether they reflect early stages of high-altitude pulmonary edema (HAPE) has been debated. Therefore, we investigated the time course of pulmonary function in relation to hemodynamics and clinical symptoms in mountaineers ascending rapidly to high altitude. METHODS In 26 unacclimatized subjects we assessed spirometry, single-breath nitrogen washout, diffusing capacity (DLCO), and Doppler echocardiography in Zurich, 490 m, after climbing within 24 h to Monte Rosa, 4559 m, and after one night at 4559 m. RESULTS Mean (+/- SD) FVC fell from 103 +/- 9% predicted in Zurich to 96 +/- 10% predicted at 4559 m, FEV1/FVC increased from 0.82 +/- 0.06 to 0.84 +/- 0.08, and closing volume increased from 0.35 +/- 0.14 to 0.44 +/- 0.11 L above residual volume (P < 0.05, all changes). On the following day at 4559 m, closing volume remained elevated in 9 of 21 subjects who had a lower DLCO but similar pulmonary artery systolic pressures compared with the remaining 12 subjects (40 +/- 8 vs 43 +/- 7 mm Hg, P = NS). None of the subjects had overt HAPE. CONCLUSION We conclude that changes in pulmonary function after rapid ascent to high altitude were consistent with interstitial fluid accumulation, but they were not related to changes in pulmonary artery pressure. Individual lung function responses to high-altitude exposure varied largely and did not predict subsequent HAPE.
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Affiliation(s)
- Oliver Senn
- Pulmonary Division, University Hospital of Zurich and Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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Compte-Torrero L, Botella de Maglia J, de Diego-Damiá A, Gómez-Pérez L, Ramírez-Galleymore P, Perpiñá-Tordera M. Changes in Spirometric Parameters and Arterial Oxygen Saturation During a Mountain Ascent to Over 3000 Meters. ACTA ACUST UNITED AC 2005; 41:547-52. [PMID: 16266667 DOI: 10.1016/s1579-2129(06)60281-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To ascertain whether climbing a mountain over 3000 meters high produces any alterations in ventilation, whether such alterations are modified by acclimatization, and whether they correlate with changes in arterial oxygen saturation (SaO2) or the development of acute mountain sickness (AMS). SUBJECTS AND METHODS The following parameters were measured in 8 unacclimatized mountaineers who climbed Aneto (3404 m) and spent 3 days at the summit: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), airway response to inhaled terbutaline, SaO2, and the symptoms of AMS. RESULTS At the summit, mean (SD) FEV1 declined by 12.3% (5.7%) and mean FVC by 7.6% (6.7%) while the ratio of FEV1 to FVC remained normal. The means for both parameters were higher on the following day. No airway response to bronchodilator treatment was observed. The restriction disappeared entirely on descent. At the peak, SaO2 increased progressively as the climbers became acclimatized. During the ascent, FEV1 correlated with SaO2 (r=0.79). One participant who suffered from AMS had a ratio of FEV1 to FVC less than 70% and the worst SaO2 during the 3 days on the summit. Obstruction preceded the AMS symptoms, did not respond to bronchodilator treatment, and disappeared when the climber descended. CONCLUSIONS The mountaineers who climbed over 3000 meters presented restriction that correlated with hypoxemia. This restriction did not respond to bronchodilator treatment, improved with acclimatization, and disappeared on descent. One person with AMS presented obstruction that did not respond to terbutaline and disappeared on descent.
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Affiliation(s)
- L Compte-Torrero
- Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain.
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15
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Compte-Torrero L, Botella de Maglia J, de Diego-Damiá A, Gómez-Pérez L, Ramírez-Galleymore P, Perpiñá-Tordera M. Cambios espirométricos y en la saturación arterial de oxígeno durante la ascensión a una montaña de más de 3.000 metros. Arch Bronconeumol 2005. [DOI: 10.1157/13079838] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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