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[Altitude and the cardiovascular system].

Jean-Paul Richalet¹

¹AP-HP, hôpital Avicenne, service de physiologie, explorations fonctionnelles et médecine du sport, Bobigny cedex, 93009 France. jean-paul.richalet@avc.aphp.fr

Presse Medicale (Paris, France : 1983)

|March 17, 2012

Summary

This summary is machine-generated.

High altitude exposure causes hypoxia, stressing the cardiovascular system. The hypoxia exercise test is the only reliable predictor of tolerance for individuals, especially those with cardiac conditions.

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Area of Science:

Cardiovascular Physiology
Environmental Medicine
Altitude Physiology

Background:

High altitude exposure presents environmental challenges, primarily hypoxia, which significantly stresses the cardiovascular system.
The cardiovascular system exhibits acclimatization mechanisms to combat oxygen deprivation at altitude.

Purpose of the Study:

To elucidate the cardiovascular adaptations and challenges associated with high altitude exposure.
To inform medical advice for cardiac patients planning high-altitude travel.
To identify reliable methods for predicting altitude tolerance.

Main Methods:

Review of physiological responses to hypoxia, including adrenergic system activation, heart rate changes, and blood pressure alterations.
Analysis of cardiovascular effects such as peripheral vasodilation and pulmonary vasoconstriction.
Evaluation of diagnostic tests for predicting high-altitude tolerance.

Main Results:

Hypoxia initially increases heart rate via adrenergic activation, which desensitizes over time, protecting the myocardium.
Pulmonary vasoconstriction increases pulmonary blood pressure, potentially leading to high-altitude pulmonary edema.
Cardiac patients with pre-existing conditions may experience exacerbated symptoms due to adrenergic activity, hypoxemia, or pulmonary hypertension.

Conclusions:

High altitude exacerbates conditions aggravated by adrenergic activity, hypoxemia, or pulmonary hypertension.
Coronary artery disease patients may show reduced ischemic thresholds at higher altitudes.
The hypoxia exercise test at 30% maxVO(2) at 4,800m is the sole validated predictor of high-altitude tolerance.