Propranolol and the respiratory, circulatory, and ECG responses to high altitude

The role of the sympatho-adrenal system in the acute respiratory and cardiovascular responses to high altitude was studies in 20 volunteers during ascent to 6,000 m in a low pressure chamber, once without (control) and once with beta-adrenergic blockade. Special attention was paid to the hypoxia-induced ECG changes. Propranolol lowered the level of hypoxia-induced cardiovascular reactions, whereas it had no effect on hypoxic hyperventilation and alveolar gases. At altitude, ECG changes during myocardial depolarization occurred in both the propranolol and the control groups, probably due to the direct effects of hypoxia. During the repolarization phase, propranolol led to an almost complete abolition of S-T depression and to significant reduction of T wave flattening. The minor but still significant flattening of the T wave as well as the relative (to the heart rate) lengthening of Q-T is probably due to the direct effects of hypoxia. Propranolol abolishes or diminishes the signs of cardiac hypoxia by antagonizing the effects of catecholamine release and/or by reducing myocardial oxygen consumption, thus probable increasing the ability to withstand oxygen-want at altitude.