Effect of prolonged exercise at altitude on the renin-aldosterone system

Milledge, J. S.; Catley, D. M.; Williams, E. S.; Withey, W. R.; Minty, B. D.

doi:10.1152/jappl.1983.55.2.413

Cited by 36 publications

(24 citation statements)

References 13 publications

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“…Stimulation of the peripheral chemoreceptors does not appear responsible because renin and aldosterone are unaltered in normoxic rats given almitrine [ 93 ]. With more chronic hypoxia, aldosterone levels remain normal [ 94 ] and rise only in those with overt illness and fl uid retention [ 17 ].…”

Section: Renin-angiotensin-aldosterone Systemmentioning

confidence: 99%

Renal Function and Fluid Homeostasis

Swenson

Olsen

2013

High Altitude

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Hypoxia can directly affect the kidneys, but more importantly, its effects on systemic acid-base balance, ventilation, neuroendocrine refl exes, and hemodynamics all play a far greater part in altering renal function and fl uid balance. Acute and chronic effects of hypoxia and their magnitude may differ and these will be highlighted. These changes will be related to the common diseases of high altitude and to their impact on patients with chronic renal disease. Other features of high altitude separate from hypoxia, either alone or in combination, including hypobaria, exercise, and cold may also signifi cantly perturb renal function.

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Section: Renin-angiotensin-aldosterone Systemmentioning

confidence: 99%

Renal Function and Fluid Homeostasis

Swenson

Olsen

2013

High Altitude

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“…Newcastle and Northumbria NHS Trust, Newcastle upon Tyne, UK e-mail: DoctorDRWoods@aol.com demonstrated a reduced resting plasma aldosterone concentration (PAC) at HA (Bartsch et al 1991a;Milledge et al 1983;Zaccaria 1998), which is a beneficial adaptation that facilitates a natriuresis and diuresis. The hormonal response to physical exertion, a dominant factor in most HA expeditions, is particularly important to acclimatization and an enhanced PAC response to exercise (though still subdued compared to SL) has been associated with AMS (Bartsch et al 1991a).…”

Section: Woods (And)mentioning

confidence: 99%

Effects of altitude exposure on brain natriuretic peptide in humans

Woods¹,

Hooper²,

Hodkinson³

et al. 2011

Eur J Appl Physiol

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Acute mountain sickness (AMS) is common at high altitude (HA) and associated with a relative failure of the natriuresis and diuresis that occurs at HA. The role of Brain Natriuretic Peptide (BNP) in this context has not been thoroughly investigated. We aimed to clarify if BNP rises in response to exercise at HA and if so whether this is related to AMS. 32 healthy subjects had assessments of BNP, aldosterone and AMS scores [as assessed by the AMS-C score of the Environmental Symptom Questionnaire (ESQ) and Lake Louise questionnaire] made following exertion at sea-level (SL), 3,400, 4,300 and 5,150 m. Data were analysed in the 23 subjects who did not consume drugs known to affect acclimatization. BNP (pg/ml, mean ± SEM) was significantly higher at 5,150 m versus the lower altitudes (p < 0.001 for all): 7.1 ± 1; 6.1 ± 0.3; 6.8 ± 0.9 and 17.7 ± 5.1 at sea-level; 3,400, 4,300 and 5,150 m. In those that showed a BNP response at 5,150 m (n = 19) versus those that did not demonstrate a BNP response (n = 4) there was a significant difference in Lake Louise (LL) AMS scores at 5,150 m on day 10 of the expedition (mean LL score 3.3 vs. 0.75, p = 0.034) and day 11 (mean LL score 3.3 vs. 0, p = 0.003). This is the first report to demonstrate a significant rise in BNP at HA. A BNP response at 5,150 m may be associated with a greater likelihood of suffering AMS.

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“…Hormones of hydromineral metabolism during exposure to chronic hypoxia have previously been studied both at rest and during exercise (Slater et al 1969;Singh et al 1974;Sutton et al 1977;Hackett et al 1978;Milledge et al 1982Milledge et al , 1983aMilledge and Catley 1987;Maresch 1985;BaÈ rtsch et al 1991;Rock et al 1993;Anand et al 1993;Ponchia et al 1995). From these studies, it has generally been admitted that hypoxia initially depresses plasma aldosterone concentration which returns to control values after 12±20 days (Milledge et al 1983b).…”

Section: Introductionmentioning

confidence: 99%

Pre-adaptation, adaptation and de-adaptation to high altitude in humans: hormonal and biochemical changes at sea level

Savourey

Garcia

Caravel³

et al. 1997

European Journal of Applied Physiology

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High altitude residence is known to modify body biochemistry and hormone status. However, the effects of such a sojourn on these status observed at sea level both immediately and later after return are not as well established as are the effects of an intermittent acclimation. The aim of this study was therefore to investigate these changes. To achieve our objectives, nine subjects received intermittent acclimation at low pressure in a barometric chamber (8 h daily for 5 days, day 1 at 4500 m, day 5 at 8500 m) before an expedition to the Himalayas. Hormonal and biochemical changes were studied using samples of venous blood taken at sea level before and after acclimation, after return from the expedition and 1 and 2 months after descent. Concentrations of thyroid hormones, adrenaline, noradrenaline (NA), hormones of hydromineral metabolism (aldosterone, renin, arginine vasopressin, atrial natriuretic peptide) as well as prolactin, cortisol, insulin and endothelin 1 were measured. Biochemical measurements made were plasma osmolality, and concentrations of glucose, total cholesterol, total proteins, pre-albumin, transferrin, complement 3C, apolipoproteins A1 and B and serum iron. Acclimation induced no alteration in hormone (except for NA with increases of about 1.5, fold P < 0.05) and biochemistry data. After the expedition, hormone responses were characterized by a higher total triidothyronine concentration (+18%, P < 0.05) while other hormones did not vary. A linear relationship was found between thyroid-stimulating-hormone and body mass changes after the expedition (r = 0.67, P < 0.05). The observed increased concentrations of plasma proteins and total cholesterol (P < 0.05) could be related to the restoration of lean body mass. At 1 and 2 months after return, no changes in hormones were observed but a significant decrease in transferrin concentration was noticed. The higher serum iron concentration reported after 1 month (P < 0.05) could have been the result of a physiological haemolysis. It was concluded that both acclimation and the expedition in the Himalayas affected hormone status and body biochemistry status even though the observed changes were slight and rapidly reversed.

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Effect of prolonged exercise at altitude on the renin-aldosterone system

Cited by 36 publications

References 13 publications

Renal Function and Fluid Homeostasis

Renal Function and Fluid Homeostasis

Effects of altitude exposure on brain natriuretic peptide in humans

Pre-adaptation, adaptation and de-adaptation to high altitude in humans: hormonal and biochemical changes at sea level

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