New strategy for rational use of antihypertensive drugs in clinical practice in high-altitude hypoxic environments

Duo, Delong; Duan, Yabin; Zhu, Junbo; Bai, Xue; Yang, Jianxin; Liu, Guiqin; Wang, Qian; Li, Xiangyang

doi:10.1080/03602532.2023.2250930

Cited by 3 publications

(4 citation statements)

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“…The higher the altitude, the lower the atmospheric pressure and partial pressure of oxygen. At altitudes beyond 2,500 m, the partial pressure of oxygen declines even further, which in turn, leads to an exponential reduction in arterial oxygen saturation (SaO2) ( 4 ). In the 1960s, Grahn and Kratchmann reported that atmospheric pressure was significantly correlated to neonatal mortality ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

“…During acute high-altitude exposures, hypocapnia is the main feature of the hypoxic ventilatory response, which increases blood pH. However, the effect of increased blood pH on pharmacokinetics is unknown and may depend on drug-specific properties ( 4 ). High altitude can adversely affect the cardiovascular system, leading to numerous unfavorable outcomes, including an increased risk of arrhythmias, systemic hypertension, high-altitude pulmonary hypertension, right ventricular hypertrophy, and right ventricular failure ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Pain control and neonatal outcomes in 211 women under epidural anesthesia during childbirth at high altitude in Qinghai, China

Wang,

Li,

et al. 2024

Front. Med.

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BackgroundHigh altitudes are characterized by low-pressure oxygen deprivation. This is further exacerbated with increasing altitude. High altitudes can be associated with reduced oxygenation, which in turn, can affect labor, as well as maternal and fetal outcomes. Epidural anesthesia can significantly relieve labor pain. This study aimed to assess the effects of elevation gradient changes at high altitude on the analgesic effect of epidural anesthesia, labor duration, and neonatal outcomes.MethodsWe divided 211 women who received epidural anesthesia into groups according to varying elevation of their residence (76 in Xining City, mean altitude 2,200 m; 63 in Haibei Prefecture, mean altitude 3,655 m; and 72 in Yushu Prefecture, mean altitude 4,493 m). The analgesic effect was assessed using a visual analog scale (VAS). Labor duration was objectively recorded. The neonatal outcome was assessed using Apgar scores and fetal umbilical artery blood pH.ResultsVAS scores among the three groups did not differ significantly (p > 0.05). The neonatal Apgar scores in descending order were: Xining group > Haibei group > Yushu group (p < 0.05). The stage of labor was similar among the three groups (p > 0.05). Fetal umbilical artery blood pH in descending order were: Xining group > Haibei group > Yushu group (p < 0.05).ConclusionElevation gradient changes in highland areas did not affect the efficacy of epidural anesthesia or labor duration. However, neonatal outcomes were affected.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pain control and neonatal outcomes in 211 women under epidural anesthesia during childbirth at high altitude in Qinghai, China

Wang,

Li,

et al. 2024

Front. Med.

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Section: Figurementioning

confidence: 99%

“…Meanwhile, aldosterone enhances sodium retention and fluid accumulation, potentially exacerbating the edematous processes observed in both HAPE and HACE ( Ferrario and Mulick, 2017 ; Hundemer and Sood, 2021 ). Furthermore, recent studies have highlighted the potential therapeutic benefits of RAAS inhibitors in mitigating the severity of altitude sickness symptoms, emphasizing the system’s critical involvement in the disease progression ( Duo et al, 2023 ; Richalet et al, 2023 ). (4) Evaluation of Prevention and Intervention Measures: Based on cohort data, scientists assess various methods for preventing and treating high altitude illnesses, such as drug prophylaxis (e.g., acetazolamide and dexamethasone use), stepwise acclimatization training, physiological and psychological conditioning, and rational dietary supplementation strategies.…”

Section: Current Status and Advances In Cohort Studies Of High Altitu...mentioning

confidence: 99%

Recent advances in predicting acute mountain sickness: from multidimensional cohort studies to cutting-edge model applications

Wang,

Chen,

Song

et al. 2024

Front. Physiol.

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High-altitude illnesses, encompassing a spectrum of health threats including Acute Mountain Sickness (AMS), pose significant challenges to individuals exposed to high altitude environments, necessitating effective prophylaxis and immediate management. Given the variability in individual responses to these conditions, accurate prediction of high-altitude illnesses onset is of paramount importance. This review systematically consolidates recent advancements in research on predicting AMS by evaluating existing cohort data, predictive models, and methodologies, while also delving into the application of emerging technologies. Through a thorough analysis of scholarly literature, we discuss traditional prediction methods anchored in physiological parameters (e.g., heart rate, respiratory frequency, blood pressure) and biochemical markers, as well as the integration and utility of novel technologies such as biosensors, genetic testing, and artificial intelligence within high-altitude prediction research. While conventional pre-diction techniques have been extensively used, they are often constrained by limitations in accuracy, reliability, and multifactorial influences. The advent of these innovative technologies holds promise for more precise individual risk assessments and personalized preventive and therapeutic strategies across various forms of AMS. Future research endeavors must pivot decisively towards the meticulous identification and stringent validation of innovative predictive biomarkers and models. This strategic re-direction should catalyze intensified interdisciplinary cooperation to significantly deepen our mechanistic insights into the pathogenesis of AMS while refining existing prediction methodologies. These groundbreaking advancements harbor the potential to fundamentally transform preventive and therapeutic frameworks for high-altitude illnesses, ultimately securing augmented safety standards and wellbeing for individuals operating at elevated altitudes with far-reaching global implications.

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Blood–Brain Barrier Permeability is Affected by Changes in Tight Junction Protein Expression at High-Altitude Hypoxic Conditions—this may have Implications for Brain Drug Transport

Liu,

Wang,

Tian

et al. 2024

AAPS J

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New strategy for rational use of antihypertensive drugs in clinical practice in high-altitude hypoxic environments

Cited by 3 publications

References 89 publications

Pain control and neonatal outcomes in 211 women under epidural anesthesia during childbirth at high altitude in Qinghai, China

Pain control and neonatal outcomes in 211 women under epidural anesthesia during childbirth at high altitude in Qinghai, China

Recent advances in predicting acute mountain sickness: from multidimensional cohort studies to cutting-edge model applications

Blood–Brain Barrier Permeability is Affected by Changes in Tight Junction Protein Expression at High-Altitude Hypoxic Conditions—this may have Implications for Brain Drug Transport

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