Safety and Efficacy of Intermittent Hypoxia Conditioning as a New Rehabilitation/
Secondary Prevention Strategy for Patients with Cardiovascular
Diseases: A Systematic Review and Meta-analysis

Глазачев, О. С.; Kryzhanovskaya, S. Yu.; Запара, М. А.; Дудник, Е. Н.; Самарцева, В. Г.

doi:10.2174/1573403x17666210514005235

Cited by 12 publications

(6 citation statements)

References 29 publications

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“…In this study, a 3-week IHHE course led to a significant decrease in SBP and DBP, with the blood pressure values in the IHHE group after the intervention being lower than in the control group despite being significantly higher initially. Similar hypotensive effects of an interval hypoxic-normoxic exposures course were noted by N.Lyamina [24], as well as in a recent systematic review which found a decrease in SBP by an average of 13.7 mmHg (p < 0.001), and DBP by 7.9 mmHg (p = 0.003) in patients with hypertension and coronary artery disease (CAD) after a course of hypoxic exposures [41]. This is corroborated by a N.Muangritdech et al [42] study showing a decrease in blood pressure and improvement of endothelial function/NO availibility in hypertensive patients both after a 6-week course of interval hypoxic-normoxic exposure at rest, and after a similar IHT course duration.…”

Section: Discussionsupporting

confidence: 71%

Intermittent Hypoxic-Hyperoxic Exposures Effects in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile

et al. 2022

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The aim of this study was to evaluate efficacy and applicability of the “intermittent hypoxic-hyperoxic exposures at rest” (IHHE) protocol as an adjuvant method for metabolic syndrome (MS) cardiometabolic components. A prospective, single-center, randomized controlled clinical study was conducted on 65 patients with MS subject to optimal pharmacotherapy, who were randomly allocated to IHHE or control (CON) groups. The IHHE group completed a 3-week, 5 days/week program of IHHE, each treatment session lasting for 45 min. The CON group followed the same protocol, but was breathing room air through a facial mask instead. The data were collected 2 days before, and at day 2 after the 3-week intervention. As the primary endpoints, systolic (SBP) and diastolic (DBP) blood pressure at rest, as well as arterial stiffness and hepatic tissue elasticity parameters, were selected. After the trial, the IHHE group had a significant decrease in SBP and DBP (Cohen’s d = 1.15 and 0.7, p < 0.001), which became significantly lower (p < 0.001) than in CON. We have failed to detect any pre-post IHHE changes in the arterial stiffness parameters (judging by the Cohen’s d), but after the intervention, cardio-ankle vascular indexes (RCAVI and LCAVI) were significantly lowered in the IHHE group as compared with the CON. The IHHE group demonstrated a medium effect (0.68; 0.69 and 0.71 Cohen’s d) in pre-post decrease of Total Cholesterol (p = 0.04), LDL (p = 0.03), and Liver Steatosis (p = 0.025). In addition, the IHHE group patients demonstrated a statistically significant decrease in pre-post differences (deltas) of RCAVI, LCAVI, all antropometric indices, NTproBNP, Liver Fibrosis, and Steatosis indices, TC, LDL, ALT, and AST in comparison with CON (p = 0.001). The pre-post shifts in SBP, DBP, and HR were significantly correlated with the reduction degree in arterial stiffness (ΔRCAVI, ΔLCAVI), liver fibrosis and steatosis severity (ΔLFibr, ΔLS), anthropometric parameters, liver enzymes, and lipid metabolism in the IHHE group only. Our results suggested that IHHE is a safe, well-tolerated intervention which could be an effective adjuvant therapy in treatment and secondary prevention of atherosclerosis, obesity, and other components of MS that improve the arterial stiffness lipid profile and liver functional state in MS patients.

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Section: Discussionsupporting

confidence: 71%

Intermittent Hypoxic-Hyperoxic Exposures Effects in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile

et al. 2022

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“…Overall, the results of this systematic review indicate that passive or active normobaric IH would have a limited positive effect on health-related outcomes in healthy older adults compared to similar intervention in normoxia, without any observed adverse effects in the participants. These findings differ from two recent reviews [ 48 , 49 ] indicating that intermittent hypoxia-hyperoxia protocols could be effective at the cardiovascular, metabolic, and cognitive levels in an elderly population suffering from various diseases. The free radical signaling during hypoxia-hyperoxia interventions may lead to better induction of antioxidant synthesis than IH only [ 25 ].…”

Section: Discussioncontrasting

confidence: 99%

Effects of Intermittent Normobaric Hypoxia on Health-Related Outcomes in Healthy Older Adults: A Systematic Review

2023

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Background Aging is a degenerative process that is associated with an increased risk of diseases. Intermittent hypoxia has been investigated in reference to performance and health-related functions enhancement. This systematic review aimed to summarize the effect of either passive or active intermittent normobaric hypoxic interventions compared with normoxia on health-related outcomes in healthy older adults. Methods Relevant studies were searched from PubMed and Web of Science databases in accordance with PRISMA guidelines (since their inceptions up until August 9, 2022) using the following inclusion criteria: (1) randomized controlled trials, clinical trials and pilot studies; (2) Studies involving humans aged > 50 years old and without any chronic diseases diagnosed; (3) interventions based on in vivo intermittent systemic normobaric hypoxia exposure; (4) articles focusing on the analysis of health-related outcomes (body composition, metabolic, bone, cardiovascular, functional fitness or quality of life). Cochrane Collaboration recommendations were used to assess the risk of bias. Results From 509 articles initially found, 17 studies were included. All interventions were performed in moderate normobaric hypoxia, with three studies using passive exposure, and the others combining intermittent hypoxia with training protocols (i.e., using resistance-, whole body vibration- or aerobic-based exercise). Conclusions Computed results indicate a limited effect of passive/active intermittent hypoxia (ranging 4–24 weeks, 2–4 days/week, 16–120 min/session, 13–16% of fraction of inspired oxygen or 75–85% of peripheral oxygen saturation) compared to similar intervention in normoxia on body composition, functional fitness, cardiovascular and bone health in healthy older (50–75 years old) adults. Only in specific settings (i.e., intermediate- or long-term interventions with high intensity/volume training sessions repeated at least 3 days per week), may intermittent hypoxia elicit beneficial effects. Further research is needed to determine the dose–response of passive/active intermittent hypoxia in the elderly. Trial registration. Systematic review registration: PROSPERO 2022 CRD42022338648.

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“…These molecules are considered as profibrotic, proinflammatory, and likely heart and liver fibrosis markers (29). Therefore, their decrease may reflect a reduction in the chronic systemic inflammation typical in the patients with MS (3,30).…”

Section: Discussionmentioning

confidence: 99%

The Effects of Intermittent Hypoxic–Hyperoxic Exposures on Lipid Profile and Inflammation in Patients With Metabolic Syndrome

Afina

Shulik

Alexander

et al. 2021

Front. Cardiovasc. Med.

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Background: Patients with metabolic syndrome (MS) tend to suffer from comorbidities, and are often simultaneously affected by obesity, dysglycemia, hypertension, and dyslipidemia. This syndrome can be reversed if it is timely diagnosed and treated with a combination of risk factors-reducing lifestyle changes and a tailored pharmacological plan. Interval hypoxic-hyperoxic training (IHHT) has been shown as an effective program in reducing cardiovascular risk factors in patients with MS even in the absence of exercise. However, the influence of IHHT on the lipid profile and inflammation in this clinical population remains relatively unknown.Methods: A prospective, single-center, randomized controlled trial was conducted on 65 (33 men) patients with MS aged 29–74 years, who were randomly allocated to the IHHT or control (sham) experimental groups. The IHHT group completed a 3-week, 5 days/week intermittent exposure to hypoxia and hyperoxia. The control (sham) group followed the same protocol but was breathing room air instead. The primary endpoints were the lipid profile (concentrations of total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL], and triglycerides [TG]) and the inflammatory factors such as high-sensitivity C-reactive protein (hs-CRP), galectin-3, heat shock proteins (Hsp70). The secondary endpoints were alanine aminotransferase (ALT), aspartate aminotransferase (AST), N-terminal pro-hormone of brain natriuretic peptide level (NTproBNP), transforming growth factor beta-1 (TGF-beta1), heart-type fatty acid-binding protein (H-FABP), and nitric oxide synthase 2 (NOS2).Results: There were no differences between the two groups but the different baseline values have affected these results. The IHHT group demonstrated pre-post decrease in total cholesterol (p = 0.001), LDL (p = 0.001), and TG levels (p = 0.001). We have also found a decrease in the CRP-hs (p = 0.015) and Hsp70 (p = 0.006) in IHHT-group after intervention, and a significant decrease in pre-post (delta) differences of NTproBNP (p < 0.0001) in the IHHT group compared to the control group. In addition, the patients of the IHHT group showed a statistically significant decrease in pre-post differences of ALT and AST levels in comparison with the control group (p = 0.001). No significant IHHT complications or serious adverse events were observed.Conclusions: The IHHT appears to improve lipid profile and anti-inflammatory status. It is a safe, well-tolerated procedure, and could be recommended as an auxiliary treatment in patients suffering from MS, however, the experiment results were limited by the baseline group differences.Clinical Trial Registration:ClinicalTrials.gov, identifier [NCT04791397]. Evaluation of the effect of IHHT on vascular stiffness and elasticity of the liver tissue in patients with MS.

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Safety and Efficacy of Intermittent Hypoxia Conditioning as a New Rehabilitation/ Secondary Prevention Strategy for Patients with Cardiovascular Diseases: A Systematic Review and Meta-analysis

Cited by 12 publications

References 29 publications

Intermittent Hypoxic-Hyperoxic Exposures Effects in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile

Intermittent Hypoxic-Hyperoxic Exposures Effects in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile

Effects of Intermittent Normobaric Hypoxia on Health-Related Outcomes in Healthy Older Adults: A Systematic Review

The Effects of Intermittent Hypoxic–Hyperoxic Exposures on Lipid Profile and Inflammation in Patients With Metabolic Syndrome

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