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Upward Shift and Steepening of the Blood Pressure Response to Exercise in Hypertensive Subjects at High Altitude

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dc.contributor.author Caravita, Sergio
dc.contributor.author Faini, Andrea
dc.contributor.author Baratto, Claudia
dc.contributor.author Bilo, Grzegorz
dc.contributor.author Macarlupu, Josè Luis
dc.contributor.author Lang, Morin
dc.contributor.author Revera, Miriam
dc.contributor.author Lombardi, Carolina
dc.contributor.author Villafuerte, Francisco C.
dc.contributor.author Agostoni, Piergiuseppe
dc.contributor.author Parati, Gianfranco
dc.date.accessioned 2018-11-30T23:41:30Z
dc.date.available 2018-11-30T23:41:30Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4208
dc.description.abstract BACKGROUND: Acute exposure to high-altitude hypobaric hypoxia induces a blood pressure rise in hypertensive humans, both at rest and during exercise. It is unclear whether this phenomenon reflects specific blood pressure hyperreactivity or rather an upward shift of blood pressure levels. We aimed at evaluating the extent and rate of blood pressure rise during exercise in hypertensive subjects acutely exposed to high altitude, and how these alterations can be counterbalanced by antihypertensive treatment. METHODS AND RESULTS: Fifty-five subjects with mild hypertension, double-blindly randomized to placebo or to a fixed-dose combination of an angiotensin-receptor blocker (telmisartan 80 mg) and a calcium-channel blocker (nifedipine slow release 30 mg), performed a cardiopulmonary exercise test at sea level and after the first night's stay at 3260 m altitude. High-altitude exposure caused both an 8 mm Hg upward shift (P<0.01) and a 0.4 mm Hg/mL/kg per minute steepening (P<0.05) of the systolic blood pressure/oxygen consumption relationship during exercise, independent of treatment. Telmisartan/nifedipine did not modify blood pressure reactivity to exercise (blood pressure/oxygen consumption slope), but downward shifted (P<0.001) the relationship between systolic blood pressure and oxygen consumption by 26 mm Hg, both at sea level and at altitude. Muscle oxygen delivery was not influenced by altitude exposure but was higher on telmisartan/nifedipine than on placebo (P<0.01). CONCLUSIONS: In hypertensive subjects exposed to high altitude, we observed a hypoxia-driven upward shift and steepening of the blood pressure response to exercise. The effect of the combination of telmisartan/nifedipine slow release outweighed these changes and was associated with better muscle oxygen delivery. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof urn:issn:2047-9980
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject high altitude en_US
dc.subject blood pressure en_US
dc.subject exercise physiology en_US
dc.subject hypoxia en_US
dc.subject oxygen consumption en_US
dc.title Upward Shift and Steepening of the Blood Pressure Response to Exercise in Hypertensive Subjects at High Altitude en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1161/JAHA.117.008506
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE

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