Universidad Peruana Cayetano Heredia

Global REACH 2018: Andean highlanders, chronic mountain sickness and the integrative regulation of resting blood pressure

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dc.contributor.author Simpson, Lydia L.
dc.contributor.author Meah, Victoria L.
dc.contributor.author Steele, Andrew R.
dc.contributor.author Gasho, Christopher
dc.contributor.author Howe, Connor A.
dc.contributor.author Dawkins, Tony G.
dc.contributor.author Busch, Stephen A.
dc.contributor.author Oliver, Samuel J.
dc.contributor.author Moralez, Gilberto
dc.contributor.author Lawley, Justin S.
dc.contributor.author Tymko, Michael M.
dc.contributor.author Vizcardo-Galindo, Gustavo A.
dc.contributor.author Figueroa-Mujíca, Rómulo J.
dc.contributor.author Villafuerte, Francisco C.
dc.contributor.author Ainslie, Phillip N.
dc.contributor.author Stembridge, Mike
dc.contributor.author Steinback, Craig D.
dc.contributor.author Moore, Jonathan P.
dc.date.accessioned 2021-04-13T20:50:58Z
dc.date.available 2021-04-13T20:50:58Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/9110
dc.description.abstract NEW FINDINGS: What is the central question of this study? Does chronic mountain sickness (CMS) alter sympathetic neural control and arterial baroreflex regulation of blood pressure in Andean (Quechua) highlanders? What is the main finding and its importance? Compared to healthy Andean highlanders, basal sympathetic vasomotor outflow is lower, baroreflex control of muscle sympathetic nerve activity is similar, supine heart rate is lower and cardiovagal baroreflex gain is greater in mild CMS. Taken together, these findings reflect flexibility in integrative regulation of blood pressure that may be important when blood viscosity and blood volume are elevated in CMS. ABSTRACT: The high-altitude maladaptation syndrome chronic mountain sickness (CMS) is characterized by excessive erythrocytosis and frequently accompanied by accentuated arterial hypoxaemia. Whether altered autonomic cardiovascular regulation is apparent in CMS is unclear. Therefore, during the 2018 Global REACH expedition to Cerro de Pasco, Peru (4383 m), we assessed integrative control of blood pressure (BP) and determined basal sympathetic vasomotor outflow and arterial baroreflex function in eight Andean natives with CMS ([Hb] 22.6 ± 0.9 g·dL(-1) ) and seven healthy highlanders ([Hb] 19.3 ± 0.8 g·dL(-1) ). R-R interval (RRI, electrocardiogram), beat-by-beat BP (photoplethysmography) and muscle sympathetic nerve activity (MSNA; microneurography) were recorded at rest and during pharmacologically induced changes in BP (modified Oxford test). Although [Hb] and blood viscosity (7.8 ± 0.7 vs. 6.6 ± 0.7 cP; d = 1.7, P = 0.01) were elevated in CMS compared to healthy highlanders, cardiac output, total peripheral resistance and mean BP were similar between groups. The vascular sympathetic baroreflex MSNA set-point (i.e. MSNA burst incidence) and reflex gain (i.e. responsiveness) were also similar between groups (MSNA set-point, d = 0.75, P = 0.16; gain, d = 0.2, P = 0.69). In contrast, in CMS the cardiovagal baroreflex operated around a longer RRI (960 ± 159 vs. 817 ± 50 ms; d = 1.4, P = 0.04) with a greater reflex gain (17.2 ± 6.8 vs. 8.8 ± 2.6 ms·mmHg(-1) ; d = 1.8, P = 0.01) versus healthy highlanders. Basal sympathetic vasomotor activity was also lower compared to healthy highlanders (33 ± 11 vs. 45 ± 13 bursts·min(-1) ; d = 1.0, P = 0.08). In conclusion, our findings indicate adaptive differences in basal sympathetic vasomotor activity and heart rate compensate for the haemodynamic consequences of excessive erythrocyte volume and contribute to integrative blood pressure regulation in Andean highlanders with mild CMS. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Experimental Physiology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject adult en_US
dc.subject Article en_US
dc.subject controlled study en_US
dc.subject human en_US
dc.subject male en_US
dc.subject erythrocytosis en_US
dc.subject Peru en_US
dc.subject Andean Amerind people en_US
dc.subject arterial baroreflex en_US
dc.subject basal sympathetic vasomotor activity en_US
dc.subject blood pressure en_US
dc.subject blood pressure control en_US
dc.subject blood pressure regulation en_US
dc.subject blood viscosity en_US
dc.subject cardiovagal baroreflex en_US
dc.subject cardiovascular parameters en_US
dc.subject chronic mountain sickness en_US
dc.subject clinical article en_US
dc.subject electrocardiogram en_US
dc.subject erythrocyte volume en_US
dc.subject excessive erythrocytosis en_US
dc.subject heart function en_US
dc.subject heart hemodynamics en_US
dc.subject heart output en_US
dc.subject microneurography en_US
dc.subject muscle sympathetic nerve activity en_US
dc.subject neuroimaging en_US
dc.subject photoelectric plethysmography en_US
dc.subject resting blood pressure en_US
dc.subject sympathetic vasomotor outflow en_US
dc.subject vascular resistance en_US
dc.subject vascular sympathetic baroreflex en_US
dc.subject vasomotor system en_US
dc.title Global REACH 2018: Andean highlanders, chronic mountain sickness and the integrative regulation of resting blood pressure en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1113/EP088473
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.08
dc.relation.issn 1469-445X


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