TY - JOUR
T1 - Effect of losartan on performance and physiological responses to exercise at high altitude (5035 m)
AU - Lucas, Samuel J. E.
AU - Malein, William L.
AU - Thomas, Owen D.
AU - Ashdown, Kimberly M.
AU - Rue, Carla A.
AU - Joyce, Kelsey E.
AU - Newman, Charles
AU - Cadigan, Patrick
AU - Johnson, Brian
AU - Myers, Stephen D.
AU - Myers, Fiona A.
AU - Wright, Alexander D.
AU - Delamere, John
AU - Imray, Chris H. E.
AU - Bradwell, Arthur R.
AU - Edsell, Mark
N1 - Funding Information:
This study was supported by the Birmingham Medical Research Expeditionary Society, which provided input for the conduct of the research. Patients were not included. Public involvement was limited to recruitment. Notification was given to participants at the time of consent that acquisition of personal data was permitted on request. Permission was also obtained at this time for the dissemination of deidentified data within the research team and only externally when a reasonable request was submitted directly to the corresponding author of the present study within 6 months of its publication. A portion of the cohort was invited to review the research methods for accuracy and readability.
Funding Information:
Funding This study was supported by a grant from the JABBS Foundation. Competing interests None declared. Patient consent for publication Not required.
Publisher Copyright:
©
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Objective: Altitude-related and exercise-related elevations in blood pressure (BP) increase the likelihood of developing pulmonary hypertension and high-Altitude illness during high-Altitude sojourn. This study examined the antihypertensive effect and potential exercise benefit of the angiotensin II receptor antagonist losartan when taken at altitude.Methods: Twenty participants, paired for age and ACE genotype status, completed a double-blinded, randomised study, where participants took either losartan (100 mg/day) or placebo for 21 days prior to arrival at 5035 m (Whymper Hut, Mt Chimborazo, Ecuador). Participants completed a maximal exercise test on a supine cycle ergometer at sea level (4 weeks prior) and within 48 hours of arrival to 5035 m (10-day ascent). Power output, beat-To-beat BP, oxygen saturation (SpO 2) and heart rate (HR) were recorded during exercise, with resting BP collected from daily medicals during ascent. Before and immediately following exercise at 5035 m, extravascular lung water prevalence was assessed with ultrasound (quantified via B-line count).Results: At altitude, peak power was reduced relative to sea level (p<0.01) in both groups (losartan vs placebo: down 100±29 vs 91±28 W, p=0.55), while SpO 2 (70±6 vs 70±5%, p=0.96) and HR (146±21 vs 149±24 bpm, p=0.78) were similar between groups at peak power, as was the increase in systolic BP from rest to peak power (up 80±37 vs 69±33 mm Hg, p=0.56). Exercise increased B-line count (p<0.05), but not differently between groups (up 5±5 vs 8±10, p=0.44).Conclusion: Losartan had no observable effect on resting or exercising BP, exercise-induced symptomology of pulmonary hypertension or performance at 5035 m.
AB - Objective: Altitude-related and exercise-related elevations in blood pressure (BP) increase the likelihood of developing pulmonary hypertension and high-Altitude illness during high-Altitude sojourn. This study examined the antihypertensive effect and potential exercise benefit of the angiotensin II receptor antagonist losartan when taken at altitude.Methods: Twenty participants, paired for age and ACE genotype status, completed a double-blinded, randomised study, where participants took either losartan (100 mg/day) or placebo for 21 days prior to arrival at 5035 m (Whymper Hut, Mt Chimborazo, Ecuador). Participants completed a maximal exercise test on a supine cycle ergometer at sea level (4 weeks prior) and within 48 hours of arrival to 5035 m (10-day ascent). Power output, beat-To-beat BP, oxygen saturation (SpO 2) and heart rate (HR) were recorded during exercise, with resting BP collected from daily medicals during ascent. Before and immediately following exercise at 5035 m, extravascular lung water prevalence was assessed with ultrasound (quantified via B-line count).Results: At altitude, peak power was reduced relative to sea level (p<0.01) in both groups (losartan vs placebo: down 100±29 vs 91±28 W, p=0.55), while SpO 2 (70±6 vs 70±5%, p=0.96) and HR (146±21 vs 149±24 bpm, p=0.78) were similar between groups at peak power, as was the increase in systolic BP from rest to peak power (up 80±37 vs 69±33 mm Hg, p=0.56). Exercise increased B-line count (p<0.05), but not differently between groups (up 5±5 vs 8±10, p=0.44).Conclusion: Losartan had no observable effect on resting or exercising BP, exercise-induced symptomology of pulmonary hypertension or performance at 5035 m.
KW - altitude
KW - cardiovascular
KW - exercise
KW - pulmonary
UR - http://www.scopus.com/inward/record.url?scp=85099141906&partnerID=8YFLogxK
U2 - 10.1136/bmjsem-2020-000982
DO - 10.1136/bmjsem-2020-000982
M3 - Article
C2 - 33489310
AN - SCOPUS:85099141906
SN - 2055-7647
VL - 7
JO - BMJ Open Sport and Exercise Medicine
JF - BMJ Open Sport and Exercise Medicine
IS - 1
M1 - e000982
ER -