The role of menopause in the development of chronic mountain sickness

1997 ◽  
Vol 272 (1) ◽  
pp. R90-R94 ◽  
Author(s):  
F. Leon-Velarde ◽  
M. A. Ramos ◽  
J. A. Hernandez ◽  
D. De Idiaquez ◽  
L. S. Munoz ◽  
...  
Keyword(s):  
Premenopausal Women ◽  
Signs And Symptoms ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Chronic Mountain Sickness ◽  
Female Population ◽  
Mountain Sickness ◽  
Cerro De Pasco ◽  
Expiratory Flow Rates

The objective of this study was to investigate the role of menopause in the appearance of the physiopathological sequence that leads to chronic mountain sickness (CMS) in a high-altitude female population. The females studied are 30-54 yr old (n = 152) and have permanent residence in Cerro de Pasco (Pasco, Peru; 4,300 m). The sample was divided into postmenopausal and premenopausal groups for comparison. Blood oxygen saturation (SaO2), excessive erythrocytosis [EE, measured by the level of hematocrit (Het)], peak expiratory flow rates (PEFR), and a score that represents the main signs and symptoms of CMS (CMSscore) were measured. Postmenopausal women had higher Het (50.2 +/- 4.04 vs. 47.4 +/- 4.13%, P < 0.001), lower SaO2 (81.9 +/- 4.12 vs. 84.7 +/- 3.14%, P < 0.001) and PEFR values (489 +/- 101 vs. 534 +/- 90 l/min, P < 0.02), and slightly higher CMSscore (19.1 +/- 3.37 vs. 17.9 +/- 3.48, P < 0.06) than premenopausal women. The prevalence of women with EE (EE = Hct > 56%) was found to be 8.8%. Forty-five percent of the postmenopausal subjects presented a high CMSscore (> 21), whereas only 22% of the premenopausal subjects presented this high value (P < 0.02). We can therefore conclude that menopause may represent a contributing factor for the development of CMS.

Role of sex hormones in development of chronic mountain sickness in rats

1994 ◽  
Vol 77 (1) ◽  
pp. 427-433 ◽  
Author(s):  
L. C. Ou ◽  
G. L. Sardella ◽  
J. C. Leiter ◽  
T. Brinck-Johnsen ◽  
R. P. Smith
Keyword(s):  
Gender Differences ◽  
Pulmonary Hypertension ◽  
High Altitude ◽  
Sex Hormones ◽  
Systolic Pressure ◽  
Female Rats ◽  
Hypoxic Exposure ◽  
Chronic Mountain Sickness ◽  
Mountain Sickness

After chronic exposure to hypoxia, Hilltop Sprague-Dawley rats developed excessive polycythemia and severe pulmonary hypertension and right ventricular (RV) hypertrophy, signs consistent with human chronic mountain sickness; however, there were gender differences in the magnitude of the polycythemia and susceptibility to the fatal consequence of chronic mountain sickness. Orchiectomy and ovariectomy were performed to evaluate the role of sex hormones in the gender differences in these hypoxic responses. After 40 days of exposure to simulated high altitude (5,500 m; barometric pressure of 370 Torr and inspired Po2 of 73 Torr), both sham-gonadectomized male and female rats developed polycythemia and had increased RV peak systolic pressure and RV hypertrophy. The hematocrit was slightly but significantly higher in males than in females. Orchiectomy did not affect these hypoxic responses, although total ventricular weight was less in the castrated high-altitude rats. At high altitude, the mortality rates were 67% in the sham-operated male rats and 50% in the castrated animals. In contrast, ovariectomy aggravated the high-altitude-associated polycythemia and increased RV peak systolic pressure and RV weight compared with the sham-operated high-altitude female rats. Both sham-operated control and ovariectomized females suffered negligible mortality at high altitude. The present study demonstrated that 1) the male sex hormones play no role in the development of the excessive polycythemia, pulmonary hypertension, and RV hypertrophy during chronic hypoxic exposure or in the associated high mortality and 2) the female sex hormones suppressed both the polycythemic and cardiopulmonary responses in vivo during chronic hypoxic exposure.

Relationship of ovarian hormones to hypoxemia in women residents of 4,300 m

2001 ◽  
Vol 280 (2) ◽  
pp. R488-R493 ◽  
Author(s):  
F. León-Velarde ◽  
M. Rivera-Chira ◽  
R. Tapia ◽  
L. Huicho ◽  
C. Monge-C
Keyword(s):  
Luteal Phase ◽  
Arterial Oxygen Saturation ◽  
Premenopausal Women ◽  
Arterial Oxygen ◽  
Chronic Mountain Sickness ◽  
Physiological Variables ◽  
Cerro De Pasco ◽  
End Tidal ◽  
Hb Concentration ◽  
Relationship Of

Prevalence of excessive erythrocytosis, the main sign of chronic mountain sickness (CMS), is greater in postmenopausal Andean women than in premenopausal women. It is uncertain whether this greater prevalence is related to the decline in female hormones and ventilatory function after the occurrence of the menopause. To study this, we compared the physiological variables involved in the physiopathology of CMS [end-tidal CO2 (Pet CO2 , Torr) and end-tidal O2 (Pet O2 , Torr), arterial oxygen saturation (SaO2 , %), and Hb concentration (g/dl)] and progesterone and estradiol levels between postmenopausal and premenopausal women, both in the luteal and follicular phases. Women residing in Cerro de Pasco ( n= 33; 4,300 m) aged 26–62 yr were studied. Postmenopausal women compared with premenopausal women in the luteal phase had lower Pet O2 (48 ± 4 vs. 53 ± 2 Torr, P = 0.005) and SaO2 levels (82 ± 12 vs. 88 ± 12%, P < 0.005) and higher Pet CO2 (34 ± 2 vs. 29 ± 3 Torr, P = 0.005) and Hb concentration (19 ± 1 vs. 14 ± 2 g/dl, P < 0.005). In addition, plasma progesterone was negatively correlated with Pet CO2 and positively correlated with Pet O2 and SaO2 . No clear relationship was found among the cycle phases between estradiol and the variables studied. In conclusion, our results reveal that, before menopause, there is better oxygenation and lower Hb levels in women long residing at altitude, and this is associated with higher levels of progesterone in the luteal phase of the cycle.

scholarly journals Association of lipoprotein levels with sleep apnea: role of autonomic dysfunction

2021 ◽  
Vol 55 (1) ◽  
pp. 22-29
Author(s):  
Pavel Siarnik ◽  
Adela Penesova ◽  
Zofia Radikova ◽  
Alzbeta Hluchanova ◽  
Oto Hanus ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Autonomic Dysfunction ◽  
Linear Regression Analysis ◽  
Area Under The Curve ◽  
Density Lipoprotein ◽  
Receiver Operating Curve ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Significant Difference

Abstract Objectives. Although multiple mechanisms, including autonomic dysfunction, seem to link sleep-disordered breathing (SDB) with dyslipidemia in animal studies, the data in clinical studies are limited. The aim of this study was to explore the association of lipoprotein levels with SDB measures in healthy habitual snorers. We supposed that autonomic dysfunction is the linking mechanism. Methods. We enrolled 110 previously healthy subjects with complaints of habitual snoring. To assess SDB, polysomnography was performed. Blood samples for the analysis of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein cholesterol (LDL), and triglycerides (TG) were obtained in a fasting condition after the polysomnography. Baroreflex sensitivity (BRS) was used to assess the autonomic dysfunction. Results. In stepwise multiple linear regression analysis, minimal nocturnal blood oxygen saturation (beta=–0.240, p=0.020) and neck circumference (beta=0.224, p=0.03) were the only significant contributors in model predicting TG. SDB measures were not identified as significant contributors in models predicting TC, LDL, and HDL. We failed to find any significant difference in BRS in SDB subjects when compared according to the presence or absence of hypercholesterolemia/ hypertriglyceridemia. In SDB subjects, the area under the curve in a receiver operating curve to predict hypercholesterolemia and hypertriglyceridemia by BRS was 0.468 (95% CI: 0.328–0.608) and 0.425 (95% CI: 0.304–0.546), respectively. Conclusions. Our results suggest that minimal nocturnal blood oxygen saturation is significant contributor in model predicting TG. No significant decrease in BRS was found in SDB subjects with hypercholesterolemia and hypertriglyceridemia. In SDB subjects, the role of autonomic dys-function in the development of dyslipidemia remains controversial.

Oxidative stress and inflammation in COVID-19 pathogenesis

2020 ◽  
Vol 26 (4) ◽  
Author(s):  
Vladimir G. Kukes ◽  
Olga K. Parfenova ◽  
Nikita G. Sidorov ◽  
Yuri V. Olefir ◽  
Albina А. Gazdanova
Keyword(s):  
Oxidative Stress ◽  
Severe Acute Respiratory Syndrome ◽  
Oxygen Saturation ◽  
Viral Infections ◽  
Blood Oxygen ◽  
The Novel ◽  
Blood Oxygen Saturation ◽  
Metabolic Products ◽  
Respiratory Viral Infections

This study discusses the role of oxidative stress and inflammation in the development of severe acute respiratory syndrome (SARS) associated with COVID-19 caused by the novel SARS-CoV-2 coronavirus. An analysis of the literature revealed that the development of respiratory viral infections, including COVID-19, is usually accompanied by the accumulation of acidic metabolic products in the blood and tissues and, accordingly, oxidative stress and increased levels of cytokines. In this regard, it seems appropriate to use the second-generation low-toxic antioxidant Ethoxidol, manufactured in Russia, which reduces the intensity of inflammation, and also improves blood oxygen saturation.

scholarly journals Optimal hemoglobin concentration and high altitude: a theoretical approach for Andean men at rest

2004 ◽  
Vol 96 (5) ◽  
pp. 1581-1588 ◽  
Author(s):  
Francisco C. Villafuerte ◽  
Rosa Cárdenas ◽  
Carlos Monge-C
Keyword(s):  
Cardiac Output ◽  
Theoretical Analysis ◽  
High Altitude ◽  
Hemoglobin Concentration ◽  
Mathematical Approach ◽  
Chronic Mountain Sickness ◽  
Physiological Variables ◽  
Mixed Mean ◽  
Mountain Sickness

The beneficial role of erythrocytosis for O2 transport has been questioned by evidence from bloodletting and hemodilution research as well as by studies suggesting the existence of an “optimal” hematocrit (Hct) or hemoglobin concentration ([Hb]) value. To assess to what extent erythrocytosis is beneficial in Andean men at high altitude, we examined and discussed optimal [Hb] using a mathematical approach by modeling the mixed (mean) venous Po2 (Pv̄O2) and arterial O2 content, considering for both the relation between [Hb] and arterial Po2. Relations of [Hb] to other physiological variables such as cardiac output and convective arterial O2 transport were also discussed, revealing the importance of Pv̄O2 in this model. Our theoretical analysis suggests that increasing [Hb] allows increase and maintenance of Pv̄O2 with only moderate declines in arterial Po2 as a consequence of moderate increases in altitude, reaching its maximum at the optimal [Hb] of 14.7 g/dl. Our analysis also shows that [Hb] corresponding to high arterial O2 content and O2 transport values is apparently not quite advantageous for improvement of oxygenation. Furthermore, chronic mountain sickness is discussed as an insightful example of the effects of excessive erythrocytosis at high altitude.

Role of the spleen in the exaggerated polycythemic response to hypoxia in chronic mountain sickness in rats

1999 ◽  
Vol 87 (5) ◽  
pp. 1901-1908 ◽  
Author(s):  
H. Y. Kam ◽  
L. C. Ou ◽  
C. D. Thron ◽  
R. P. Smith ◽  
J. C. Leiter
Keyword(s):  
Bone Marrow ◽  
Chronic Hypoxia ◽  
Hypoxic Exposure ◽  
Large Measure ◽  
Chronic Mountain Sickness ◽  
Fe Uptake ◽  
Rat Strain ◽  
Mountain Sickness ◽  
Rapid Appearance

In a rat model of chronic mountain sickness, the excessive polycythemic response to hypoxic exposure is associated with profound splenic erythropoiesis. We studied the uptake and distribution of radioactive iron and red blood cell (RBC) morphology in intact and splenectomized rats over a 30-day hypoxic exposure. Retention of59Fe in the plasma was correlated with59Fe uptake by both spleen and marrow and the appearance of59Fe-labeled RBCs in the blood.59Fe uptake in both the spleen and the marrow paralleled the production of nucleated RBCs. Splenic59Fe uptake was ∼10% of the total marrow uptake under normoxic conditions but increased to 60% of the total marrow uptake during hypoxic exposure. Peak splenic59Fe uptake and splenomegaly occurred at the most intense phase of erythropoiesis and coincided with the rapid appearance of59Fe-labeled RBCs in the blood. The bone marrow remains the most important erythropoietic organ under both resting and stimulated states, but inordinate splenic erythropoiesis in this rat strain accounts in large measure for the excessive polycythemia during the development of chronic mountain sickness in chronic hypoxia.

scholarly journals Office and Ambulatory Arterial Hypertension in Highlanders

Hypertension ◽  
2020 ◽  
Vol 76 (6) ◽  
pp. 1962-1970
Author(s):  
Grzegorz Bilo ◽  
Lorenzo Acone ◽  
Cecilia Anza-Ramírez ◽  
José Luis Macarlupú ◽  
Davide Soranna ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Measurement ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Blood Oxygen Saturation ◽  
Chronic Mountain Sickness ◽  
Nocturnal Hypertension ◽  
Mountain Sickness

Millions of people worldwide live at high altitude, being chronically exposed to hypobaric hypoxia. Hypertension is a major cardiovascular risk factor but data on its prevalence and determinants in highlanders are limited, and systematic studies with ambulatory blood pressure monitoring are not available. Aim of this study was to assess the prevalence of clinic and ambulatory hypertension and the associated factors in a sample of Andean highlanders. Hypertension prevalence and phenotypes were assessed with office and ambulatory blood pressure measurement in a sample of adults living in Cerro de Pasco, Peru (altitude 4340 m). Basic clinical data, blood oxygen saturation, hematocrit, and Qinghai Chronic Mountain Sickness score were obtained. Participants were classified according to the presence of excessive erythrocytosis and chronic mountain sickness diagnosis. Data of 289 participants (143 women, 146 men, mean age 38.3 years) were analyzed. Office hypertension was present in 20 (7%) participants, while ambulatory hypertension was found in 58 (20%) participants. Masked hypertension was common (15%), and white coat hypertension was rare (2%). Among participants with ambulatory hypertension, the most prevalent phenotypes included isolated nocturnal hypertension, isolated diastolic hypertension, and systodiastolic hypertension. Ambulatory hypertension was associated with male gender, age, overweight/obesity, 24-hour heart rate, and excessive erythrocytosis. Prevalence of hypertension among Andean highlanders may be significantly underestimated when based on conventional blood pressure measurements, due to the high prevalence of masked hypertension. In highlanders, ambulatory hypertension may be independently associated with excessive erythrocytosis.

scholarly journals High serum testosterone levels are associated with excessive erythrocytosis of chronic mountain sickness in men

2009 ◽  
Vol 296 (6) ◽  
pp. E1319-E1325 ◽  
Author(s):  
Gustavo F. Gonzales ◽  
Manuel Gasco ◽  
Vilma Tapia ◽  
Cynthia Gonzales-Castañeda
Keyword(s):  
Thyroid Hormones ◽  
High Altitude ◽  
Serum Testosterone ◽  
High Serum ◽  
Chronic Mountain Sickness ◽  
Testosterone Levels ◽  
High Altitude Natives ◽  
Mountain Sickness ◽  
Low Altitude ◽  
Cerro De Pasco

Chronic mountain sickness (CMS) is characterized by excessive erythrocytosis (EE) secondary to hypoventilation. Erythropoietin (Epo) and testosterone regulate erythrocyte production. Low thyroid hormone levels are also associated to hypoventilation. Hence, these hormones can play a role in etiopathogeny of EE. The purpose of this study was to elucidate the effect of sexual and thyroid hormones and Epo in residents from Lima (150 m) and Cerro de Pasco (4,340 m), Peru, and the response to human chorionic gonadotrophin stimulation (hCG). Three groups, one at low altitude and two at high altitude [1 with hemoglobin values >16–21 g/dl and the second with Hb ≥21 g/dl (EE)], were studied. hCG was administered intramuscularly in a single dose (1,000 IU), and blood samples were obtained at 0, 6, 12, 24, 48, and 72 h after injection. High-altitude natives present similar levels of gonadotropins and thyroid hormones but lower dehydroepiandrosterone sulphate (DHEAS) levels ( P < 0.01) and greater Epo ( P < 0.01), 17α-hydroxyprogesterone ( P < 0.01), and testosterone levels ( P < 0.01) than those at 150 m. Serum testosterone levels (524.13 ± 55.91 μg/dl vs. 328.14 ± 53.23 ng/dl, means ± SE; P < 0.05) and testosterone/DHEAS ratios are higher (7.98 ± 1.1 vs. 3.65 ± 1.1; P < 0.01) and DHEAS levels lower in the EE group (83.85 ± 14.60 μg/dl vs. 148.95 ± 19.11 ug/dl; P < 0.05), whereas Epo was not further affected. Testosterone levels were highest and DHEAS levels lowest in the EE group at all times after hCG stimulation. In conclusion, high androgen activity could be involved in the etiopathogeny of CMS. This evidence provides an opportunity to develop new therapeutic strategies.

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