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Effect of losartan on performance and physiological responses to exercise at high altitude (5035 m)
BMJ Open Sport & Exercise Medicine Pub Date : 2021-01-01 , DOI: 10.1136/bmjsem-2020-000982
Samuel J E Lucas , William L Malein , Owen D Thomas , Kimberly M Ashdown , Carla A Rue , Kelsey E Joyce , Charles Newman , Patrick Cadigan , Brian Johnson , Stephen D Myers , Fiona A Myers , Alexander D Wright , John Delamere , Chris H E Imray , Arthur R Bradwell , Mark Edsell

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 (SpO2) 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 SpO2 (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.

中文翻译:

氯沙坦对高原(5035 m)运动表现和生理反应的影响

目的与海拔高度和运动相关的血压升高(BP)会增加在高空逗留期间发生肺动脉高压和高海拔疾病的可能性。这项研究检查了在海拔高度服用时血管紧张素II受体拮抗剂洛沙坦的降压作用和潜在的运动益处。方法20位年龄和ACE基因型状态配对的参与者完成了一项双盲随机研究,参与者在到达5035 m之前服用氯沙坦(100 mg /天)或安慰剂21天(Whymper Hut,Mt Chimborazo,厄瓜多尔)。参与者在海平面(之前4周)和到达5035 m(上升10天)的48小时内,在仰卧自行车测力计上完成了最大运动测试。功率输出,逐拍BP,运动期间记录血氧饱和度(SpO2)和心率(HR),并在上升过程中从日常医疗中收集静息血压。在5035 m运动之前和之后,用超声(通过B线计数量化)评估血管外肺水患病率。结果在海拔高度,两组的峰值功率均相对于海平面降低(p <0.01)(氯沙坦对安慰剂:下降100±29对91±28 W,p = 0.55),而血氧饱和度(70±6对70±5) %,p = 0.96)和HR(146±21 vs 149±24 bpm,p = 0.78)在峰值功率时两组之间相似,从静止到峰值功率的收缩压增加(80±37 vs 69±) 33毫米汞柱,p = 0.56)。运动使B线计数增加(p <0.05),但各组之间无差异(5±5 vs 8±10,p = 0.44)。结论氯沙坦对静息或运动血压无明显影响,
更新日期:2021-02-12
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