Document Detail

Effect of high-altitude exposure in the elderly: the Tenth Mountain Division study.
MedLine Citation:
PMID:  9286953     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: More than 5 million people/year over age 60 visit high altitude, which may exacerbate underlying cardiac or pulmonary disease. We hypothesized that the elderly would exhibit an impaired functional capacity at altitude, with increased myocardial ischemia compared with sea level (SL). METHODS AND RESULTS: Twenty veterans (68+/-3 years) were studied at (1) SL, (2) acute simulated altitude to 2500 m, and (3) after 5 days of acclimatization to 2500 m. With acute altitude, PaO2 and oxyhemoglobin saturation decreased and pulmonary artery pressure increased 43%, associated with sympathetic activation. VO2peak decreased 12% acutely but normalized after acclimatization. The best predictor of VO2peak with acute altitude was VO2peak at SL (r=.94). The double product that induced 1-mm ST depression during exercise with acute altitude was 5% less than SL but normalized after acclimatization. One patient with severe coronary disease sustained a myocardial infarction after an exercise test. CONCLUSIONS: Moderate altitude exposure in the elderly is associated with hypoxemia, sympathetic activation, and pulmonary hypertension resulting in a reduced exercise capacity that is predictable based on exercise performance at SL. Patients with coronary artery disease who are well compensated at SL do well at moderate altitude, although acutely ischemia may be provoked at modestly lower myocardial and systemic work rates. The elderly acclimatize well with normalization of SL performance after 5 days. A prudent policy would be for elderly individuals, particularly those with coronary artery disease, to limit their activity during the first few days at altitude to allow this acclimatization process to occur.
B D Levine; J H Zuckerman; C R deFilippi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  96     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-09-22     Completed Date:  1997-09-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1224-32     Citation Subset:  AIM; IM; S    
The Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, and Division of Cardiology, University of Texas Southwestern Medical Center at Dallas, USA.
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MeSH Terms
Age Factors
Aged / physiology*
Altitude Sickness / complications*
Arrhythmias, Cardiac / etiology
Exercise Test
Myocardial Ischemia / etiology
Respiratory Function Tests
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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