Department of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Eur Heart J. 2013 Mar;34(10):759-66. doi: 10.1093/eurheartj/ehs140. Epub 2012 Jun 17.
We assessed the haemodynamic changes induced by exposure to high altitude hypoxia and the effects on them of acetazolamide, a drug prescribed to prevent and treat mountain sickness.
In 42 subjects (21 males, age 36.8 ± 8.9 years) randomized to double blind acetazolamide 250 mg b.i.d. or placebo, pulse wave velocity and pulse wave parameters were assessed (PulsePen) at baseline; after 2-day treatment at sea level; within 6 h and on 3rd day of exposure to high altitude. Exposure to high altitude significantly increased diastolic (P < 0.005) and mean blood pressure (BP) (P < 0.05, after prolonged exposure) in placebo but not in the acetazolamide group. Therefore, subjects on acetazolamide showed significantly lower values of diastolic (P < 0.005) and mean BP (P < 0.05) at altitude. Furthermore, they also showed significantly lower values of systolic BP (P < 0.05). Pulse wave velocity did not change at high altitude, while the augmentation index, normalized for a theoretical heart rate of 75 b.p.m., significantly increased (P < 0.05) under placebo, but not under acetazolamide. In a multivariate model, unadjusted augmentation index at high altitude was not affected by BP changes, while significant determinants were heart rate and gender.
Acute exposure to high altitude induced a rise in brachial BP and changes in pulse waveform-derived parameters, independent from changes in mean BP and partly counteracted by treatment with acetazolamide. The impact of acetazolamide on the haemodynamic alterations induced by hypobaric hypoxia may be considered among the beneficial effects of this drug in subjects prone to mountain sickness.
EudraCT Number: 2010-019986-27.
我们评估了暴露于高海拔低氧环境引起的血液动力学变化，以及乙酰唑胺（一种用于预防和治疗高山病的药物）对这些变化的影响。
在 42 名受试者（21 名男性，年龄 36.8 ± 8.9 岁）中，随机分为乙酰唑胺 250mg 每日两次双盲或安慰剂组，在基线时（PulsePen）评估脉搏波速度和脉搏波参数；在海平面治疗 2 天后；在暴露于高海拔的 6 小时内和第 3 天。暴露于高海拔环境显著增加了安慰剂组的舒张压（P < 0.005）和平均血压（BP）（P < 0.05，长时间暴露后），但在乙酰唑胺组中没有。因此，乙酰唑胺组在高海拔环境下的舒张压（P < 0.005）和平均 BP（P < 0.05）值显著较低。此外，他们的收缩压也显著较低（P < 0.05）。在高海拔环境下，脉搏波速度没有变化，而经理论心率 75 次/分时标准化的增强指数显著增加（P < 0.05），而在乙酰唑胺组中则没有。在多变量模型中，未经校正的高海拔增强指数不受 BP 变化的影响，而心率和性别是显著的决定因素。
急性暴露于高海拔环境会引起肱动脉 BP 升高和脉搏波形态参数变化，这些变化独立于平均 BP 变化，并部分被乙酰唑胺治疗所抵消。乙酰唑胺对低气压缺氧引起的血液动力学改变的影响可能被认为是该药在易患高山病的患者中的有益作用之一。
EudraCT 编号：2010-019986-27。
