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Rausch L, Limmer M, Pocecco E, Ruedl G, Posch M, Faulhaber M. Sex-specific analysis of hiking accidents in the Austrian Alps: a follow-up from 2015 to 2021. AIMS Public Health 2024; 11:160-175. [PMID: 38617419 PMCID: PMC11007419 DOI: 10.3934/publichealth.2024008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 04/16/2024] Open
Abstract
Background Hiking is one of the most popular leisure sport activities practiced in the Alps during the summer season, but bears the risk of mountain emergencies, accidents, and fatalities. This paper provides an updated analysis of hiking accidents for the years 2015 to 2021 in the Austrian Alps, thereby outlining fatal and non-fatal accident characteristics. Methods For this retrospective analysis, mountain hiking accidents documented by the Austrian Alpine Police during a 7-year period were screened for potential exclusion criteria. The final sample size consisted of 7368 accidents and 7552 victims. The outcome measures were mainly specified by sex, age, injury degree, injury location, pathophysiological characteristics, and cause of injury. Results The overall annual number of accidents showed a continuous increase from 428 in 2015 to 544 in 2021. In total, 7.1% of the total victims died during the 7-year period, with male hikers being significantly more affected than female hikers (m: 80.8%, f: 19.2%; p ≤ 0.001). The sex specific distribution for non-fatal hiking accidents was 55.9% in women and 44.1% in men. Male victims showed significantly more frequent cardiovascular events (m: 78.5%, f: 21.5%), multiple injuries (m: 60.2%, f: 39.8%), and wounds/blood loss (m: 57.4%, f: 42.6%) than female victims, whereas women showed more fractures (m: 31.5%, f: 68.5%) than men (p ≤ 0.001). Additionally, men were more likely to injure their abdomen/chest (3.7%), head (14.1%), and multiple body parts (26.5%), whereas women were more likely to injure their ankle or foot (42.3%). Finally, men were more likely to have an accident during the ascent (24.1%), whereas women during the descent (69.0%) (p ≤ 0.001). Conclusion This paper provides the latest data and a deeper insight into sex-specific characteristics of mountain hiking accidents in the Austrian Alps.
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Affiliation(s)
- Linda Rausch
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Tyrol, Austria
| | - Mirjam Limmer
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Tyrol, Austria
- Institute of Outdoor Sports and Environmental Science, German Sports University Cologne, 50933 Cologne, North Rhine-Westphalia, Germany
| | - Elena Pocecco
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Tyrol, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Tyrol, Austria
| | - Markus Posch
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Tyrol, Austria
| | - Martin Faulhaber
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Tyrol, Austria
- Austrian Society of Alpine and High-Altitude Medicine, 6414 Mieming, Tyrol, Austria
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Yang A, Guo L, Zhang Y, Qiao C, Wang Y, Li J, Wang M, Xing J, Li F, Ji L, Guo H, Zhang R. MFN2-mediated mitochondrial fusion facilitates acute hypobaric hypoxia-induced cardiac dysfunction by increasing glucose catabolism and ROS production. Biochim Biophys Acta Gen Subj 2023:130413. [PMID: 37331409 DOI: 10.1016/j.bbagen.2023.130413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/06/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Rapid ascent to high-altitude environment which is characterized by acute hypobaric hypoxia (HH) may increase the risk of cardiac dysfunction. However, the potential regulatory mechanisms and prevention strategies for acute HH-induced cardiac dysfunction have not been fully clarified. Mitofusin 2 (MFN2) is highly expressed in the heart and is involved in the regulation of mitochondrial fusion and cell metabolism. To date, however, the significance of MFN2 in the heart under acute HH has not been investigated. METHODS AND RESULTS Our study revealed that MFN2 upregulation in hearts of mice during acute HH led to cardiac dysfunction. In vitro experiments showed that the decrease in oxygen concentration induced upregulation of MFN2, impairing cardiomyocyte contractility and increasing the risk of QT prolongation. Additionally, acute HH-induced MFN2 upregulation promoted glucose catabolism and led to excessive mitochondrial reactive oxygen species (ROS) production in cardiomyocytes, ultimately resulting in decreased mitochondrial function. Furthermore, co-immunoprecipitation (co-IP) and mass spectrometry analyses indicated that MFN2 interacted with the NADH-ubiquinone oxidoreductase 23 kDa subunit (NDUFS8). Specifically, acute HH-induced MFN2 upregulation increased NDUFS8-dependent complex I activity. CONCLUSIONS Taken together, our studies provide the first direct evidence that MFN2 upregulation exacerbates acute HH-induced cardiac dysfunction by increasing glucose catabolism and ROS production. GENERAL SIGNIFICANCE Our studies indicate that MFN2 may be a promising therapeutic target for cardiac dysfunction under acute HH.
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Affiliation(s)
- Ailin Yang
- College of Life Sciences, Northwest University, Xi'an 710069, China
| | - Lifei Guo
- College of Life Sciences, Northwest University, Xi'an 710069, China
| | - Yanfang Zhang
- College of Life Sciences, Northwest University, Xi'an 710069, China
| | - Chenjin Qiao
- College of Life Sciences, Northwest University, Xi'an 710069, China
| | - Yijin Wang
- College of Life Sciences, Northwest University, Xi'an 710069, China
| | - Jiaying Li
- College of Life Sciences, Northwest University, Xi'an 710069, China
| | - Min Wang
- College of Life Sciences, Northwest University, Xi'an 710069, China; Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Jinliang Xing
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an 710032, China
| | - Fei Li
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Lele Ji
- Experimental Teaching Center of Basic Medicine, Fourth Military Medical University, Xi'an 710032, China.
| | - Haitao Guo
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an 710032, China.
| | - Ru Zhang
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an 710032, China.
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Adzika GK, Mprah R, Rizvi R, Adekunle AO, Ndzie Noah ML, Wowui PI, Adzraku SY, Adu-Amankwaah J, Wang F, Lin Y, Fu L, Liu X, Xiang J, Sun H. Occlusion preconditioned mice are resilient to hypobaric hypoxia-induced myocarditis and arrhythmias due to enhanced immunomodulation, metabolic homeostasis, and antioxidants defense. Front Immunol 2023; 14:1124649. [PMID: 36875113 PMCID: PMC9975755 DOI: 10.3389/fimmu.2023.1124649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
Background Sea-level residents experience altitude sickness when they hike or visit altitudes above ~2,500 m due to the hypobaric hypoxia (HH) conditions at such places. HH has been shown to drive cardiac inflammation in both ventricles by inducing maladaptive metabolic reprogramming of macrophages, which evokes aggravated proinflammatory responses, promoting myocarditis, fibrotic remodeling, arrhythmias, heart failure, and sudden deaths. The use of salidroside or altitude preconditioning (AP) before visiting high altitudes has been extensively shown to exert cardioprotective effects. Even so, both therapeutic interventions have geographical limitations and/or are inaccessible/unavailable to the majority of the population as drawbacks. Meanwhile, occlusion preconditioning (OP) has been extensively demonstrated to prevent hypoxia-induced cardiomyocyte damage by triggering endogenous cardioprotective cascades to mitigate myocardial damage. Herein, with the notion that OP can be conveniently applied anywhere, we sought to explore it as an alternative therapeutic intervention for preventing HH-induced myocarditis, remodeling, and arrhythmias. Methods OP intervention (6 cycles of 5 min occlusion with 200 mmHg for 5 min and 5 min reperfusion at 0 mmHg - applying to alternate hindlimb daily for 7 consecutive days) was performed, and its impact on cardiac electric activity, immunoregulation, myocardial remodeling, metabolic homeostasis, oxidative stress responses, and behavioral outcomes were assessed before and after exposure to HH in mice. In humans, before and after the application of OP intervention (6 cycles of 5 min occlusion with 130% of systolic pressure and 5 min reperfusion at 0 mmHg - applying to alternate upper limb daily for 6 consecutive days), all subjects were assessed by cardiopulmonary exercise testing (CPET). Results Comparing the outcomes of OP to AP intervention, we observed that similar to the latter, OP preserved cardiac electric activity, mitigated maladaptive myocardial remodeling, induced adaptive immunomodulation and metabolic homeostasis in the heart, enhanced antioxidant defenses, and conferred resistance against HH-induce anxiety-related behavior. Additionally, OP enhanced respiratory and oxygen-carrying capacity, metabolic homeostasis, and endurance in humans. Conclusions Overall, these findings demonstrate that OP is a potent alternative therapeutic intervention for preventing hypoxia-induced myocarditis, cardiac remodeling, arrhythmias, and cardiometabolic disorders and could potentially ameliorate the progression of other inflammatory, metabolic, and oxidative stress-related diseases.
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Affiliation(s)
| | - Richard Mprah
- Department of Physiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ruqayya Rizvi
- Department of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | | | | | | | - Seyram Yao Adzraku
- Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | | | - Fengli Wang
- Department of Rehabilitation Medicine, The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yuwen Lin
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Lu Fu
- Department of Physiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaomei Liu
- Jiangsu Key Laboratory of Immunity and Metabolism, Department of Pathogen Biology and Immunology and Laboratory of Infection and Immunity, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jie Xiang
- Department of Rehabilitation Medicine, The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Hong Sun
- Department of Physiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Posch M, Burtscher J, Ruedl G, Pocecco E, Burtscher M. Unchanged Fatality Rate on Austrian Ski Slopes during the COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137771. [PMID: 35805425 PMCID: PMC9265540 DOI: 10.3390/ijerph19137771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023]
Abstract
Fatalities on ski slopes are very rare, with about one death per one million skier days. Whether the fatality rate is affected by substantial changes in the number of skier days and potentially associated alterations in the structure of the skier population is unknown. Thus, we compared the fatality rate on Austrian ski slopes in the winter season of 2020/21, when skiing activities were dramatically restricted during the COVID-19 lockdown, with those of the previous winter seasons. As a consequence of COVID-19 measures, the number of skier days dropped from over 50 million in previous years to 9.2 million skier days in the winter season of 2020/21. Still, the fatality rate (6.5 deaths/10 million skier days) was not different when compared to any of the seasons from 2011/12 to 2019/20. Despite the lack of international skiers and the reduction in skier days by more than 80%, the fatality rate remained surprisingly unchanged. The weather and snowfall conditions were on average comparable to those of previous winters, and, except for nationality, the composition of the skier population appears to have remained relatively unaltered. In conclusion, the fatality rate during downhill skiing is low and the absolute fatality numbers are primarily a function of the number of skier days.
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Affiliation(s)
- Markus Posch
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
| | - Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, 1005 Lausanne, Switzerland;
- Institute of Sport Sciences, University of Lausanne, 1015 Lausanne, Switzerland
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
| | - Elena Pocecco
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
- Austrian Society for Alpine and High-Altitude Medicine, 6020 Innsbruck, Austria
- Correspondence:
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Gasser B, Schwendinger F. 4000ers of the Alps–So beautiful, so dangerous: An analysis of falls in the Swiss Alps between 2009–2020. PLoS One 2022; 17:e0266032. [PMID: 35385546 PMCID: PMC8985987 DOI: 10.1371/journal.pone.0266032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/20/2022] [Indexed: 11/22/2022] Open
Abstract
Background This study aimed to analyze falls regarding their demographic characteristics, severity, frequency over time, and the localization of injuries while high-altitude mountaineering in the Swiss Alps. Methods Data on fall-related emergencies during mountaineering between 2009 to 2020 from the Swiss Alpine Club central registry were analyzed retrospectively. The variables age, sex, time of occurrence, severity of an event quantified by NACA-Score (National Advisory Committee for Aeronautics Score), and injury localization were examined descriptively. Changes in injury severity, number of total emergencies, and fatal emergencies over time were analyzed using linear regression models. Results Out of 1347 (28.7%) victims of fall-related emergencies, 1027 were men (76.2%) and 320 (23.8%) women. Around 70% of the cases happened during summer in July and August. The mean age was 49.9 ± 14.9 years for men and 51.3 ± 14.4 years for women with no between-sex difference. Higher NACA-Scores were found in men than women (3.6 ± 2.2 vs. 3.1 ± 1.6; p < 0.01). Approximately 80% of all victims originated from the countries close to the Alps (Switzerland, Germany, Italy, France, and Austria). There was a slight decrease of total cases (R2 = 0.104) and fatal cases over time (R2 = 0.183). NACA-Scores decreased over time (R2 = 0.168). Likewise, risk aversion decreased over time as the severity of emergencies decreased. Injuries occurred predominantly at the extremities (90%). Out of all cases, 228 fatal emergencies (16.9%) could be identified of which 82 occurred while climbing one of the classic 4000ers. Conclusions The decrease of the number and severity implies that security standards of the average alpinist have in tendency increased. Nevertheless, the high number of emergencies on classic 4000ers implies that despite the potentially improved security standards, many tours on famous mountains still have high requirements in terms of alpine skills.
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Affiliation(s)
- Benedikt Gasser
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
- * E-mail:
| | - Fabian Schwendinger
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Gasser BA, Schwendinger F. Has Being Lost While High-Altitude Mountaineering Become Less Frequent? A Retrospective Analysis from the Swiss Alps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1844. [PMID: 35162867 PMCID: PMC8834690 DOI: 10.3390/ijerph19031844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/11/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND High-altitude mountaineering is becoming more popular. Despite technical developments such as global positioning systems, mountaineers still lose their way. This study aimed to analyze characteristics of alpinists that lost their way while high-altitude mountaineering in Switzerland. MATERIAL AND METHODS Data from the central registry of the Swiss Alpine Club between 2009 and 2020 were retrospectively analyzed. Changes in the number of cases and severity of injuries over time were examined using simple linear regression models. Descriptive analyses were performed for age, time of emergency occurrence, and factors associated with being lost. The Mann-Whitney U test assessed between-sex comparisons. RESULTS Of the 4596 emergency cases during the observation period, 275 cases (5.9%) were due to being lost (76.4% male). A mean of 22.9 ± 9.6 cases per year was detected. The number of cases did not change significantly over time. Similarly, this was the case for the NACA-Score (National Advisory Committee for Aeronautics Score) with the majority of mountaineers remaining uninjured (77.8%). The median age was 42 (35-54) years for the full sample and 45 (35-56) years and 40 (33-48) years for males and females, respectively. Fog or weather changes, exhaustion, and inadequate tour planning (time and darkness) were frequently documented by rescuers as perceived reasons for being lost. Regarding the time of emergency occurrence, three peaks were detected, around 10 am, 5 pm, and 8 pm. CONCLUSIONS Our findings show that the number of emergencies due to being lost was stable during the 12-year period. Furthermore, we presented factors that might be associated with losing one's way during mountaineering. These results may form an important basis for future studies determining risk factors for being lost and the prevention of such emergencies.
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Affiliation(s)
- Andrew M Luks
- From the Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle (A.M.L.); and the Altitude Research Center, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (P.H.H.)
| | - Peter H Hackett
- From the Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle (A.M.L.); and the Altitude Research Center, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (P.H.H.)
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Crevasse accidents in the Swiss Alps Epidemiology and mortality of 405 victims of crevasse accidents from 2010 to 2020. Injury 2022; 53:183-189. [PMID: 34412853 DOI: 10.1016/j.injury.2021.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/21/2021] [Accepted: 08/06/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The clinical spectrum of injuries in crevasse accidents can range from benign to life-threatening, even including death. To date, little is known about incidence and causes. METHODS We retrospectively analyzed mountain rescue missions that included crevasse accidents and took place in Switzerland from 2010 to 2020. Demographic and epidemiological data were collected. Injury severity was graded according to the National Advisory Committee for Aeronautics (NACA) score. Winter season was defined as December to May, and summer season as June to November. RESULTS A total of 321 victims of crevasse falls were included in the study. The median age of victims was 41.2 years (interqauartile range [IQR] 31.3 to 51.6), with 82% (n=260) being male and 59% (n=186) foreigners. The typical altitude range at which rescue missions were performed was between 3000 and 3499m (44% of all cases). The median depth of the fall was 15 meters (IQR 8 to 20) during the winter season compared to 8 meters (IQR 5 to 10) during the summer, p<0.001. Overall mortality was 6.5%. The NACA score was ≥4 for 9.4% (n=30) of the victims. 55% (n=177) had a NACA score of 0 or 1. There was a significant positive correlation between the depth of fall and the injury severity (Pearson`s correlation r=0.35, 95%- confidence interval: 0.18 to 0.51), p<0.001. CONCLUSION More than half of victims fallen into a crevasse are uninjured or sustain mild injury. Life-threathening injuries were found in about 10% of victims and the crevasse fall was fatal in 6.5% of cases. Injury severity positively correlates with the depth of fall, which is higher during winter season.
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Mallet RT, Burtscher J, Richalet JP, Millet GP, Burtscher M. Impact of High Altitude on Cardiovascular Health: Current Perspectives. Vasc Health Risk Manag 2021; 17:317-335. [PMID: 34135590 PMCID: PMC8197622 DOI: 10.2147/vhrm.s294121] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/12/2021] [Indexed: 12/12/2022] Open
Abstract
Globally, about 400 million people reside at terrestrial altitudes above 1500 m, and more than 100 million lowlanders visit mountainous areas above 2500 m annually. The interactions between the low barometric pressure and partial pressure of O2, climate, individual genetic, lifestyle and socio-economic factors, as well as adaptation and acclimatization processes at high elevations are extremely complex. It is challenging to decipher the effects of these myriad factors on the cardiovascular health in high altitude residents, and even more so in those ascending to high altitudes with or without preexisting diseases. This review aims to interpret epidemiological observations in high-altitude populations; present and discuss cardiovascular responses to acute and subacute high-altitude exposure in general and more specifically in people with preexisting cardiovascular diseases; the relations between cardiovascular pathologies and neurodegenerative diseases at altitude; the effects of high-altitude exercise; and the putative cardioprotective mechanisms of hypobaric hypoxia.
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Affiliation(s)
- Robert T Mallet
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, Lausanne, CH-1015, Switzerland
- Institute of Sport Sciences, University of Lausanne, Lausanne, CH-1015, Switzerland
| | - Jean-Paul Richalet
- Laboratoire Hypoxie & Poumon, UMR Inserm U1272, Université Sorbonne Paris Nord 13, Bobigny Cedex, F-93017, France
| | - Gregoire P Millet
- Department of Biomedical Sciences, University of Lausanne, Lausanne, CH-1015, Switzerland
- Institute of Sport Sciences, University of Lausanne, Lausanne, CH-1015, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, A-6020, Austria
- Austrian Society for Alpine and High-Altitude Medicine, Mieming, Austria
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Acute Hypobaric and Hypoxic Preconditioning Reduces Myocardial Ischemia-Reperfusion Injury in Rats. Cardiol Res Pract 2021; 2021:6617374. [PMID: 33815836 PMCID: PMC7990552 DOI: 10.1155/2021/6617374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/22/2021] [Accepted: 03/03/2021] [Indexed: 12/30/2022] Open
Abstract
Background Chronic and/or intermittent exposure to hypobaric hypoxia reportedly exerts cardioprotective effects against ischemia-reperfusion injury. However, few studies have focused on the cardioprotective effects of acute and/or short-term hypobaric and hypoxic exposures. This study investigated the effects of acute hypobaric hypoxia on myocardial ischemia-reperfusion injury. Materials and Methods Rats were assigned to groups receiving normobaric normoxia (NN group), hypobaric hypoxia (HH group), or normobaric hypoxia (NH group). HH group rats were exposed to 60.8 kPa and 12.6% fraction of inspired oxygen in a hypobaric chamber for 6 h. NH group rats were exposed to hypoxic conditions under normal pressure. After each exposure, 30 min of myocardial ischemia was followed by 60 min of reperfusion. Cardiac function and infarct size were determined after reperfusion. Expression of hypoxia-inducible factor 1 alpha (HIF1α) was also measured. Results Cardiac function was better preserved in the HH and NH groups than in the NN group (p < 0.01 each). Median infarct size/area at risk was significantly lower in the HH group (50%, interquartile range [IQR] 48–54%; p < 0.01 vs. NN group) and NH group (45%, IQR 36–50%; p < 0.01 vs. NN group) than in the NN group (72%, IQR 69–75%). HIF1α expression was significantly higher in the HH group (p < 0.05 vs. NN group) and NH group (p < 0.01 vs. NN group) than in the NN group. Conclusions Exposure to acute and/or short-term hypobaric and hypoxic conditions might exert cardioprotective effects against myocardial ischemia-reperfusion injury via HIF1α modulation.
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Abstract
Accidents with Animals While Hiking in the Swiss Alps Abstract. Mountain hiking is very popular. However, despite potential benefits, there are risks, also by animals. Retrospectively, all mountain hiking emergencies (n = 10 185) from the years 2009-2018 were analyzed using the registry of the Swiss Alpine Club (SAC), with 104 mountain emergencies caused by animals. The average NACA score was 3.2 ± 1.6, and more than half of the mountain emergencies had a NACA score >4, which can be associated with a life-threatening condition. More than half of the emergencies were caused by insects (bees, wasps, bumblebees, hornets), and just under a quarter each by hoofed animals and snakes, respectively. Three of these events were mortal, and all of these were caused by hoofed animals (mother cow herd, horse, bull). Therefore, it is recommended to keep a safe distance from these animals when passing them.
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Affiliation(s)
| | - Robin Schaub
- Universität Basel, Departement für Sport, Bewegung und Gesundheit (DSBG), Basel
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Blood Pressure Changes While Hiking at Moderate Altitudes: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217978. [PMID: 33142996 PMCID: PMC7663232 DOI: 10.3390/ijerph17217978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/19/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022]
Abstract
Recreational hiking in the mountains is a common activity, whether for a single day or for several days in a row. We sought to measure blood pressure (BP) response during a 10-day trek at moderate-altitude elevation (6500-13,000 feet) and observe for uncontrolled hypertension and/or adverse cardiovascular outcomes. A total of 1279 adult participants completed an observational study of resting BP during a 10-day trek in the Sangre de Cristo mountains. Following initial recruitment, participants were issued a trail data card to record BP measurements at day 0 (basecamp), day 3, day 6 and day 9. BP was measured using a sphygmomanometer and auscultation. Demographic data, height, weight, home altitude, daily water and sports drink intake, existence of pre-arrival hypertension and BP medication class were also recorded. We observed a rise in mean blood pressure for the cohort during all exposures to moderate altitudes. The increases were greatest for individuals with pre-existing hypertension and/or obesity. There were no observed life-threatening cardiovascular events for participants. We conclude that for individuals with a modestly controlled blood pressure of 160/95 mmHg, hiking at a moderate altitude is a safe activity.
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Duke CB, Sallade TD, Starling J, Pant S, Sheets A, McElwee MK, Young DS, Taylor RA, Keyes LE. Hypertension and Acute Mountain Sickness in Himalayan Trekkers in Nepal: An Observational Cohort Study. Wilderness Environ Med 2020; 31:157-164. [PMID: 32205041 DOI: 10.1016/j.wem.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 01/03/2020] [Accepted: 01/15/2020] [Indexed: 01/14/2023]
Abstract
INTRODUCTION A history of preexisting hypertension is common in people participating in mountain activities; however, the relationship between blood pressure (BP), preexisting hypertension, and acute mountain sickness (AMS) is not well studied. We sought to determine these relationships among trekkers in the Everest region of Nepal. METHODS This was a prospective observational cohort study of a convenience sample of adult, nonpregnant volunteers trekking in the Everest Base Camp region in Nepal. We recorded Lake Louise Scores for AMS and measured BP at 2860 m, 3400 m, and 4300 m. The primary outcome was AMS. RESULTS A total of 672 trekkers (including 60 with history of preexisting hypertension) were enrolled at 2860 m. We retained 529 at 3400 m and 363 at 4300 m. At 3400 m, 11% of participants had AMS, and 13% had AMS at 4300 m. We found no relationship between AMS and measured BP values (P>0.05), nor was there any relation of BP to AMS severity as measured by higher Lake Louise Scores (P>0.05). Preexisting hypertension (odds ratio [OR] 0.16; 95% CI 0.025-0.57), male sex (OR 0.59; 95% CI 0.37-0.96), and increased SpO2 (OR 0.93; 95% CI 0.87-0.98) were associated with reduced rates of AMS in multivariate analyses adjusting for known risk factors for AMS. CONCLUSIONS AMS is common in trekkers in Nepal, even at 3400 m. There is no relationship between measured BP and AMS. However, a medical history of hypertension may be associated with a lower risk of AMS. More work is needed to confirm this novel finding.
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Affiliation(s)
- Charles B Duke
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - T Douglas Sallade
- Department of Emergency Medicine, Geisinger Medical Center, Danville, PA
| | - Jennifer Starling
- Department of Emergency Medicine, University of Colorado and Colorado Permanente Medical Group, Saint Joseph Hospital, Denver, CO
| | - Sushil Pant
- Mountain Medicine Society of Nepal, Kathmandu, Nepal
| | | | - Matthew K McElwee
- Department of Medicine, Division of Rheumatic and Autoimmune Diseases, University of Minnesota, Minneapolis, MN
| | - David S Young
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| | | | - Linda E Keyes
- University of Colorado Emergency Medicine and Boulder Emergency Physicians, Boulder, CO.
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Faulhaber M, Ruedl G, Schneider F, Walter D, Sterr R, Schobersberger W, Schwendinger F, Pocecco E. Characteristics of Victims of Fall-Related Accidents during Mountain Hiking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031115. [PMID: 32050553 PMCID: PMC7036860 DOI: 10.3390/ijerph17031115] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 11/26/2022]
Abstract
The study evaluated characteristics of non-fatal mountain hiking accidents caused by falls. Questionnaires were sent to mountain hikers who suffered a fall-related accident in Tyrol (Austria) during a 3-year period. The questionnaire included details of socio-demographic data, physical activity, medication intake, defective vision, breaks, fluid intake, level of fatigue, muscle soreness, use of backpacks, use of hiking sticks, and type of shoes. Data of 405 individuals (57% females and 43% males) were included in the analyses. Victims were 56 ± 15 years of age, had a body mass index of 24.8 ± 3.5, and indicated 4.2 ± 3.9 h/week regular physical activity. A defective vision was reported by 70% of the victims, breaks were frequent (in 80%), and alcohol intake was rare (4%) among the interviewed hikers. Subjective level of fatigue was low and only 5% reported muscle soreness. A backpack was carried by 83% of the victims and the average weight was higher in males compared to females. The majority (61%) of the victims wore ankle-height hiking shoes with a profiled sole. Victims of non-fatal falls in mountain hiking are older than the general population of mountain hikers and are often afflicted with defective vision.
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Affiliation(s)
- Martin Faulhaber
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (G.R.); (F.S.); (E.P.)
- Austrian Society of Alpine and High Altitude Medicine, 6414 Mieming, Austria;
- Correspondence: ; Tel.: +43-512-507-45893
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (G.R.); (F.S.); (E.P.)
| | - Friedemann Schneider
- Department for Trauma Surgery and Sports Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Dagmar Walter
- Austrian Board of Alpine Safety, 6020 Innsbruck, Austria; (D.W.); (R.S.)
| | - Regina Sterr
- Austrian Board of Alpine Safety, 6020 Innsbruck, Austria; (D.W.); (R.S.)
| | - Wolfgang Schobersberger
- Austrian Society of Alpine and High Altitude Medicine, 6414 Mieming, Austria;
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), Tirol Kliniken GmbH, 6020 Innsbruck, Austria
- Private University for Health Sciences, Medical Informatics and Technology (UMIT), 6060 Hall/Tyrol, Austria
| | - Fabian Schwendinger
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (G.R.); (F.S.); (E.P.)
| | - Elena Pocecco
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (G.R.); (F.S.); (E.P.)
- Pedagogical University Tyrol, 6020 Innsbruck, Austria
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Ströhle M, Vögele A, Neuhauser P, Rauch S, Brugger H, Paal P. Sudden Cardiac Arrest and Cardiopulmonary Resuscitation with Automated External Defibrillator in the Austrian Mountains: A Retrospective Study. High Alt Med Biol 2019; 20:392-398. [PMID: 31618064 DOI: 10.1089/ham.2018.0134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Few data exist on the likelihood of surviving sudden cardiac arrest in the mountains. The aim of this study was to analyze the epidemiology and outcomes of patients suffering sudden cardiac arrest and undergoing cardiopulmonary resuscitation (CPR) with automated external defibrillator (AED) in the Austrian mountains. Materials and Methods: We analyzed all cardiac arrest cases in the Austrian mountains reported in the nationwide Austrian Alpine Police database from October 26, 2005, to December 31, 2015. To obtain information on outcomes, these patient data were manually merged with patient data from the main Austrian referral center for mountain emergencies, Innsbruck Medical University Hospital. Results: Overall, 781 cases of sudden cardiac arrest in the Austrian mountains were recorded. In 136 cases (17%), CPR with AED was attempted. The most frequent activities at the time of sudden cardiac arrest were hiking (n = 63, 46%) and skiing or snowboarding (n = 44, 32%). In the nationwide Austrian Alpine Police database, only 4 (3%) patients survived, whereas in the Innsbruck Medical University Hospital database, there were seven survivors who received CPR and AED. All survivors had received immediate CPR with an AED. Five patients had good neurological outcome (cerebral performance category 1-2). Conclusions: In the Austrian mountains, CPR was attempted in less than 20% of sudden cardiac arrest cases. The few that survived had received immediate CPR with an AED. To better understand the circumstances and outcome of sudden cardiac arrest in the mountains, out-of hospital and in-hospital data should be linked.
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Affiliation(s)
- Mathias Ströhle
- Department of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Vögele
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Paul Neuhauser
- Department of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Simon Rauch
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine, Paracelsus Medical University Salzburg, Hospitallers Brothers Hospital, Salzburg, Austria
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Rossi VA, Schmied C, Niebauer J, Niederseer D. Cardiovascular effects and risks of recreational alpine skiing in the elderly. J Sci Med Sport 2019; 22 Suppl 1:S27-S33. [PMID: 30772188 DOI: 10.1016/j.jsams.2019.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 11/14/2018] [Accepted: 01/22/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Alpine skiing is one of the most popular recreational winter sports and attracts millions of tourists every year alone in the Alpine region. Several studies highlight the positive effects of alpine skiing as aerobic physical training and isometric muscle activity that is able to increase exercise capacity and reduce cardiovascular risk factors. However, a certain cardiovascular risk mainly related to an abrupt increase of myocardial oxygen consumption during skiing especially in otherwise sedentary subjects and effects of hypoxia in untrained patients have to be acknowledged. DESIGN In this article, we provide an up-to-date evaluation of risks and benefits of alpine skiing in relation of cardiovascular disease and elderly persons. METHODS Narrative Review. RESULTS In the first section, the current recommendations of physical activity and effects of alpine skiing - with particular attention to the elderly population - are described. In the second section, the present knowledge regarding cardiovascular risk and alpine skiing is summarized and possible pathophysiological mechanisms are highlighted. Finally, a summary regarding actual clinical recommendations is provided. CONCLUSIONS Alpine skiing may safely be recommended also to the elderly if certain precautions are applied, as the benefits outbalance the potential risks in most subjects.
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Affiliation(s)
- Valentina Alice Rossi
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland.
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Gasser B. [The Older the Hiker, the More Severe the Injury - a Retrospective Analysis of Mountain Hiking Accidents in the Swiss Alps from 2009 to 2018]. PRAXIS 2019; 108:1065-1071. [PMID: 31822226 DOI: 10.1024/1661-8157/a003328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Older the Hiker, the More Severe the Injury - a Retrospective Analysis of Mountain Hiking Accidents in the Swiss Alps from 2009 to 2018 Abstract. Hiking is a regular activity of the elderly, however, the question of a relationship between age and the severity of a mountaineering accident is still unanswered. A total of 10 185 hikers was analyzed between the years 2009 and 2018. For every mountain accident, the NACA score was available allowing to conduct regression analysis between age and NACA scores. The results show that elderly hikers had higher NACA scores compared to younger ones, implying more severe events in the elderly. The tendency of more severe mountain accidents can be attributed to several reasons. Especially emphasized should be falls that are probably favoured by the age-dependent decrease of postural stability, turning a fall into a downfall, predisposing more severe events.
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Affiliation(s)
- Benedikt Gasser
- Swiss Health & Performance Lab, Institut für Anatomie, Universität Bern
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18
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Church BJ, Daniel NJ. Elevation 3 mm: A Case of a Cardiac Emergency and Rescue on Mount Monadnock. Wilderness Environ Med 2018; 29:125-131. [PMID: 29331297 DOI: 10.1016/j.wem.2017.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/19/2017] [Accepted: 08/23/2017] [Indexed: 11/17/2022]
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Faulhaber M, Pocecco E, Niedermeier M, Ruedl G, Walter D, Sterr R, Ebner H, Schobersberger W, Burtscher M. Fall-related accidents among hikers in the Austrian Alps: a 9-year retrospective study. BMJ Open Sport Exerc Med 2017; 3:e000304. [PMID: 29259815 PMCID: PMC5728251 DOI: 10.1136/bmjsem-2017-000304] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 01/08/2023] Open
Abstract
Objective To analyse the circumstances of fatal and non-fatal mountain hiking accidents caused by falls. Methods The study was designed as a retrospective analysis. Mountain hiking accidents caused by falls were documented during a 9-year period (2006–2014). After screening of all data for potential exclusion criteria the final sample size of 5368 accidents and 5665 victims was included into the analyses. Main outcome measures were details about accidents, victims, type of trail and surface. Results The annual number of accidents showed a continuous increase from 467 in 2006 to 700 in 2014. In total, 5.8% of all victims died during the 9-year period. 75.3% of the hikers fell during descent and 80.9% of the victims had their accident on a marked hiking trail or small path. The sex ratio for non-fatal accidents was 55% female and 45% male; for fatal accidents the female-to-male ratio was 28%:72%. Mean age of all victims was 52.5±17.5 years and victims of fatalities were about 5 years older compared with victims of non-fatal accidents (57.5±16.5 vs 52.2±17.5 years, P<0.01). Conclusion Descent is the most risky part for accidents caused by falls during mountain hiking. Male hikers are at greater risk for fatalities independent of age and this is associated with accidents occurring in pathless terrain. The death rate from falls was 6%. We recommend a critical self-assessment of the individual capabilities and mountain hiking skills and adequate planning of the hiking tours for mountain hikers.
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Affiliation(s)
- Martin Faulhaber
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Elena Pocecco
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Regina Sterr
- Austrian Board of Alpine Safety, Innsbruck, Austria
| | - Hans Ebner
- Austrian Alpine Police/Ministry of the Interior, Vienna, Austria
| | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), Tirol Kliniken GmbH, Innsbruck, Austria.,Institute of Sports Medicine, Health Tourism and Leisure Sciences, Private University for Health Sciences, Medical Informatics and Technology (UMIT), Hall, Austria
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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20
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Keyes LE, Sallade TD, Duke C, Starling J, Sheets A, Pant S, Young DS, Twillman D, Regmi N, Phelan B, Paudel P, McElwee M, Mather L, Cole D, McConnell T, Basnyat B. Blood Pressure and Altitude: An Observational Cohort Study of Hypertensive and Nonhypertensive Himalayan Trekkers in Nepal. High Alt Med Biol 2017; 18:267-277. [DOI: 10.1089/ham.2017.0001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Linda E. Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado
- Longmont United Hospital, Longmont, Colorado
| | | | - Charles Duke
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Jennifer Starling
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado
- Colorado Permanente Medical Group, Saint Joseph Hospital, Denver, Colorado
| | | | - Sushil Pant
- Mountain Medicine Society of Nepal and Kunde Hospital, Kathmandu, Nepal
| | - David S. Young
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| | - David Twillman
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado
| | - Nirajan Regmi
- Mountain Medicine Society of Nepal, Kathmandu, Nepal
| | | | - Purshotam Paudel
- Mountain Medical Society of Nepal and District Hospital, Dhading, Nepal
| | - Matthew McElwee
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Luke Mather
- Family Medicine Residency of Idaho, Boise, Idaho
- University of Washington School of Medicine, Seattle, Washington
| | - Devlin Cole
- Kapiolani Women and Children's Hospital, Honolulu, Hawaii
| | | | - Buddha Basnyat
- Oxford University Clinical Research Unit-Nepal, Nepal and Nepal International Clinic, Kathmandu, Nepal
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
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21
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Sustainability and Mountain Tourism: The Millennial’s Perspective. SUSTAINABILITY 2017. [DOI: 10.3390/su9071219] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Gatterer H, Raab C, Pramsohler S, Faulhaber M, Burtscher M, Netzer N. Effect of weekly hiking on cardiovascular risk factors in the elderly. Z Gerontol Geriatr 2015; 48:150-3. [PMID: 24609428 DOI: 10.1007/s00391-014-0622-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Hiking is one of the most popular activities among the elderly in Alpine regions. Due to the long-lasting, moderately intensive nature of this form of physical activity, hiking is generally considered to be beneficial to health. However, it is currently unclear whether once-weekly hiking--as commonly practiced at weekends--really does yield such positive effects in elderly persons aged 60 years and over. OBJECTIVES This study investigated the effect of a single weekly mountain hiking session on cardiovascular risk factors. MATERIALS AND METHODS A 9-month mountain hiking program was completed by 14 male (age 65.6 ± 2.7 years) and 10 female (age 66.2 ± 4.4 years) elderly participants. The program consisted of a single weekly hiking session with the goal of achieving a 500-m altitude increase within 3 h. Before and after the 9-month program, an electrocardiogram (ECG) was performed and blood pressure, glycated hemoglobin (HbA1c), high-density (HDL) and low-density lipoprotein (LDL) measurements were made. RESULTS The elderly participants showed a normal cardiovascular risk profile at the start of the investigation. The estimated net energy expenditure for one hiking session was approximately 521 ± 91 kcal. Over the 9-month period, no changes were found in any of the investigated parameters for the entire group. However, participants with untreated hypertension showed a reduced systolic blood pressure. CONCLUSION The present investigation showed that moderate-intensity activity only at weekends does not improve cardiovascular risk factors in elderly persons with a relatively normal cardiovascular risk profile. Conversely, elderly persons suffering from hypertension might profit from such a practice.
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Affiliation(s)
- H Gatterer
- Department of Sport Science, University Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria,
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23
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Parati G, Ochoa JE, Torlasco C, Salvi P, Lombardi C, Bilo G. Aging, High Altitude, and Blood Pressure: A Complex Relationship. High Alt Med Biol 2015; 16:97-109. [DOI: 10.1089/ham.2015.0010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Gianfranco Parati
- Cardiovascular Medicine, Department of Health Sciences, University of Milan-Bicocca, Milan, Italy
- Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Juan Eugenio Ochoa
- Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Camilla Torlasco
- Cardiovascular Medicine, Department of Health Sciences, University of Milan-Bicocca, Milan, Italy
- Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Paolo Salvi
- Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Carolina Lombardi
- Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Grzegorz Bilo
- Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Santantonio M, Chapplain JM, Tattevin P, Leroy H, Mener E, Gangneux JP, Michelet C, Revest M. Prevalence of and risk factors for acute mountain sickness among a cohort of high-altitude travellers who received pre-travel counselling. Travel Med Infect Dis 2014; 12:534-40. [DOI: 10.1016/j.tmaid.2014.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 08/21/2014] [Accepted: 08/22/2014] [Indexed: 11/24/2022]
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25
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Pre-existing cardiovascular conditions and high altitude travel. Travel Med Infect Dis 2014; 12:237-52. [DOI: 10.1016/j.tmaid.2014.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 02/09/2014] [Accepted: 02/19/2014] [Indexed: 12/28/2022]
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Seccombe LM, Peters MJ. Physiology in Medicine: Acute altitude exposure in patients with pulmonary and cardiovascular disease. J Appl Physiol (1985) 2014; 116:478-85. [DOI: 10.1152/japplphysiol.01013.2013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Travel is more affordable and improved high-altitude airports, railways, and roads allow rapid access to altitude destinations without acclimatization. The physiology of exposure to altitude has been extensively described in healthy individuals; however, there is a paucity of data pertaining to those who have reduced reserve. This Physiology in Medicine article discusses the physiological considerations relevant to the safe travel to altitude and by commercial aircraft in patients with pulmonary and/or cardiac disease.
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Affiliation(s)
- Leigh M. Seccombe
- Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Australia; and
- Thoracic Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Matthew J. Peters
- Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Australia; and
- Thoracic Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
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27
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Considerations for resuscitation at high altitude in elderly and untrained populations and rescuers. Am J Emerg Med 2014; 32:270-6. [DOI: 10.1016/j.ajem.2013.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 11/04/2013] [Accepted: 11/05/2013] [Indexed: 12/21/2022] Open
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Aortic dissection type A in alpine skiers. BIOMED RESEARCH INTERNATIONAL 2013; 2013:192459. [PMID: 23971024 PMCID: PMC3736490 DOI: 10.1155/2013/192459] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 06/13/2013] [Accepted: 06/26/2013] [Indexed: 11/17/2022]
Abstract
PATIENTS AND METHODS 140 patients with aortic dissection type A were admitted for cardiac surgery. Seventy-seven patients experienced their dissection in the winter season (from November to April). We analyzed cases of ascending aortic dissection associated with alpine skiing. RESULTS In 17 patients we found skiing-related aortic dissections. Skiers were taller (180 (172-200) cm versus 175 (157-191) cm, P = 0.008) and heavier (90 (68-125) kg versus 80 (45-110) kg, P = 0.002) than nonskiers. An extension of aortic dissection into the aortic arch, the descending thoracic aorta, and the abdominal aorta was found in 91%, 74%, and 69%, respectively, with no significant difference between skiers and nonskiers. Skiers experienced RCA ostium dissection requiring CABG in 17.6% while this was true for 5% of nonskiers (P = 0.086). Hospital mortality of skiers was 6% versus 13% in nonskiers (P = 0.399). The skiers live at an altitude of 170 (0-853) m.a.s.l. and experience their dissection at 1602 (1185-3105; P < 0.001) m.a.s.l. In 82% symptom start was during recreational skiing without any trauma. CONCLUSION Skiing associated aortic dissection type A is usually nontraumatic. The persons affected live at low altitudes and practice an outdoor sport at unusual high altitude at cold temperatures. Postoperative outcome is good.
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Niederseer D, Ledl-Kurkowski E, Kvita K, Patsch W, Dela F, Mueller E, Niebauer J. Salzburg Skiing for the Elderly Study: changes in cardiovascular risk factors through skiing in the elderly. Scand J Med Sci Sports 2011; 21 Suppl 1:47-55. [PMID: 21679323 DOI: 10.1111/j.1600-0838.2011.01341.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Numerous studies have shown that treatment of the modifiable cardiovascular risk factors (CVRF) results in a decreased risk to suffer from stroke or myocardial infarction. Despite the fact that exercise training is a potent treatment choice for CVRF, this is the first randomized study to assess the effects of alpine skiing on CVRF in elderly skiers. Subjects (n=42) were randomized into an intervention group (IG; n=22; 12 males/10 females; age: 66.6 ± 2.1 years) completing 12 weeks of guided skiing or a control group (CG; n=20; 10 males/10 females; age: 67.3 ± 4.4 years). CVRF were assessed before and after the intervention period. No cardiovascular event occurred within a total of 795.1 h of skiing. A significant increase in exercise capacity in IG (ΔVO(2 max) : +2.0 mL/kg/min, P=0.005) but not in CG (ΔVO(2 max) : -0.1 mL/kg/min, P=0.858; IG vs CG: P=0.008) as well as a decrease in body fat mass [IG: -2.3%, P<0.0001; CG: ± 0.0%, P=0.866; IG vs CG: P<0.0001] was achieved. Blood pressure, blood lipids, heart rate and everyday physical activity remained essentially unchanged. Alpine skiing in the elderly is safe with respect to cardiovascular events, and improves some, but not all CVRF.
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Affiliation(s)
- D Niederseer
- Department of Sports Medicine, Prevention and Rehabilitation, Institute of Sports Medicine of the State of Salzburg, Paracelsus Medical University Salzburg, Sports Medicine of Olympic Center Salzburg-Rif, Sulzburg, Austria
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Faulhaber M, Gatterer H, Burtscher M. Preexisting cardiovascular diseases among high-altitude mountaineers in the alps. J Travel Med 2011; 18:355-7. [PMID: 21896101 DOI: 10.1111/j.1708-8305.2011.00536.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This survey evaluated the prevalence of cardiovascular diseases (CVD) among high-altitude mountaineers (n = 473). The prevalence of CVD amounted to 7.4% and increased with age. Hypertension was the most frequent type of CVD. However, the recorded frequency of CVD in high-altitude mountaineers is lower compared to hikers and alpine skiers.
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Affiliation(s)
- Martin Faulhaber
- Department of Sport Science, University Innsbruck, Innsbruck, Austria.
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Chacornac M, Baronne-Rochette G, Schmidt MH, Savary D, Habold D, Bouvaist H, Marliere S, Belle L, Machecourt J, Vanzetto G. Characteristics and management of acute ST-segment elevation myocardial infarctions occurring in ski resorts in the French Alps: Impact of an acute coronary care network. Arch Cardiovasc Dis 2010; 103:460-8. [DOI: 10.1016/j.acvd.2010.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 09/02/2010] [Accepted: 09/06/2010] [Indexed: 10/18/2022]
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Luks AM. Should Travelers with Hypertension Adjust Their Medications When Traveling to High Altitude? High Alt Med Biol 2009; 10:11-5. [DOI: 10.1089/ham.2008.1076] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Andrew M. Luks
- Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA
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