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Mutschler T, Furian M, Lichtblau M, Buergin A, Schneider SR, Appenzeller P, Mayer L, Muralt L, Mademilov M, Abdyraeva A, Aidaralieva S, Muratbekova A, Akylbekov A, Shabykeeva S, Sooronbaev TM, Ulrich S, Bloch KE. Effect of altitude and acetazolamide on postural control in healthy lowlanders 40 years of age or older. Randomized, placebo-controlled trial. Front Physiol 2024; 14:1274111. [PMID: 38250659 PMCID: PMC10797772 DOI: 10.3389/fphys.2023.1274111] [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: 08/07/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
Background: Hypoxia and old age impair postural control and may therefore enhance the risk of accidents. We investigated whether acetazolamide, the recommended drug for prevention of acute mountain sickness, may prevent altitude-induced deterioration of postural control in older persons. Methods: In this parallel-design trial, 95 healthy volunteers, 40 years of age or older, living <1,000 m, were randomized to preventive therapy with acetazolamide (375 mg/d) or placebo starting 24 h before and during a 2-day sojourn at 3,100 m. Instability of postural control was quantified by a balance platform with the center of pressure path length (COPL) as primary outcome while pulse oximetry (SpO2) was monitored. Effects of altitude and treatment on COPL were evaluated by ordered logistic regression. www.ClinicalTrials.gov NCT03536429. Results: In participants taking placebo, ascent from 760 m to 3,100 m increased median COPL from 25.8 cm to 27.6 cm (odds ratio 3.80, 95%CI 2.53-5.70) and decreased SpO2 from 96% to 91% (odds ratio 0.0003, 95%CI 0.0002-0.0007); in participants taking acetazolamide, altitude ascent increased COPL from 24.6 cm to 27.3 cm (odds ratio 2.22, 95%CI 1.57-3.13), while SpO2 decreased from 96% to 93% (odds ratio 0.007, 95%CI 0.004-0.012). Altitude-induced increases in COPL were smaller with acetazolamide vs. placebo (odds ratio 0.58, 95%CI 0.34-0.99) while drops in SpO2 were mitigated (odds ratio 19.2, 95%CI 9.9-37.6). Conclusion: In healthy individuals, 40 years of age or older, postural control was impaired after spending a night at 3,100 m. The altitude-induced deterioration of postural control was mitigated by acetazolamide, most likely due to the associated improvement in oxygenation.
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Affiliation(s)
- Tim Mutschler
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Michael Furian
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Mona Lichtblau
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Aline Buergin
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Simon R. Schneider
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Paula Appenzeller
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Laura Mayer
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Lara Muralt
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Maamed Mademilov
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Ainura Abdyraeva
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Shoira Aidaralieva
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Aibermet Muratbekova
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Azamat Akylbekov
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Saltanat Shabykeeva
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Talant M. Sooronbaev
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Silvia Ulrich
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
| | - Konrad E. Bloch
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Bishkek, Kyrgyzstan
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