Altitude-Induced Pulmonary Hypertension on One-Day Rapid Ascent of Mount Fuji: Incidence and Therapeutic Effects of Sildenafil

Echocardiography. 2016 Jun;33(6):838-43. doi: 10.1111/echo.13189. Epub 2016 Feb 21.

Abstract

Aims: Exposure to high altitudes especially with rapid ascent may induce hypoxic pulmonary vasoconstriction (HPV) and pulmonary hypertension (PH) possibly leading to life-threatening high-altitude pulmonary edema (HAPE). The aim of the study was to evaluate the incidence of PH on a 1-day rapid ascent up Mount Fuji (3775 m) in recreational climbers and also to determine the effectiveness of sildenafil for this rapid ascent-induced PH as measured by echocardiography.

Methods and results: Twenty-five subjects who climbed Mount Fuji showed significantly increased pulmonary artery systolic pressure (PASP) from 22.3 ± 5.3 mmHg at sea level to 29.4 ± 8.7 mmHg at 3775 m. Five subjects showed PASP >35 mmHg (35.6-46.2 mmHg, average 42.0 ± 3.9 mmHg) and took oral sildenafil 50 mg after which PASP decreased significantly to 24.5 ± 4.6 mmHg (18.7-31.0 mmHg) after 30 minutes.

Conclusions: One-day rapid ascent of Mount Fuji may induce mild-to-moderate PH and intervention with sildenafil can reduce this PH, suggesting that the therapeutic use of sildenafil would be more reasonable for the relatively infrequent occurrence of altitude-induced PH than its prophylactic use.

Keywords: altitude illness; echocardiography; pulmonary artery pressure.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Altitude
  • Altitude Sickness / diagnostic imaging
  • Altitude Sickness / drug therapy*
  • Altitude Sickness / epidemiology*
  • Antihypertensive Agents / administration & dosage
  • Echocardiography / statistics & numerical data
  • Female
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging
  • Hypertension, Pulmonary / epidemiology*
  • Hypertension, Pulmonary / prevention & control*
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Mountaineering / statistics & numerical data*
  • Risk Factors
  • Sildenafil Citrate / administration & dosage*
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage

Substances

  • Antihypertensive Agents
  • Vasodilator Agents
  • Sildenafil Citrate