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The effect of high altitude on central blood pressure and arterial stiffness

Journal of Human Hypertension volume 31, pages 715–719 (2017)Cite this article

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Abstract

Central arterial systolic blood pressure (SBP) and arterial stiffness are known to be better predictors of adverse cardiovascular outcomes than brachial SBP. The effect of progressive high altitude (HA) on these parameters has not been examined. Ninety healthy adults were included. Central BP and the augmentation index (AI) were measured at the level of the brachial artery (Uscom BP+ device) at <200 m and at 3619, 4600 and 5140 m. The average age of the subjects (70% men) were 32.2±8.7 years. Compared with central arterial pressures, brachial SBP (+8.1±6.4 mm Hg; P<0.0001) and pulse pressure (+10.9±6.6 mm Hg; P<0.0001) were significantly higher and brachial diastolic BP was lower (−2.8±1.6 mm Hg; P<0.0001). Compared with <200 m, HA led to a significant increase in brachial and central SBP. Central SBP correlated with AI (r=0.50; 95% confidence interval (CI): 0.41–0.58; P<0.0001) and age (r=0.32; 95% CI: 21–0.41; P<0.001). AI positively correlated with age (r=0.39; P<0.001) and inversely with subject height (r=−0.22; P<0.0001), weight (r=−0.19; P=0.006) and heart rate (r=−0.49; P<0.0001). There was no relationship between acute mountain sickness scores (Lake Louis Scoring System (LLS)) and AI or central BP. The independent predictors of central SBP were male sex (coefficient, t=4.7; P<0.0001), age (t=3.6; P=0.004) and AI (t=7.5; P<0.0001; overall r2=0.40; P<0.0001). Subject height (t=2.4; P=0.02), age (7.4; P<0.0001) and heart rate (t=11.4; P<0.0001) were the only independent predictors of AI (overall r2=0.43; P<0.0001). Central BP and AI significantly increase at HA. This rise was influenced by subject-related factors and heart rate but not independently by altitude, LLS or SpO2.

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Acknowledgements

We acknowledge and thank the staff in the Department of Cardiology at Poole Hospital for their support. We are extremely grateful to the subjects for their time and for volunteering to take part in this study.

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Authors and Affiliations

  1. Department of Cardiology, Poole Hospital NHS Foundation Trust, Leeds Beckett and Bournemouth Universities, Poole, UK

    C J Boos

  2. Department of Postgraduate Medical Education, Bournemouth University, Bournemouth, UK

    C J Boos

  3. Research Institute, For Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK

    C J Boos, A Mellor, D R Woods, M Barlow, M Cooke, K Deighton, S Clarke & J O'Hara

  4. Defence Medical Services, Lichfield, UK

    E Vincent, A Mellor, D R Woods, C New, R Cruttenden & P Scott

  5. James Cook University Hospital, Middlesbrough, UK

    A Mellor

  6. Northumbria and Newcastle NHS Trusts, Wansbeck General and Royal Victoria Infirmary, Newcastle upon Tyne, UK

    D R Woods

  7. University of Newcastle, Newcastle upon Tyne, UK

    D R Woods

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  1. C J Boos
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Correspondence to C J Boos.

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Boos, C., Vincent, E., Mellor, A. et al. The effect of high altitude on central blood pressure and arterial stiffness. J Hum Hypertens 31, 715–719 (2017). https://doi.org/10.1038/jhh.2017.40

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