Sildenafil and Exercise Capacity in the Elderly at Moderate Altitude

George W Rodway, Anne J. Lovelace, Michael J. Lanspa, Scott E. McIntosh, James Bell, Ben Briggs, Lindell K. Weaver, Frank Yanowitz, Colin K. Grissom

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective Hypobaric hypoxia decreases exercise capacity and causes hypoxic pulmonary vasoconstriction and pulmonary hypertension. The phosphodiesterase-5 inhibitor sildenafil is a pulmonary vasodilator that may improve exercise capacity at altitude. We aimed to determine whether sildenafil improves exercise capacity, measured as maximal oxygen consumption (peak Vo2), at moderate altitude in adults 60 years or older. Methods The design was a randomized, double-blind, placebo-controlled, crossover study. After baseline cardiopulmonary exercise testing at 1400 m, 12 healthy participants (4 women) aged 60 years or older, who reside permanently at approximately 1400 m and are regularly active in self-propelled mountain recreation above 2000 m, performed maximal cardiopulmonary cycle exercise tests in a hypobaric chamber at a simulated altitude of 2750 m after ingesting sildenafil and after ingesting a placebo. Results After placebo, mean peak Vo2 was significantly lower at 2750 m than 1400 m: 37.0 mL · kg-1 · min-1 (95% CI, 32.7 to 41.3) vs 39.1 mL · kg-1 · min-1 (95% CI, 33.5 to 44.7; P =.020). After placebo, there was no difference in heart rate (HR) or maximal workload at either altitude (z = 0.182; P =.668, respectively). There was no difference between sildenafil and placebo at 2750 m in peak Vo2 (P =.668), O2 pulse (P =.476), cardiac index (P =.143), stroke volume index (z = 0.108), HR (z = 0.919), or maximal workload (P =.773). Transthoracic echocardiography immediately after peak exercise at 2750 m showed tricuspid annular plane systolic velocity was significantly higher after sildenafil than after placebo (P =.019), but showed no difference in tricuspid annular plane systolic excursion (P =.720). Conclusions Sildenafil (50 mg) did not improve exercise capacity in adults 60 years or older at moderate altitude in our study. This might be explained by a "dosing effect" or insufficiently high altitude.

Original languageEnglish (US)
Pages (from-to)307-315
Number of pages9
JournalWilderness and Environmental Medicine
Volume27
Issue number2
DOIs
StatePublished - Jun 1 2016

Fingerprint

Placebos
Exercise
Workload
Heart Rate
Phosphodiesterase 5 Inhibitors
Recreation
Lung
Vasoconstriction
Vasodilator Agents
Exercise Test
Pulmonary Hypertension
Oxygen Consumption
Stroke Volume
Cross-Over Studies
Echocardiography
Pulse
Sildenafil Citrate
Healthy Volunteers

Keywords

  • elderly
  • exercise
  • high altitude
  • peak Vo
  • sildenafil

ASJC Scopus subject areas

  • Emergency Medicine
  • Public Health, Environmental and Occupational Health

Cite this

Rodway, G. W., Lovelace, A. J., Lanspa, M. J., McIntosh, S. E., Bell, J., Briggs, B., ... Grissom, C. K. (2016). Sildenafil and Exercise Capacity in the Elderly at Moderate Altitude. Wilderness and Environmental Medicine, 27(2), 307-315. https://doi.org/10.1016/j.wem.2016.01.006

Sildenafil and Exercise Capacity in the Elderly at Moderate Altitude. / Rodway, George W; Lovelace, Anne J.; Lanspa, Michael J.; McIntosh, Scott E.; Bell, James; Briggs, Ben; Weaver, Lindell K.; Yanowitz, Frank; Grissom, Colin K.

In: Wilderness and Environmental Medicine, Vol. 27, No. 2, 01.06.2016, p. 307-315.

Research output: Contribution to journalArticle

Rodway, GW, Lovelace, AJ, Lanspa, MJ, McIntosh, SE, Bell, J, Briggs, B, Weaver, LK, Yanowitz, F & Grissom, CK 2016, 'Sildenafil and Exercise Capacity in the Elderly at Moderate Altitude', Wilderness and Environmental Medicine, vol. 27, no. 2, pp. 307-315. https://doi.org/10.1016/j.wem.2016.01.006
Rodway, George W ; Lovelace, Anne J. ; Lanspa, Michael J. ; McIntosh, Scott E. ; Bell, James ; Briggs, Ben ; Weaver, Lindell K. ; Yanowitz, Frank ; Grissom, Colin K. / Sildenafil and Exercise Capacity in the Elderly at Moderate Altitude. In: Wilderness and Environmental Medicine. 2016 ; Vol. 27, No. 2. pp. 307-315.
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abstract = "Objective Hypobaric hypoxia decreases exercise capacity and causes hypoxic pulmonary vasoconstriction and pulmonary hypertension. The phosphodiesterase-5 inhibitor sildenafil is a pulmonary vasodilator that may improve exercise capacity at altitude. We aimed to determine whether sildenafil improves exercise capacity, measured as maximal oxygen consumption (peak Vo2), at moderate altitude in adults 60 years or older. Methods The design was a randomized, double-blind, placebo-controlled, crossover study. After baseline cardiopulmonary exercise testing at 1400 m, 12 healthy participants (4 women) aged 60 years or older, who reside permanently at approximately 1400 m and are regularly active in self-propelled mountain recreation above 2000 m, performed maximal cardiopulmonary cycle exercise tests in a hypobaric chamber at a simulated altitude of 2750 m after ingesting sildenafil and after ingesting a placebo. Results After placebo, mean peak Vo2 was significantly lower at 2750 m than 1400 m: 37.0 mL · kg-1 · min-1 (95{\%} CI, 32.7 to 41.3) vs 39.1 mL · kg-1 · min-1 (95{\%} CI, 33.5 to 44.7; P =.020). After placebo, there was no difference in heart rate (HR) or maximal workload at either altitude (z = 0.182; P =.668, respectively). There was no difference between sildenafil and placebo at 2750 m in peak Vo2 (P =.668), O2 pulse (P =.476), cardiac index (P =.143), stroke volume index (z = 0.108), HR (z = 0.919), or maximal workload (P =.773). Transthoracic echocardiography immediately after peak exercise at 2750 m showed tricuspid annular plane systolic velocity was significantly higher after sildenafil than after placebo (P =.019), but showed no difference in tricuspid annular plane systolic excursion (P =.720). Conclusions Sildenafil (50 mg) did not improve exercise capacity in adults 60 years or older at moderate altitude in our study. This might be explained by a {"}dosing effect{"} or insufficiently high altitude.",
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AU - Bell, James

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AU - Grissom, Colin K.

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N2 - Objective Hypobaric hypoxia decreases exercise capacity and causes hypoxic pulmonary vasoconstriction and pulmonary hypertension. The phosphodiesterase-5 inhibitor sildenafil is a pulmonary vasodilator that may improve exercise capacity at altitude. We aimed to determine whether sildenafil improves exercise capacity, measured as maximal oxygen consumption (peak Vo2), at moderate altitude in adults 60 years or older. Methods The design was a randomized, double-blind, placebo-controlled, crossover study. After baseline cardiopulmonary exercise testing at 1400 m, 12 healthy participants (4 women) aged 60 years or older, who reside permanently at approximately 1400 m and are regularly active in self-propelled mountain recreation above 2000 m, performed maximal cardiopulmonary cycle exercise tests in a hypobaric chamber at a simulated altitude of 2750 m after ingesting sildenafil and after ingesting a placebo. Results After placebo, mean peak Vo2 was significantly lower at 2750 m than 1400 m: 37.0 mL · kg-1 · min-1 (95% CI, 32.7 to 41.3) vs 39.1 mL · kg-1 · min-1 (95% CI, 33.5 to 44.7; P =.020). After placebo, there was no difference in heart rate (HR) or maximal workload at either altitude (z = 0.182; P =.668, respectively). There was no difference between sildenafil and placebo at 2750 m in peak Vo2 (P =.668), O2 pulse (P =.476), cardiac index (P =.143), stroke volume index (z = 0.108), HR (z = 0.919), or maximal workload (P =.773). Transthoracic echocardiography immediately after peak exercise at 2750 m showed tricuspid annular plane systolic velocity was significantly higher after sildenafil than after placebo (P =.019), but showed no difference in tricuspid annular plane systolic excursion (P =.720). Conclusions Sildenafil (50 mg) did not improve exercise capacity in adults 60 years or older at moderate altitude in our study. This might be explained by a "dosing effect" or insufficiently high altitude.

AB - Objective Hypobaric hypoxia decreases exercise capacity and causes hypoxic pulmonary vasoconstriction and pulmonary hypertension. The phosphodiesterase-5 inhibitor sildenafil is a pulmonary vasodilator that may improve exercise capacity at altitude. We aimed to determine whether sildenafil improves exercise capacity, measured as maximal oxygen consumption (peak Vo2), at moderate altitude in adults 60 years or older. Methods The design was a randomized, double-blind, placebo-controlled, crossover study. After baseline cardiopulmonary exercise testing at 1400 m, 12 healthy participants (4 women) aged 60 years or older, who reside permanently at approximately 1400 m and are regularly active in self-propelled mountain recreation above 2000 m, performed maximal cardiopulmonary cycle exercise tests in a hypobaric chamber at a simulated altitude of 2750 m after ingesting sildenafil and after ingesting a placebo. Results After placebo, mean peak Vo2 was significantly lower at 2750 m than 1400 m: 37.0 mL · kg-1 · min-1 (95% CI, 32.7 to 41.3) vs 39.1 mL · kg-1 · min-1 (95% CI, 33.5 to 44.7; P =.020). After placebo, there was no difference in heart rate (HR) or maximal workload at either altitude (z = 0.182; P =.668, respectively). There was no difference between sildenafil and placebo at 2750 m in peak Vo2 (P =.668), O2 pulse (P =.476), cardiac index (P =.143), stroke volume index (z = 0.108), HR (z = 0.919), or maximal workload (P =.773). Transthoracic echocardiography immediately after peak exercise at 2750 m showed tricuspid annular plane systolic velocity was significantly higher after sildenafil than after placebo (P =.019), but showed no difference in tricuspid annular plane systolic excursion (P =.720). Conclusions Sildenafil (50 mg) did not improve exercise capacity in adults 60 years or older at moderate altitude in our study. This might be explained by a "dosing effect" or insufficiently high altitude.

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