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 language | English (US) |
|---|---|
| Pages (from-to) | 307-315 |
| Number of pages | 9 |
| Journal | Wilderness and Environmental Medicine |
| Volume | 27 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jun 1 2016 |
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Keywords
- elderly
- exercise
- high altitude
- peak Vo
- sildenafil
ASJC Scopus subject areas
- Emergency Medicine
- Public Health, Environmental and Occupational Health
Cite this
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 journal › Article
}
TY - JOUR
T1 - Sildenafil and Exercise Capacity in the Elderly at Moderate Altitude
AU - Rodway, George W
AU - Lovelace, Anne J.
AU - Lanspa, Michael J.
AU - McIntosh, Scott E.
AU - Bell, James
AU - Briggs, Ben
AU - Weaver, Lindell K.
AU - Yanowitz, Frank
AU - Grissom, Colin K.
PY - 2016/6/1
Y1 - 2016/6/1
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.
KW - elderly
KW - exercise
KW - high altitude
KW - peak Vo
KW - sildenafil
UR - http://www.scopus.com/inward/record.url?scp=84964194078&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84964194078&partnerID=8YFLogxK
U2 - 10.1016/j.wem.2016.01.006
DO - 10.1016/j.wem.2016.01.006
M3 - Article
C2 - 27116921
AN - SCOPUS:84964194078
VL - 27
SP - 307
EP - 315
JO - Wilderness and Environmental Medicine
JF - Wilderness and Environmental Medicine
SN - 1080-6032
IS - 2
ER -