Skip to main content
SpringerLink
Log in

Hypertension at High Altitude

  • Chapter
  • First Online:
Translational Research in Environmental and Occupational Stress

  • 627 Accesses

Abstract

Systemic hypoxia is associated with conditions like anemia, lung diseases, sleep disorders, breathing, and exposure to high altitude. The physiological responses including blood pressure regulation to acute, chronic, intermittent normobaric, and hypobaric hypoxia have been under intense investigation for the past many years; however, the regulatory mechanisms are incompletely understood. The available literature indicates a differential response to hypoxia in pulmonary versus systemic circulation. Multiple physiological and metabolic changes contribute towards high-altitude acclimatization; yet, in some individuals, exposure to high altitude could be life threatening due to maladaptation. There are a few studies on the prevalence of hypertension in high-altitude natives and sea-level dwellers exposed to high altitude (acute and chronic). Elevated blood pressure is an established risk factor for different cardiovascular disease and the evidence suggests that the blood pressure rises to a modest extent in patients with mild to moderate hypertension upon acute ascent to high altitude (Luks et al., Congenit Heart Dis 5:220–232, 2010), but there is no clear evidence on increased risk of complications due to increased systemic blood pressures. This book chapter reviews available literature on systemic blood pressure responses to high altitude.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Luks AM, Stout K, Swenson ER (2010) Evaluating the safety of high-altitude travel in patients with adult congenital heart disease. Congenit Heart Dis 5:220–232

    Article  PubMed  Google Scholar 

  2. Higgins JP, Tuttle T, Higgins JA (2010) Altitude and the heart: is going high safe for your cardiac patient? Am Heart J 159:25–32

    Article  PubMed  Google Scholar 

  3. Calbet JA, Boushel R, Radegran G, Sondergaard H, Wagner PD, Saltin B (2003) Why is VO2 max after altitude acclimatization still reduced despite normalization of arterial O2 content? Am J Physiol Regul Integr Comp Physiol 284:R304–R316

    PubMed  CAS  Google Scholar 

  4. Curran LS, Zhuang J, Sun SF, Moore LG (1997) Ventilation and hypoxic ventilatory responsiveness in Chinese-Tibetan residents at 3,658 m. J Appl Physiol 83:2098–2104

    PubMed  CAS  Google Scholar 

  5. Penaloza D, Arias-Stella J (2007) The heart and pulmonary circulation at high altitudes: healthy highlanders and chronic mountain sickness. Circulation 115:1132–1146

    Article  PubMed  Google Scholar 

  6. Zhuang J, Droma T, Sun S, Janes C, McCullough RE, McCullough RG, Cymerman A, Huang SY, Reeves JT, Moore LG (1993) Hypoxic ventilatory responsiveness in Tibetan compared with Han residents of 3,658 m. J Appl Physiol 74:303–311

    PubMed  CAS  Google Scholar 

  7. Wolfel EE, Selland MA, Mazzeo RS, Reeves JT (1994) Systemic hypertension at 4,300 m is related to sympathoadrenal activity. J Appl Physiol 76:1643–1650

    PubMed  CAS  Google Scholar 

  8. Mazzeo RS, Reeves JT (2003) Adrenergic contribution during acclimatization to high altitude: perspectives from Pikes Peak. Exerc Sport Sci Rev 31:13–18

    Article  PubMed  Google Scholar 

  9. Weisbrod CJ, Minson CT, Joyner MJ, Halliwill JR (2001) Effects of regional phentolamine on hypoxic vasodilatation in healthy humans. J Physiol 537:613–621

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Marshall JM (2000) Adenosine and muscle vasodilatation in acute systemic hypoxia. Acta Physiol Scand 168:561–573

    Article  PubMed  CAS  Google Scholar 

  11. Markwald RR, Kirby BS, Crecelius AR, Carlson RE, Voyles WF, Dinenno FA (2011) Combined inhibition of nitric oxide and vasodilating prostaglandins abolishes forearm vasodilatation to systemic hypoxia in healthy humans. J Physiol 589:1979–1990

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  12. Blitzer ML, Loh E, Roddy MA, Stamler JS, Creager MA (1996) Endothelium-derived nitric oxide regulates systemic and pulmonary vascular resistance during acute hypoxia in humans. J Am Coll Cardiol 28:591–596

    Article  PubMed  CAS  Google Scholar 

  13. Janocha AJ, Koch CD, Tiso M, Ponchia A, Doctor A, Gibbons L, Gaston B, Beall CM, Erzurum SC (2011) Nitric oxide during altitude acclimatization. N Engl J Med 365:1942–1944

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  14. Lugliani R, Whipp BJ, Wasserman K (1973) A role for the carotid body in cardiovascular control in man. Chest 63:744–750

    Article  PubMed  CAS  Google Scholar 

  15. Kaufmann PA, Schirlo C, Pavlicek V, Berthold T, Burger C, von Schulthess GK, Koller EA, Buck A (2001) Increased myocardial blood flow during acute exposure to simulated altitudes. J Nucl Cardiol 8:158–164

    Article  PubMed  CAS  Google Scholar 

  16. Daugherty RM Jr, Scott JB, Dabney JM, Haddy FJ (1967) Local effects of O2 and CO2 on limb, renal, and coronary vascular resistances. Am J Physiol 213:1102–1110

    PubMed  Google Scholar 

  17. Heistad DD, Abboud FM, Mark AL, Schmid PG (1975) Effect of hypoxemia on responses to norepinephrine and angiotensin in coronary and muscular vessels. J Pharmacol Exp Ther 193:941–950

    PubMed  CAS  Google Scholar 

  18. Rimoldi SF, Sartori C, Seiler C, Delacretaz E, Mattle HP, Scherrer U, Allemann Y (2010) High-altitude exposure in patients with cardiovascular disease: risk assessment and practical recommendations. Prog Cardiovasc Dis 52:512–524

    Article  PubMed  Google Scholar 

  19. Bosc LV, Resta T, Walker B, Kanagy NL (2010) Mechanisms of intermittent hypoxia induced hypertension. J Cell Mol Med 14:3–17

    Article  PubMed  Google Scholar 

  20. Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP (2010) Pathophysiology of sleep apnea. Physiol Rev 90:47–112

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. Kuo TB, Yuan ZF, Lin YS, Lin YN, Li WS, Yang CC, Lai CJ (2011) Reactive oxygen species are the cause of the enhanced cardiorespiratory response induced by intermittent hypoxia in conscious rats. Respir Physiol Neurobiol 175(1):70–79

    Article  PubMed  Google Scholar 

  22. Prabhakar NR, Kumar GK (2010) Mechanisms of sympathetic activation and blood pressure elevation by intermittent hypoxia. Respir Physiol Neurobiol 174(1–2):156–161

    Article  PubMed  PubMed Central  Google Scholar 

  23. Nagai M, Hoshide S, Kario K (2010) Hypertension and dementia. Am J Hypertens 23:116–124

    Article  PubMed  Google Scholar 

  24. Bartsch P, Gibbs JS (2007) Effect of altitude on the heart and the lungs. Circulation 116:2191–2202

    Article  PubMed  Google Scholar 

  25. Heistad DD, Abboud FM, Dickinson W (1980) Richards lecture: circulatory adjustments to hypoxia. Circulation 61:463–470

    Article  PubMed  CAS  Google Scholar 

  26. Lundberg JO, Weitzberg E (2005) NO generation from nitrite and its role in vascular control. Arterioscler Thromb Vasc Biol 25:915–922

    Article  PubMed  CAS  Google Scholar 

  27. Singel DJ, Stamler JS (2005) Chemical physiology of blood flow regulation by red blood cells: the role of nitric oxide and S-nitrosohemoglobin. Annu Rev Physiol 67:99–145

    Article  PubMed  CAS  Google Scholar 

  28. Calbet JA (2003) Chronic hypoxia increases blood pressure and noradrenaline spillover in healthy humans. J Physiol 551:379–386

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  29. Kamat SR, Banerji BC (1972) Study of cardiopulmonary function on exposure to high altitude. I. Acute acclimatization to an altitude of 3,5000 to 4,000 meters in relation to altitude sickness and cardiopulmonary function. Am Rev Respir Dis 106:404–413

    PubMed  CAS  Google Scholar 

  30. Kanstrup IL, Poulsen TD, Hansen JH, Andersen LJ, Bestle MH, Christensen NJ, Olsen NV (1999) Blood pressure and plasma catecholamines in acute and prolonged hypoxia: effects of local hypothermia. J Appl Physiol 87(6):2053–2058

    PubMed  CAS  Google Scholar 

  31. Malhotra MS, Selvamurthy W, Purkayastha SS, Mukherjee AK, Mathew L, Dua GL (1976) Responses of the autonomic nervous system during acclimatization to high altitude in man. Aviat Space Environ Med 47:1076–1079

    PubMed  CAS  Google Scholar 

  32. Palatini P, Businaro R, Berton G, Mormino P, Rossi GP, Racioppa A, Pessina AC, Dal Palu C (1989) Effects of low altitude exposure on 24-hour blood pressure and adrenergic activity. Am J Cardiol 64:1379–1382

    Article  PubMed  CAS  Google Scholar 

  33. Roach RC, Houston CS, Honigman B, Nicholas RA, Yaron M, Grissom CK, Alexander JK, Hultgren HN (1995) How well do older persons tolerate moderate altitude? West J Med 162:32–36

    PubMed  CAS  PubMed Central  Google Scholar 

  34. Kriemler S, Jansen C, Linka A, Kessel-Schaefer A, Zehnder M, Schurmann T, Kohler M, Bloch K, Brunner-La Rocca HP (2008) Higher pulmonary artery pressure in children than in adults upon fast ascent to high altitude. Eur Respir J 32:664–669

    Article  PubMed  CAS  Google Scholar 

  35. MacLean DA, Sinoway LI, Leuenberger U (1998) Systemic hypoxia elevates skeletal muscle interstitial adenosine levels in humans. Circulation 98:1990–1992

    Article  PubMed  CAS  Google Scholar 

  36. Richalet JP, Larmignat P, Rathat C, Keromes A, Baud P, Lhoste F (1988) Decreased cardiac response to isoproterenol infusion in acute and chronic hypoxia. J Appl Physiol (1985) 65:1957–1961

    CAS  Google Scholar 

  37. Somers VK, Mark AL, Abboud FM (1988) Potentiation of sympathetic nerve responses to hypoxia in borderline hypertensive subjects. Hypertension 11:608–612

    Article  PubMed  CAS  Google Scholar 

  38. Levine BD, Zuckerman JH, deFilippi CR (1997) Effect of high-altitude exposure in the elderly: the Tenth Mountain Division study. Circulation 96:1224–1232

    Article  PubMed  CAS  Google Scholar 

  39. Canepa A, Chavez R, Hurtado A, Rotta A, Velasquez T (1956) Pulmonary circulation at sea level and at high altitudes. J Appl Physiol 9:328–336

    PubMed  CAS  Google Scholar 

  40. Mirrakhimov MM, Meymanaliev TS (1984) High altitude cardiology. Frunze, Kyrgyzstan, 316 p (in Russian)

    Google Scholar 

  41. Vogel JA, Hartley LH, Cruz JC (1974) Cardiac output during exercise in altitude natives at sea level and high altitude. J Appl Physiol 36:173–176

    PubMed  CAS  Google Scholar 

  42. Nakashima M (1983) High altitude medical research in Japan. Prog Clin Biol Res 136:173–182

    PubMed  CAS  Google Scholar 

  43. Levett DZ, Fernandez BO, Riley HL, Martin DS, Mitchell K, Leckstrom CA, Ince C, Whipp BJ, Mythen MG, Montgomery HE, Grocott MP, Feelisch M (2011) The role of nitrogen oxides in human adaptation to hypoxia. Sci Rep 1:109

    Article  PubMed  PubMed Central  Google Scholar 

  44. Bender PR, Groves BM, McCullough RE, McCullough RG, Huang SY, Hamilton AJ, Wagner PD, Cymerman A, Reeves JT (1988) Oxygen transport to exercising leg in chronic hypoxia. J Appl Physiol (1985) 65:2592–2597

    CAS  Google Scholar 

  45. Hansen J, Sander M (2003) Sympathetic neural overactivity in healthy humans after prolonged exposure to hypobaric hypoxia. J Physiol 546:921–929

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  46. Kumar R, Qadar Pasha MA, Khan AP, Gupta V, Grover SK, Norboo T, Srivastava KK, Selvamurthy W, Brahamchari SK (2003) Association of high-altitude systemic hypertension with the deletion allele-of the angiotensin-converting enzyme (ACE) gene. Int J Biometeorol 48:10–14

    Article  PubMed  Google Scholar 

  47. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Redon J, Dominiczak A, Narkiewicz K, Nilsson PM, Burnier M, Viigimaa M, Ambrosioni E, Caufield M, Coca A, Olsen MH, Schmieder RE, Tsioufis C, van de Borne P, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Clement DL, Coca A, Gillebert TC, Tendera M, Rosei EA, Ambrosioni E, Anker SD, Bauersachs J, Hitij JB, Caulfield M, De Buyzere M, De Geest S, Derumeaux GA, Erdine S, Farsang C, Funck-Brentano C, Gerc V, Germano G, Gielen S, Haller H, Hoes AW, Jordan J, Kahan T, Komajda M, Lovic D, Mahrholdt H, Olsen MH, Ostergren J, Parati G, Perk J, Polonia J, Popescu BA, Reiner Z, Ryden L, Sirenko Y, Stanton A et al (2013) 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 34:2159–2219

    Article  PubMed  Google Scholar 

  48. Faulhaber M, Flatz M, Gatterer H, Schobersberger W, Burtscher M (2007) Prevalence of cardiovascular diseases among alpine skiers and hikers in the Austrian Alps. High Alt Med Biol 8:245–252

    Article  PubMed  Google Scholar 

  49. Honigman B, Theis MK, Koziol-McLain J, Roach R, Yip R, Houston C, Moore LG, Pearce P (1993) Acute mountain sickness in a general tourist population at moderate altitudes. Ann Intern Med 118:587–592

    Article  PubMed  CAS  Google Scholar 

  50. Nault P, Halman S, Paradis J (2009) Ankle-brachial index on Kilimanjaro: lessons from high altitude. Wilderness Environ Med 20:72–76

    Article  PubMed  Google Scholar 

  51. Ponchia A, Noventa D, Bertaglia M, Carretta R, Zaccaria M, Miraglia G, Pascotto P, Buja G (1994) Cardiovascular neural regulation during and after prolonged high altitude exposure. Eur Heart J 15:1463–1469

    PubMed  CAS  Google Scholar 

  52. Savonitto S, Cardellino G, Doveri G, Pernpruner S, Bronzini R, Milloz N, Colombo MD, Sardina M, Nassi G, Marraccini P (1992) Effects of acute exposure to altitude (3,460 m) on blood pressure response to dynamic and isometric exercise in men with systemic hypertension. Am J Cardiol 70:1493–1497

    Article  PubMed  CAS  Google Scholar 

  53. Hasler E, Suter PM, Vetter W (1997) Race specific altitude effects on blood pressure. J Hum Hypertens 11:435–438

    Article  PubMed  CAS  Google Scholar 

  54. D’Este D, Mantovan R, Martino A, D’Este F, Artusi L, Allibardi P, Franceschi M, Zerio C, Pascotto P (1991) The behavior of the arterial pressure at rest and under exertion in normotensive and hypertensive subjects exposed to acute hypoxia at a median altitude. G Ital Cardiol 21:643–649

    PubMed  Google Scholar 

  55. Wu TY, Ding SQ, Liu JL, Yu MT, Jia JH, Chai ZC, Dai RC, Zhang SL, Li BY, Pan L, Liang BZ, Zhao JZ, de Qi T, Sun YF, Kayser B (2007) Who should not go high: chronic disease and work at altitude during construction of the Qinghai-Tibet railroad. High Alt Med Biol 8:88–107

    Article  PubMed  Google Scholar 

  56. Sizlan A, Ogur R, Ozer M, Irmak MK (2008) Blood pressure changes in young male subjects exposed to a median altitude. Clin Auton Res 18:84–89

    Article  PubMed  Google Scholar 

  57. Erdmann J, Sun KT, Masar P, Niederhauser H (1998) Effects of exposure to altitude on men with coronary artery disease and impaired left ventricular function. Am J Cardiol 81:266–270

    Article  PubMed  CAS  Google Scholar 

  58. Schmid JP, Noveanu M, Gaillet R, Hellige G, Wahl A, Saner H (2006) Safety and exercise tolerance of acute high altitude exposure (3454 m) among patients with coronary artery disease. Heart 92:921–925

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  59. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A (2007) 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC task force on the management of arterial hypertension. J Hypertens 25:1751–1762

    Article  PubMed  CAS  Google Scholar 

  60. Guazzi MD, Berti M, Doria E, Fiorentini C, Galli C, Pepi M, Tamborini G (1989) Enhancement of the pulmonary vasoconstriction reaction to alveolar hypoxia in systemic high blood pressure. Clin Sci (Lond) 76:589–594

    CAS  Google Scholar 

  61. Burtscher M (2007) Risk of cardiovascular events during mountain activities. Adv Exp Med Biol 618:1–11

    Article  PubMed  Google Scholar 

  62. Beall CM (2003) High-altitude adaptations. Lancet 362(Suppl):s14–s15

    Article  PubMed  Google Scholar 

  63. Frisancho AR (1993) Human adaptation and accommodation. University of Michigan Press, Ann Arbor

    Google Scholar 

  64. Hultgren HN (1992) Effect of high altitude on cardiovascular diseases. J Wilderness Med 3:301–308

    Article  Google Scholar 

  65. Ruiz L, Penaloza D (1977) Altitude and hypertension. Mayo Clin Proc 52:442–445

    PubMed  CAS  Google Scholar 

  66. Sun SF (1986) Epidemiology of hypertension on the Tibetan Plateau. Hum Biol 58:507–515

    PubMed  CAS  Google Scholar 

  67. Monge MC, Monge M (1966) High altitude diseases: mechanism and management. Thomas, Springfield

    Google Scholar 

  68. Heath D, Williams RR (1977) Man at high altitude. The pathophysiology of acclimatization and adaptation. Churchill Livingstone, Edinburg

    Google Scholar 

  69. Ward M (1975) Mountain medicine a clinical study of cold and high altitude. Van Nostrand Reinhold Co., New York

    Google Scholar 

  70. Faeh D, Gutzwiller F, Bopp M (2009) Lower mortality from coronary heart disease and stroke at higher altitudes in Switzerland. Circulation 120:495–501

    Article  PubMed  Google Scholar 

  71. Hanna JM (1999) Climate, altitude, and blood pressure. Hum Biol 71:553–582

    PubMed  CAS  Google Scholar 

  72. Shrestha S, Shrestha A, Shrestha S, Bhattarai D (2012) Blood pressure in inhabitants of high altitude of Western Nepal. JNMA J Nepal Med Assoc 52:154–158

    PubMed  CAS  Google Scholar 

  73. Fiori G, Facchini F, Pettener D, Rimondi A, Battistini N, Bedogni G (2000) Relationships between blood pressure, anthropometric characteristics and blood lipids in high- and low-altitude populations from Central Asia. Ann Hum Biol 27:19–28

    Article  PubMed  CAS  Google Scholar 

  74. Gamboa A, Gamboa JL, Holmes C, Sharabi Y, Leon-Velarde F, Fischman GJ, Appenzeller O, Goldstein DS (2006) Plasma catecholamines and blood volume in native Andeans during hypoxia and normoxia. Clin Auton Res 16:40–45

    Article  PubMed  Google Scholar 

  75. Otsuka K, Norboo T, Otsuka Y, Higuchi H, Hayajiri M, Narushima C, Sato Y, Tsugoshi T, Murakami S, Wada T, Ishine M, Okumiya K, Matsubayashi K, Yano S, Chogyal T, Angchuk D, Ichihara K, Cornelissen G, Halberg F (2005) Chronoecological health watch of arterial stiffness and neuro-cardio-pulmonary function in elderly community at high altitude (3524 m), compared with Japanese town. Biomed Pharmacother 59(Suppl 1):S58–S67

    Article  PubMed  PubMed Central  Google Scholar 

  76. Tripathy V, Gupta R (2007) Blood pressure variation among Tibetans at different altitudes. Ann Hum Biol 34:470–483

    Article  PubMed  Google Scholar 

  77. Tripathy V, Charan Satapathy K, Gupta R (2006) Nutritional status and hypertension among Tibetan adults in India. Hum Ecol 14:77–82

    Google Scholar 

  78. Zhao X, Li S, Ba S, He F, Li N, Ke L, Li X, Lam C, Yan L, Zhou Y, Wu Y (2012) Prevalence, awareness, treatment and control of hypertension among herdsmen living at 4300 in Tibet. Am J Hypertens 7:583–589

    Article  Google Scholar 

  79. Henley WN, Bellush LL, Notestine MA (1992) Reemergence of spontaneous hypertension in hypoxia-protected rats returned to normoxia as adults. Brain Res 579:211–218

    Article  PubMed  CAS  Google Scholar 

  80. Kolar F, Ostadal B, Prochazka J, Pelouch V, Widimsky J (1989) Comparison of cardiopulmonary response to intermittent high-altitude hypoxia in young and adult rats. Respiration 56:57–62

    Article  PubMed  CAS  Google Scholar 

  81. Milano G, Corno AF, Lippa S, Von Segesser LK, Samaja M (2002) Chronic and intermittent hypoxia induce different degrees of myocardial tolerance to hypoxia-induced dysfunction. Exp Biol Med (Maywood) 227:389–397

    CAS  Google Scholar 

  82. Gupte SA, Wolin MS (2012) Relationships between vascular oxygen sensing mechanisms and hypertensive disease processes. Hypertension 60:269–275

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  83. Semenza GL, Prabhakar NR (2012) The role of hypoxia-inducible factors in oxygen sensing by the carotid body. Adv Exp Med Biol 758:1–5

    Article  PubMed  PubMed Central  Google Scholar 

  84. Harrison DG, Guzik TJ, Lob HE, Madhur MS, Marvar PJ, Thabet SR, Vinh A, Weyand CM (2011) Inflammation, immunity, and hypertension. Hypertension 57:132–140

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  85. Paravicini TM, Touyz RM (2006) Redox signaling in hypertension. Cardiovasc Res 71:247–258

    Article  PubMed  CAS  Google Scholar 

  86. Severinghaus JW, Bainton CR, Carcelen A (1966) Respiratory insensitivity to hypoxia in chronically hypoxic man. Respir Physiol 1:308–334

    Article  PubMed  CAS  Google Scholar 

  87. Otsuka K, Norboo T, Otsuka Y, Higuchi H, Hayajiri M, Narushima C, Sato Y, Tsugoshi T, Murakami S, Wada T, Ishine M, Okumiya K, Matsubayashi K, Yano S, Choygal T, Angchuk D, Ichihara K, Cornelissen G, Halberg F (2005) Effect of aging on blood pressure in Leh, Ladakh, a high-altitude (3524 m) community, by comparison with a Japanese town. Biomed Pharmacother 59(Suppl 1):S54–S57

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. National Centre of Cardiology & Internal Medicine (NCCIM), Togolok Moldo Str. 3, 720040, Bishkek, Kyrgyz Republic

    Akpay Sarybaev

  2. High Altitude Medical Research Center, Leh, Ladakh, India

    Deepak Mulajkar & Gaurav Sikri

  3. Ladakh Institute of Prevention, Leh, Ladakh, India

    Tsering Norboo

  4. Cardiorespiratory Division, Defense Institute of Physiology & Allied Sciences, Defense Research & Development Organization, Lucknow Road, Timarpur, Delhi, India

    Amit Badhya & Maramreddy Prasanna Reddy

  5. Defence Institute of Physiology and Allied Sciences (DIPAS), New Delhi, India

    Shashi Bala Singh

Authors
  1. Akpay Sarybaev
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deepak Mulajkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gaurav Sikri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tsering Norboo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amit Badhya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shashi Bala Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maramreddy Prasanna Reddy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akpay Sarybaev .

Editor information

Editors and Affiliations

  1. Defence Institute of Physiology and Allied Sciences (DIPAS), New Delhi, Delhi, India

    Shashi Bala Singh

  2. Department of Medicine and Director for Systems, The University of Chicago, Chicago, USA

    Nanduri R. Prabhakar

  3. Department of Anaesthesiology, School of Medicine, State University of New York, Stony Brook, New York, USA

    Srinivas N Pentyala

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer India

About this chapter

Cite this chapter

Sarybaev, A. et al. (2014). Hypertension at High Altitude. In: Singh, S., Prabhakar, N., Pentyala, S. (eds) Translational Research in Environmental and Occupational Stress. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1928-6_20

Download citation

Publish with us

Policies and ethics

Search

Navigation