Low altitude assessment of arterial blood pressure predicts susceptibility to acute mountain sickness at high altitude / 军事医学

ABSTRACT

Objective To explore that whether the normoxic low altitude measurement of arterial blood pressure would predict subsequent susceptibility to acute mountain sickness ( AMS) during rapid ascent to high altitude .Methods Arterial blood pressure ( using a wrist sphygmomanometer ) was determined in two hundred and four healthy lowlanders first exposed to 3700 m-altitude (Lhasa) from plain (500 m) by air, and the Lake Louise self-report questionnaire(LLS) was used to assess AMS.We compared the low altitude blood pressure related indicators of two groups ( AMS and non-AMS ) and analyzed the relationship of diagnostic score and blood pressure related indicators .Results ①The incidence of AMS in the selected subjects was 53.92% by LLS.AMS scores increased markedly at high-altitude (P<0.05 versus low altitude).②Diastolic blood pressure (DBP) and mean arterial BP (MABP) in the AMS group were higher than those in the non-AMS group(P<0.05).The low altitude DBP levels for diagnosis of AMS at high-altitude (3700 m) had an area under curve(AUC) =0.598, P<0.05, with sensitivity of 56.3%, specificity of 63.2%, and cut-off point of 72.5 mmHg. Conclusion ①After acute exposure to high altitude , the incidence of AMS increases significantly .②A higher baseline DBP may be considered a potential risk factor for AMS , and is positively associated with LLS .DBP may serve as a predic-tive parameter for diagnosis of AMS .However , the clinical application of DBP as a predictive criterion is limited because of its poor specificity or sensitivity .The use of DBP as a predictive criterion should be combined with other indicators for the better predictive value of AMS .