Seasonal Effects of High-Altitude Forest Travel on Cardiovascular Function: An Overlooked Cardiovascular Risk of Forest Activity
Abstract
:1. Introduction
2. Material and Methods
2.1. Design and Participants
2.2. Environmental Assessment
2.3. Cardiac and Vascular Functions Assessments
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Cheng, F.Y.; Jeng, M.J.; Lin, Y.L.; Wang, S.H.; Li, W.C.; Huang, K.F.; Chiu, T.F. Incidence and severity of acute mountain sickness and associated symptoms in children trekking on Xue Mountain, Taiwan. PLoS ONE 2017, 9, e0183207. [Google Scholar] [CrossRef] [Green Version]
- Basnyat, B.; Gertsch, J.H.; Johnson, E.W.; Castro-Marin, F.; Inoue, Y.; Yeh, C. Efficacy of low-dose acetazolamide (125 mg BID) for the prophylaxis of acute mountain sicknes: A prospective, double-blind, randomized, placebo-controlled trial. High Alt. Med. Biol. 2003, 4, 45–52. [Google Scholar] [CrossRef] [PubMed]
- Rao, M.Y.; Li, J.B.; Qin, J.; Rao, M.Y.; Li, J.B.; Qin, J.; Zhang, J.H.; Gao, X.B.; Yu, S.Y.; Yu, J.; et al. Left Ventricular Function during Acute High-Altitude Exposure in a Large Group of Healthy Young Chinese Men. PLoS ONE 2015, 10, e0116936. [Google Scholar] [CrossRef]
- Baggish, A.L.; Wolfel, E.E.; Levine, B.D. The Cardiovascular System at High Altitude; Springer Publications: New York, NY, USA, 2014. [Google Scholar]
- Bärtsch, P.; Swenson, E.R. Acute High-altitude illnesses. N. Eng. J. Med. 2013, 368, 2294–2302. [Google Scholar] [CrossRef]
- Siebenmann, C.; Lundby, C. Regulation of cardiac output in hypoxia. Scand. J. Med. Sci. Sports 2015, 25 (Suppl. S4), 53–59. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Imray, C.; Wright, A.; Subudhi, A.; Roach, R. Acute mountain sickness: Pathophysiology, prevention, and treatment. Prog. Card. Dis. 2010, 52, 467–484. [Google Scholar] [CrossRef]
- Naeije, R. Physiological Adaptation of the Cardiovascular System to High Altitude. Prog. Cardiovasc. Dis. 2010, 52, 456–466. [Google Scholar] [CrossRef]
- Lo, M.Y.; Daniels, J.D.; Levine, B.D.; Burtscher, M. Sleeping altitude and sudden cardiac death. Am. Heart J. 2013, 166, 71–75. [Google Scholar] [CrossRef]
- Soria, R.; Egger, M.; Scherrer, U. Pulmonary artery pressure and arterial oxygen saturation in people living at high or low altitude: Systematic review and meta-analysis. J. Appl. Physiol. 2016, 121, 1151–1159. [Google Scholar] [CrossRef]
- Al-Tahan, A.; Buchur, J.; Khwsky, F.; Ogunniyi, A.; Al-Rajeh, S.; Larbi, E.; Daif, A.; Bamgboye, E. Risk factors of stroke at high and low altitude areas in Saudi Arabia. Arch. Med. Res. 1998, 29, 173–177. [Google Scholar]
- Tsao, T.M.; Tsai, M.J.; Hwang, J.S.; Su, T.C. Health effects of seasonal variation in cardiovascular hemodynamics among workers in forest environments. Hypertens. Res. 2019, 42, 223–232. [Google Scholar] [CrossRef]
- Stefano, F.R.; Claudio Sb Christian, S.; Etienne, D.; Heinrich, P.M.; Urs, S.; Yves, A. High-Altitude Exposure in Patients with Cardiovascular Disease: Risk Assessment and Practical Recommendations. Prog. Cardiov. Dis. 2010, 52, 512–524. [Google Scholar] [CrossRef]
- Aryal, N.; Weatherall, M.; Deo Bhatta, Y.K.; Mann, S. Blood pressure and hypertension in adults permanently living at high altitude: A systematic review and Meta-analysis. High Alt. Med. Biol. 2016, 17, 185–193. [Google Scholar] [CrossRef]
- Miele, C.H.; Schwartz, A.R.; Gilman, R.H.; Pham, L.; Wise, R.A.; Davila-Roman, V.G.; Jun, J.C.; Polotsky, Y.; Miranda, J.J.; Leon-Velarde, F.; et al. Increased cardiometabolic risk andworsening hypoxemia at high altitude. High Alt. Med. Biol. 2016, 17, 93–100. [Google Scholar] [CrossRef] [Green Version]
- Hainsworth, R.; Drinkhill, M.J. Cardiovascular adjustments for life at high altitude. Respir. Physiol. Neurobiol. 2007, 158, 204–211. [Google Scholar] [CrossRef]
- Bärtsch, P.; Saltin, B.; Dvorak, J. Consensus statement on playing football at different altitude. Scand. J. Med. Sci. Sports 2008, 18, 96–99. [Google Scholar] [CrossRef] [PubMed]
- Thomas, G.; Camille, L.B.; Sophie, F.; Pierre, M.; Marc, D.; Alban, F.C. Effects of Altitude on Chronic Obstructive Pulmonary Disease Patients: Risks and Care. Life 2021, 11, 798. [Google Scholar] [CrossRef]
- Veglio, M.; Maule, S.; Cametti, G.; Cogo, A.; Lussiana, L.; Madrigale, G.; Pecchio, O. The effects of exposure to moderate altitude on cardiovascular autonomic function in normal subjects. Clin. Auton Res. 1999, 9, 123–127. [Google Scholar] [CrossRef] [PubMed]
- Brinton, T.J.; Cotter, B.; Kailasam, M.T.; Browm, D.L.; Chio, S.S.; O’Connor, D.T.; DeMaria, A.N. Development and validation of a non-invasive method to determine arterial pressure and vascular compliance. Am. J. Cardiol. 1997, 80, 323–330. [Google Scholar] [CrossRef]
- Brinton, T.J.; Daniel Walls, E.; Chio, S.S. Validation of pulse dynamic blood pressure measurement by auscultation. Blood Press Monit. 1998, 3, 121–124. [Google Scholar]
- Chio, S.S.; Tsai, J.J.; Hsu, Y.M.; Lapointe, J.C.; Huynh-Covey, T.; Kwan, O.B.; Maria, A.N. Development and validation of a noninvasive method to estimate cardiac output using cuff sphygmomanometry. Clin. Cardiol. 2007, 30, 615–620. [Google Scholar] [CrossRef]
- Chen, S.Y.; Chan, C.C.; Lin, Y.L.; Hwang, J.S.; Su, T.C. Fine particulate matter results in hemodynamic changes in subjects with blunted nocturnal blood pressure dipping. Environ. Res. 2014, 131, 1–5. [Google Scholar] [CrossRef] [PubMed]
- Enrico, A.R.; Mancia, G.; O’Rourke, M.F.; Roman, M.J.; Safar, M.E.; Smulyan, H.; Wang, J.G.; Wilkinson, I.B.; Williams, B.; Vlachopoulos, C. Central blood pressure measurements and antihypertensive therapy. Hypertension 2007, 50, 154–160. [Google Scholar] [CrossRef] [Green Version]
- Al-Tamer, Y.Y.; Al-Hayali, J.M.; Al-Ramadhan, E.A. Seasonality of hypertension. J. Clin. Hypertens. 2008, 10, 125–129. [Google Scholar] [CrossRef]
- Takenaka, T.; Kojima, E.; Sueyoshi, K.; Sato, T.; Uchida, K.; Arai JHoshi, H.; Kato, N.; Takane, H.; Suzuki, H. Seasonal variations of daily changes in blood pressure among hypertensive patients with end-stage renal diseases. Clin. Exp. Hypertens. 2010, 32, 227–233. [Google Scholar] [CrossRef]
- Fares, A. Winter cardiovascular diseases phenomenon. N. Am. J. Med. Sci. 2013, 5, 2662–2679. [Google Scholar] [CrossRef] [Green Version]
- West, J.B. High-altitude medicine. Am. J. Respir. Crit. Care Med. 2012, 186, 1229–1237. [Google Scholar] [CrossRef]
- Whayne, T.F. Cardiovascular medicine at high altitude. Angiology 2014, 65, 459–472. [Google Scholar] [CrossRef]
- León-Velarde, F.; Maggiorini, M.; Reeves, J.T.; Aldashev, A.; Asmus, I.; Berbardi, L.; Ge, R.L.; Hackett, P.; Kobayashi, T.; Moore, L.G.; et al. Consensus statement on chronic and subacute high altitude diseases. High Alt. Med. Biol. 2005, 6, 147–157. [Google Scholar] [CrossRef]
- Vargas, E.; Spielvogel, H. Chronic mountain sickness, optimal hemoglobin, and heart disease. High Alt. Med. Biol. 2006, 7, 138–149. [Google Scholar] [CrossRef]
- De Ferrari, A.; Miranda, J.J.; Gilman, R.H.; Dávila-Román, V.G.; León-Velarde, F.; Rivera-Ch, M.; Huicho, L.; Bernabé-Ortiz, A.; Wise, R.A.; Checkley, W. Prevalence, clinical profile, iron status, and subject-specific traits for excessive erythrocytosis in andean adults living permanently at 3825 m above sea level. Chest 2014, 145, 1327–1336. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ryan, S.; McNicholas, W.T. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 2005, 112, 2660–2667. [Google Scholar] [CrossRef] [Green Version]
- Polotsky, V.Y.; Li, J.; Punjabi, N.M.; Rubin, A.E.; Smith, P.L.; Schwartz, A.R.; O’Donnell, C.P. Intermittent hypoxia increase insulin resistance in genetically obese mice. J. Physiol. 2004, 552, 253–264. [Google Scholar] [CrossRef]
- Hansen, J.; Sander, M. Sympathetic neural over activity in healthy humans after prolonged exposure to hypobaric hypoxia. J. Physiol. 2003, 546, 921–929. [Google Scholar] [CrossRef]
- Levine, B.D. Going high with heart disease: The effect of high altitude exposure I older individuals and patients with coronary artery disease. High Alt. Med. Biol. 2015, 16, 89–96. [Google Scholar] [CrossRef]
- Khanna, K.; Mishra, K.P.; Ganju, L.; Kumar, B.; Singh, S.B. High-altitude-induced alterations in gut-immune Axis: A review. Int. Rev. Immunol. 2018, 37, 119–126. [Google Scholar] [CrossRef]
- Guo, X.S.; Long, R.J.; Kreuzer, M.; Ding, L.M.; Shang, Z.H.; Zhang, Y.; Yang, Y.; Cui, G. Importance of functional ingredients in yak milk derived food on health of Tibetan nomads living under high-altitudes stress: A review. Crit. Rev. Food Sci. Nutr. 2014, 54, 292–302. [Google Scholar] [CrossRef]
- Hill, N.; Stacey, M.; Woods, D. Energy at high altitude. BMJ Mil. Health 2011, 157, 43–48. [Google Scholar] [CrossRef]
Winter Winter | Summer Summer | |
---|---|---|
Variables | January 2017 | June 2017 |
(n = 11) | (n = 16) | |
Age (years) | 43.6 ± 11.6 | 41.2 ±3.6 |
Male sex (%) | 54.6 | 87.5 |
BMI (kg/m2) | 25.0 ± 4.0 | 25.8 ± 1.1 |
Smoking habit (%) | 0 | 12.5 |
Alcohol drinking habit (%) | 18.2 | 37.5 |
Diabetes (%) | 9.1 | 0 |
Hypertension (%) | 36.4 | 6.3 |
Hypercholesterolemia with medication (%) | 18.2 | 6.3 |
Winter | Shuili N = 107 | Tataka before N = 54 | Lulin N = 40 | Tataka after N = 23 | Wuqi N = 102 | |
PM1 | μg/m3 | 58.16 ± 3.10 | 11.56 ± 2.75 | 0.13 ± 0.33 | 6.17 ± 2.52 | 76.71 ± 20.63 |
PM2.5 | μg/m3 | 59.10 ± 3.18 | 12.38 ± 2.71 | 0.13 ± 0.33 | 6.35 ± 2.53 | 79.50 ± 21.48 |
PM10 | μg/m3 | 64.88 ± 4.23 | 21.13 ± 4.22 | 0.23 ± 0.48 | 10.57 ± 3.72 | 88.07 ± 24.42 |
Temperature | °C | 21.90 ± 0.20 | 11.43 ± 0.48 | 9.48 ± 0.41 | 13.50 ± 0.63 | 22.29 ± 0.50 |
Relative H. | % | 71.49 ± 1.52 | 63.48 ± 2.96 | 68.87 ± 1.74 | 64.39 ± 1.21 | 82.86 ± 2.43 |
Atmosphere | atm | 0.97 | 0.74 | 0.73 | 0.74 | 1.0 |
Summer | Shuili N = 126 | Tataka before N = 39 | Lulin N = 41 | Tataka after N = 17 | Heshe N = 65 | |
PM1 | μg/m3 | 21.67 ± 1.81 | 17.15 ± 7.02 | 15.50 ± 5.56 | 18.12 ± 0.70 | 15.42 ± 1.26 |
PM2.5 | μg/m3 | 22.14 ± 1.94 | 18.00 ± 7.05 | 15.85 ± 5.96 | 18.18 ± 0.73 | 15.63 ± 1.16 |
PM10 | μg/m3 | 24.52 ± 2.42 | 20.92 ± 11.93 | 19.74 ± 14.99 | 19.00 ± 0.71 | 17.00 ± 1.41 |
Temperature | °C | 30.69 ± 0.13 | 17.06 ± 1.69 | 16.53 ± 0.66 | 15.30 ± 0.31 | 25.3 ± 0.89 |
Relative H. | % | 67.62 ± 0.75 | 87.74 ± 9.18 | 83.64 ± 3.06 | 91.37 ± 1.89 | 78.3 ± 1.03 |
Atmosphere | atm | 0.97 | 0.74 | 0.73 | 0.74 | 1.0 |
Winter (N = 22) | Summer (N = 32) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
1. Shuili (298 m) | 2. Tataka (2610 m) | 3. Lulin (2729 m) | P1 1 vs. 2 | P2 1 vs. 3 | 4. Shuili (298 m) | 5. Tataka (2610 m) | 6. Lulin (2729 m) | P3 4 vs. 5 | P4 4 vs. 6 | |
BP Components | ||||||||||
SBP (mmHg) | 120.4 ± 17.6 | 136.1 ± 19.3 | 141.1 ± 19.3 | <0.0001 | <0.0001 | 120.7 ± 13.2 | 123.6 ± 17.0 | 129.3 ± 16.6 | 0.0786 | <0.0001 |
DBP (mmHg) | 78.1 ± 11.6 | 82.6 ± 10.9 | 85.8 ± 9.9 | 0.0096 | 0.0034 | 78.9 ± 8.9 | 76.2 ± 8.9 | 82.2 ± 10.7 | 0.0022 | 0.0011 |
cSBP (mmHg) | 128.8 ± 17.5 | 142.9 ± 18.2 | 148.2 ± 18.4 | <0.0001 | <0.0001 | 129.1 ± 15.5 | 131.3 ± 18.0 | 137.3 ± 16.4 | 0.2298 | <0.0001 |
cDBP (mmHg) | 73.4 ± 11.2 | 76.8 ± 11.0 | 79.8 ± 10.4 | 0.0781 | 0.0530 | 75.0 ± 9.1 | 72.0 ± 9.4 | 78.0 ± 10.1 | 0.0052 | <0.0001 |
MAP (mmHg) | 90.9 ± 12.3 | 97.7 ± 12.4 | 101.3 ± 12.2 | 0.0001 | 0.0005 | 92.4 ± 10.3 | 91.8 ± 11.9 | 97.5 ± 11.8 | 0.5742 | 0.0042 |
PP (mmHg) | 55.3 ± 11.3 | 66.1 ± 11.3 | 68.4 ± 9.9 | 0.0026 | 0.0015 | 54.1 ± 11.0 | 59.3 ± 12.3 | 59.4 ± 9.7 | 0.0065 | <0.0001 |
HR (beats/min) | 69.2 ± 7.6 | 83.8 ± 10.7 | 88.4 ± 11.8 | <0.0001 | <0.0001 | 71.5 ± 9.1 | 81.5 ± 10.7 | 81.4 ± 10.0 | <0.0001 | 0.008 |
Cardiac Function | ||||||||||
LVE (sec) | 0.29 ± 0.04 | 0.24 ± 0.02 | 0.22 ± 0.03 | <0.0001 | <0.0001 | 0.3 ± 0.004 | 0.26 ± 0.04 | 0.24 ± 0.02 | <0.0001 | <0.0001 |
LV Max (mmHg/s) | 1116 ± 230 | 1419 ± 263 | 1463 ± 240 | <0.0001 | <0.0001 | 1182 ± 213 | 1359 ± 281 | 1341 ± 199 | <0.0001 | <0.0001 |
LVC (1/s) | 14.0 ± 1.9 | 16.4 ± 1.9 | 16.3 ± 1.6 | 0.0001 | 0.0003 | 15.0 ± 1.8 | 17.0 ± 1.9 | 16.1 ± 1.4 | <0.0001 | <0.0001 |
CO (L/min) | 4.6 ± 0.75 | 5.9 ± 1.02 | 6.0 ± 1.1 | <0.0001 | <0.0001 | 5.2 ± 1.0 | 6.4 ± 1.8 | 6.0 ± 1.4 | <0.0001 | <0.0001 |
CI (L/min/m2) | 2.6 ± 0.4 | 3.45 ± 0.6 | 3.6 ± 0.7 | <0.0001 | <0.0001 | 2.8 ± 0.4 | 3.4 ± 0.7 | 3.2 ± 0.6 | <0.0001 | <0.0001 |
SV (mL) | 65.4 ± 11.0 | 69.4 ± 9.8 | 67.5 ± 6.8 | 0.0173 | 0.0488 | 70.4 ± 12.4 | 76.0 ± 15.1 | 72.7 ± 13.8 | <0.0001 | 0.0074 |
SVI (mL/m2) | 36.8 ± 4.9 | 40.3 ± 5.1 | 39.7 ± 4.7 | 0.0178 | 0.0544 | 38.0 ± 3.9 | 41.1 ± 4.7 | 39.3 ± 4.6 | <0.0001 | 0.0093 |
Vascular Function | ||||||||||
SVC (mL/mmHg) | 1.2 ± 0.24 | 1.07 ± 0.18 | 1.0 ± 0.1 | 0.0146 | 0.0017 | 1.3 ± 0.3 | 1.3 ± 0.3 | 1.3 ± 0.3 | 0.6611 | 0.0209 |
SVR (dynes/sec/cm5) | 1654 ± 354 | 1351 ± 245 | 1376 ± 263 | <0.0001 | <0.0001 | 1486 ± 319 | 1213 ± 306 | 1363 ± 327 | <0.0001 | 0.0016 |
BAC (mL/mmHg) | 0.07 ± 0.03 | 0.06 ± 0.02 | 0.07 ± 0.02 | 0.1733 | 0.0349 | 0.08 ± 0.02 | 0.08 ± 0.02 | 0.08 ± 0.02 | 0.2167 | 0.5220 |
BAD (%/mmHg) | 6.1 ± 1.79 | 5.3 ± 1.0 | 5.1 ± 0.8 | 0.0586 | 0.0072 | 6.1 ± 1.3 | 6.0 ± 1.4 | 5.8 ± 1.0 | 0.4023 | 0.0935 |
BAR (dynes/sec/cm5) | 212 ± 107 | 207 ± 104 | 175 ± 80 | 0.0447 | 0.0488 | 158 ± 57 | 152 ± 72 | 146 ± 64 | 0.3395 | 0.0475 |
SpO2 (%) | 98.1 ± 0.9 | 88.17 ± 5.46 | 81.2 ± 8.0 | <0.001 | <0.001 | 97.7 ± 0.7 | 90.8 ± 2.8 | 89.8 ± 3.0 | <0.0001 | 0.0002 |
Winter (N = 22) | Summer (N = 32) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
1. Lulin after (2729 m) | 2. Tataka after (2610 m) | 3.Wuqi (10 m) | P1 1 vs. 3 | P2 2 vs. 3 | 4. Lulin after (2729 m) | 5. Tataka after (2610 m) | 6. Heshe (760 m) | P3 4 vs. 6 | P4 5 vs. 6 | |
BP Components | ||||||||||
SBP (mmHg) | 133.4 ± 20.8 | 125.0 ± 14.4 | 120.6 ± 15.0 | <0.0001 | 0.0774 | 131 ± 18 | 127.9 ± 17.8 | 124.4 ± 18.1 | 0.0150 | 0.2663 |
DBP (mmHg) | 82.2 ± 10.7 | 80.4 ± 7.2 | 76.5 ± 10.4 | 0.0016 | 0.0176 | 82.4 ± 12.2 | 83.6 ± 8.9 | 82.6 ± 12.4 | 0.9119 | 0.6388 |
cSBP (mmHg) | 141.5 ± 21.5 | 132.5 ± 16.4 | 129.1 ± 14.8 | <0.0001 | 0.1840 | 138 ± 18 | 135.0 ± 17.4 | 130.7 ± 18.5 | 0.0050 | 0.2160 |
cDBP(mmHg) | 75.8 ± 10.1 | 76.4 ± 9.8 | 72.5 ± 8.9 | 0.0692 | 0.0325 | 78.1 ± 11.3 | 79.3 ± 9.0 | 77.5 ± 11.80 | 0.6859 | 0.4138 |
MAP (mmHg) | 96.1 ± 12.8 | 94.4 ± 10.2 | 90.8 ± 10.3 | 0.0072 | 0.0450 | 97.3 ± 12.8 | 96.6 ± 10.7 | 94.3 ± 13.06 | 0.0329 | 0.3308 |
PP (mmHg) | 65.7 ± 14.2 | 56.1 ± 12.2 | 56.6 ± 9.4 | 0.0008 | 0.8062 | 59.9 ± 10.3 | 55.7 ± 11.1 | 53.2 ± 11.08 | 0.0141 | 0.3001 |
HR (beats/min) | 87.5 ± 13.0 | 82.9 ± 14.2 | 73.8 ± 8.0 | <0.0001 | <0.0001 | 80.2 ± 4.8 | 74.2 ± 7.9 | 69.7 ± 7.01 | <0.0001 | 0.0046 |
Cardiac Function | ||||||||||
LVE(sec) | 0.23 ± 0.03 | 0.25 ± 0.04 | 0.29 ± 0.04 | <0.0001 | <0.0001 | 0.24 ± 0.01 | 0.26 ± 0.03 | 0.3 ± 0.03 | <0.0001 | 0.0064 |
LV Max (mmHg/s) | 1383 ± 254 | 1242 ± 228 | 1196 ± 164 | <0.0001 | 0.1623 | 1340 ± 202 | 1227 ± 191 | 1158 ± 197 | 0.0002 | 0.1722 |
LVC(1/s) | 16.1 ± 1.5 | 15.4 ± 1.4 | 15.1 ± 1.4 | 0.0102 | 0.1734 | 16.0 ± 1.4 | 145.0 ± 1.0 | 14.6 ± 1.7 | 0.0005 | 0.3679 |
CO (L/min) | 5.9 ± 1.1 | 5.7 ± 0.98 | 5.0 ± 0.5 | <0.0001 | <0.0001 | 6.2 ± 1.4 | 5.5 ± 1.0 | 5.1 ± 1.1 | <0.0001 | 0.0039 |
CI (L/min/m2) | 3.4 ± 0.6 | 3.3 ± 0.62 | 2.9 ± 0.4 | <0.0001 | <0.0001 | 3.3 ± 0.5 | 2.9 ± 0.4 | 2.7 ± 0.4 | <0.0001 | 0.0026 |
SV (mL) | 67.4 ± 7.3 | 66.8 ± 9.5 | 66.7 ± 7.6 | 0.0392 | 0.4108 | 76.0 ± 15.8 | 72.3 ± 10.7 | 72.2 ± 13.3 | 0.0081 | 0.9800 |
SVI (mL/m2) | 39.1 ± 4.6 | 38.7 ± 5.1 | 38.6 ± 3.5 | 0.0948 | 0.6461 | 40.4 ± 5.3 | 38.3 ± 3.4 | 38.5 ± 4.7 | 0.0117 | 0.9075 |
Vascular Function | ||||||||||
SVC (mL/mmHg) | 1.1 ± 0.2 | 1.2 ± 0.18 | 1.2 ± 0.19 | 0.0039 | 0.5188 | 1.3 ± 0.3 | 1.3 ± 0.3 | 1.4 ± 0.3 | 0.0376 | 0.2547 |
SVR(dynes/sec/cm5) | 1325 ± 255 | 1344 ± 238 | 1485 ± 227 | 0.0001 | <0.0001 | 1324 ± 341 | 1458 ± 305 | 1533 ± 379 | <0.0001 | 0.0801 |
BAC (mL/mmHg) | 0.07 ± 0.02 | 0.07 ± 0.02 | 0.06 ± 0.02 | 0.7248 | 0.0316 | 0.08 ± 0.02 | 0.09 ± 0.03 | 0.09 ± 0.02 | 0.1408 | 0.2811 |
BAD (%/mmHg) | 5.4 ± 1.1 | 5.95 ± 1.10 | 5.5 ± 1.0 | 0.3507 | 0.0508 | 5.7 ± 1.1 | 6.6 ± 1.4 | 6.3 ± 1.2 | 0.1202 | 0.5035 |
BAR (dynes/sec/cm5) | 179 ± 83 | 177 ± 78 | 213 ± 86 | 0.0066 | <0.0001 | 152 ± 70 | 146 ± 68 | 159 ± 76 | 0.4939 | 0.1565 |
SpO2 (%) | 83.8 ± 5.1 | 90.3 ± 3.4 | 97.7 ± 1.4 | <0.0001 | <0.0001 | 89.9 ± 3.5 | 92.1 ± 1.7 | 96.8 ± 2.1 | 0.0010 | 0.0010 |
Parameters | Tataka Baseline | Tataka after (2 h Later) | p1-Value | Lulin Villa Baseline | Lulin after (1 h Later) | p2-Value |
---|---|---|---|---|---|---|
BP Components | ||||||
SBP (mmHg) | 136.1 ± 19.3 | 125.0 ± 14.4 | <0.0001 | 141.1 ± 19.3 | 133.4 ± 20.8 | 0.0648 |
DBP (mmHg) | 82.6 ± 10.9 | 80.4 ± 7.17 | 0.0472 | 85.8 ± 9.9 | 82.2 ± 10.7 | 0.2573 |
cSBP (mmHg) | 142.9 ± 18.2 | 132.5 ± 16.4 | 0.0002 | 148.2 ± 18.4 | 141.5 ± 21.5 | 0.1290 |
cDBP(mmHg) | 76.8 ± 11.0 | 76.4 ± 9.8 | 0.8511 | 79.8 ± 10.4 | 75.8 ± 10.1 | 0.1387 |
MAP (mmHg) | 97.7 ± 12.4 | 94.4 ± 10.2 | 0.1193 | 101.3 ± 12.2 | 96.1 ± 12.8 | 0.0465 |
PP (mmHg) | 66.1 ± 11.3 | 56.1 ± 12.2 | 0.0001 | 68.4 ± 1.0 | 65.7 ± 14.2 | 0.6065 |
HR (beats/min) | 83.8 ± 10.7 | 82.9 ± 14.2 | 0.6197 | 88.4 ± 11.8 | 87.5 ± 13.0 | 0.2418 |
Cardiac Function | ||||||
LVE(sec) | 0.24 ± 0.02 | 0.25 ± 0.04 | 0.0281 | 0.22 ± 0.03 | 0.23 ± 0.03 | 0.0532 |
LV Max (mmHg/s) | 1419 ± 263 | 1242 ± 229 | <0.0001 | 1463 ± 240 | 1383 ± 254 | 0.2170 |
LVC(1/s) | 16.4 ± 1.9 | 15.4 ± 1.4 | 0.0021 | 16.3 ± 1.6 | 16.1 ± 1.5 | 0.4449 |
CO (L/min) | 5.9 ± 1.0 | 5.7 ± 1.0 | 0.0206 | 6.0 ± 1.1 | 5.9 ± 1.1 | 0.2344 |
CI (L/min/m2) | 3.5 ± 0.6 | 3.3 ± 0.6 | 0.0170 | 3.6 ± 0.7 | 3.4 ± 0.6 | 0.2208 |
SV (mL) | 69.4 ± 9.8 | 66.8 ± 9.5 | 0.0100 | 67.5 ± 6.8 | 67.4 ± 7.3 | 0.5578 |
SVI (mL/m2) | 40.3 ± 5.1 | 38.7 ± 5.1 | 0.0064 | 39.7 ± 4.7 | 39.1 ± 4.6 | 0.5501 |
Vascular Function | ||||||
SVC (mL/mmHg) | 1.1 ± 0.18 | 1.2 ± 0.2 | 0.0006 | 1.0 ± 0.1 | 1.1 ± 0.2 | 0.3606 |
SVR(dynes/sec/cm5) | 1351 ± 245 | 1345 ± 238 | 0.8452 | 1376 ± 263 | 1326 ± 255 | 0.8754 |
BAC (mL/mmHg) | 0.06 ± 0.02 | 0.07 ± 0.02 | 0.0610 | 0.07 ± 0.02 | 0.07 ± 0.02 | 0.7425 |
BAD (%/mmHg) | 5.3 ± 1.0 | 6.0 ± 1.1 | 0.0104 | 5.1 ± 0.8 | 5.4 ± 1.11 | 0.3198 |
BAR (dynes/sec/cm5) | 207 ± 104 | 177 ± 78 | 0.0514 | 175 ± 80 | 179 ± 83 | 0.3215 |
SpO2 (%) | 88.17 ± 5.46 | 90.3 ± 3.4 | 0.1282 | 81.2 ± 8.0 | 83.8 ± 5.1 | 0.6052 |
High alt. vs. Low alt. | High alt. vs. Low alt. | |||
---|---|---|---|---|
Variables | in Winter | in Summer | ||
Est. ± S.E. | p | Est. ± S.E. | p | |
BP Components | ||||
SBP (mmHg) | 9.16 ± 3.40 | 0.0088 | 3.93 ± 6.14 | 0.5242 |
DBP (mmHg) | 3.28 ± 2.23 | 0.1093 | −0.86 ±3.65 | 0.8148 |
cSBP (mmHg) | 7.61 ± 3.51 | 0.0334 | 4.47 ± 6.33 | 0.4820 |
cDBP(mmHg) | 2.71 ± 2.23 | 0.2288 | −0.23 ± 4.03 | 0.9551 |
MAP (mmHg) | 4.23 ± 2.36 | 0.0780 | 2.92± 4.26 | 0.4961 |
PP (mmHg) | 5.02 ± 2.89 | 0.0865 | 4.30 ± 5.21 | 0.4118 |
HR (beats/min) | 16.48 ± 2.35 | <0.0001 | 9.51 ± 4.24 | 0.0282 |
Cardiac Function | ||||
LVE(sec) | −0.06 ± 0.01 | <0.0001 | −0.04 ± 0.02 | 0.0511 |
LV Max (mmHg/s) | 207.42 ± 60.51 | 0.0010 | 178.14 ±105.53 0.03 | 0.0959 |
LVC(1/s) | 1.86 ± 0.55 | 0.0012 | 2.07 ± 0.96 | 0.0346 |
CO (L/min) | 1.42 ± 0.26 | <0.0001 | 1.30 ± 0.46 | 0.0060 |
CI (L/min/m2) | 0.83 ± 0.14 | <0.0001 | 0.64 ± 0.24 | 0.0101 |
SV (mL) | 2.98 ± 2.03 | 0.1468 | 7.0 ± 3.6 | 0.0531 |
SVI (mL/m2) | 1.89 ± 1.10 | 0.0912 | 3.28 ± 1.93 | 0.0934 |
Vascular Function | ||||
SVC (mL/mmHg) | −0.07 ± 0.06 | 0.2669 | 0.01 ± 0.11 | 0.9150 |
SVR(dynes/sec/cm5) | −350.98 ± 70.21 | <0.0001 | −185.91 ± 122.73 | 0.1344 |
BAC (mL/mmHg) | −0.004 ± 0.005 | 0.4228 | −0.004 ± 0.008 | 0.6286 |
BAD (%/mmHg) | −0.39 ± 0.40 | 0.3259 | −0.34 ± 0.69 | 0.6227 |
BAR (dynes/sec/cm5) | −43.49 ± 12.33 | 0.0008 | −12.38 ± 21.51 | 0.5667 |
SpO2 (%) | −8.25 ± 1.47 | <0.0001 | −7.98 ± 2.84 | 0.0070 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Tsao, T.-M.; Hwang, J.-S.; Tsai, M.-J.; Lin, S.-T.; Wu, C.; Su, T.-C. Seasonal Effects of High-Altitude Forest Travel on Cardiovascular Function: An Overlooked Cardiovascular Risk of Forest Activity. Int. J. Environ. Res. Public Health 2021, 18, 9472. https://doi.org/10.3390/ijerph18189472
Tsao T-M, Hwang J-S, Tsai M-J, Lin S-T, Wu C, Su T-C. Seasonal Effects of High-Altitude Forest Travel on Cardiovascular Function: An Overlooked Cardiovascular Risk of Forest Activity. International Journal of Environmental Research and Public Health. 2021; 18(18):9472. https://doi.org/10.3390/ijerph18189472
Chicago/Turabian StyleTsao, Tsung-Ming, Jing-Shiang Hwang, Ming-Jer Tsai, Sung-Tsun Lin, Charlene Wu, and Ta-Chen Su. 2021. "Seasonal Effects of High-Altitude Forest Travel on Cardiovascular Function: An Overlooked Cardiovascular Risk of Forest Activity" International Journal of Environmental Research and Public Health 18, no. 18: 9472. https://doi.org/10.3390/ijerph18189472