PMID- 34992358 OWN - NLM STAT- MEDLINE DCOM- 20220322 LR - 20220429 IS - 1178-2005 (Electronic) IS - 1176-9106 (Print) IS - 1176-9106 (Linking) VI - 16 DP - 2021 TI - Effect of Nocturnal Oxygen on Blood Pressure Response to Altitude Exposure in COPD - Data from a Randomized Placebo-Controlled Cross-Over Trial. PG - 3503-3512 LID - 10.2147/COPD.S331658 [doi] AB - PURPOSE: Patients with chronic obstructive pulmonary disease (COPD) are particularly vulnerable to hypoxia-induced autonomic dysregulation. Hypoxemia is marked during sleep. In COPD, altitude exposure is associated with an increase in blood pressure (BP) and a decrease in baroreflex-sensitivity (BRS). Whether nocturnal oxygen therapy (NOT) may mitigate these cardiovascular autonomic changes in COPD at altitude is unknown. MATERIALS AND METHODS: In a randomized placebo-controlled cross-over trial, 32 patients with moderate-to-severe COPD living <800 m were subsequently allocated to NOT and placebo during acute exposure to altitude. Measurements were done at low altitude at 490 m and during two stays at 2048 m on NOT (3 L/min) and placebo (3 L/min, ambient air) via nasal cannula. Allocation and intervention sequences were randomized. Outcomes of interest were BP, BRS (from beat-to-beat BP measurement), BP variability (BPV), and heart rate. RESULTS: About 23/32 patients finished the trial per protocol (mean (SD) age 66 (5) y, FEV(1) 62 (14) % predicted) and 9/32 experienced altitude-related illnesses (8 vs 1, p < 0.05 placebo vs NOT). NOT significantly mitigated the altitude-induced increase in systolic BP compared to placebo (Delta median -5.8 [95% CI -22.2 to -1.4] mmHg, p = 0.05) but not diastolic BP (-3.5 [95% CI -12.6 to 3.0] mmHg; p = 0.21) or BPV. BRS at altitude was significantly higher in NOT than in placebo (1.7 [95% CI 0.3 to 3.4] ms/mmHg, p = 0.02). CONCLUSION: NOT may protect from hypoxia-induced autonomic dysregulation upon altitude exposure in COPD and thus protect from a relevant increase in BP and decrease in BRS. NOT may provide cardiovascular benefits in COPD during conditions of increased hypoxemia and may be considered in COPD travelling to altitude. CI - (c) 2021 Meszaros et al. FAU - Meszaros, Martina AU - Meszaros M AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Latshang, Tsogyal D AU - Latshang TD AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Aeschbacher, Sayaka S AU - Aeschbacher SS AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Huber, Fabienne AU - Huber F AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Flueck, Deborah AU - Flueck D AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Lichtblau, Mona AU - Lichtblau M AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Ulrich, Stefanie AU - Ulrich S AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Hasler, Elisabeth D AU - Hasler ED AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Scheiwiller, Philipp M AU - Scheiwiller PM AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Reinhard, Lukas AU - Reinhard L AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Ulrich, Silvia AU - Ulrich S AUID- ORCID: 0000-0002-5250-5022 AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. AD - Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland. FAU - Bloch, Konrad E AU - Bloch KE AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. AD - Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland. AD - Centre of Competence Sleep & Health, University of Zurich, Zurich, Switzerland. FAU - Furian, Michael AU - Furian M AUID- ORCID: 0000-0002-8518-5029 AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. FAU - Schwarz, Esther I AU - Schwarz EI AUID- ORCID: 0000-0001-8840-981X AD - Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland. AD - Centre of Competence Sleep & Health, University of Zurich, Zurich, Switzerland. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20211224 PL - New Zealand TA - Int J Chron Obstruct Pulmon Dis JT - International journal of chronic obstructive pulmonary disease JID - 101273481 RN - S88TT14065 (Oxygen) SB - IM MH - Aged MH - *Altitude MH - Blood Pressure MH - Cross-Over Studies MH - Humans MH - Hypoxia/diagnosis/therapy MH - Oxygen MH - *Pulmonary Disease, Chronic Obstructive/drug therapy/therapy PMC - PMC8713709 OTO - NOTNLM OT - COPD OT - altitude OT - baroreflex sensitivity OT - blood pressure OT - blood pressure variability OT - hypoxia OT - oxygen COIS- Prof. Dr. Silvia Ulrich reports grants from Swiss National Science Foundation, Swiss Lung League, Zurich Lung; grants, personal fees from Janssen/Actelion SA, Orpha Swiss; and personal fees from MSD SA, Switzerland, outside the submitted work. The authors declare that they do not have any financial or other conflict of interest to declare in relation with this work. EDAT- 2022/01/08 06:00 MHDA- 2022/03/23 06:00 PMCR- 2021/12/24 CRDT- 2022/01/07 06:19 PHST- 2021/08/12 00:00 [received] PHST- 2021/10/12 00:00 [accepted] PHST- 2022/01/07 06:19 [entrez] PHST- 2022/01/08 06:00 [pubmed] PHST- 2022/03/23 06:00 [medline] PHST- 2021/12/24 00:00 [pmc-release] AID - 331658 [pii] AID - 10.2147/COPD.S331658 [doi] PST - epublish SO - Int J Chron Obstruct Pulmon Dis. 2021 Dec 24;16:3503-3512. doi: 10.2147/COPD.S331658. eCollection 2021.