Effects of aspirin during exercise on the incidence of high-altitude headache: a randomized, double-blind, placebo-controlled trial.
OBJECTIVE
To evaluate the efficacy of aspirin for headache when exercising during acute high-altitude exposure.


BACKGROUND
Aspirin effectively prevents headache when mostly resting during acute high-altitude exposure. However, the majority of individuals exposed to high altitude perform mountaineering activities, which might trigger headache.


METHODS
Randomized, double-blind, placebo-controlled trial.


METHODS
Thirty-one healthy volunteers (20 men, 11 women; aged 22 to 59 years) were transported to an altitude of about 3000 meters and climbed up to 3800 meters. They then descended to a mountain hut at 3480 meters and spent 2 nights there. Tablets (placebo or 320 mg aspirin) were administered three times at 4-hour intervals, beginning 2 hours before arrival at high altitude. Headache scoring and measurements of heart rate, blood pressure, and arterial oxygen saturation were performed.


RESULTS
Ninety-three percent (14 of 15) of the placebo group and 56% (9 of 16) of the aspirin group developed headache when mountaineering activities were performed during acute exposure to high altitude (P<.05). Five hours after arrival at high altitude, mean resting oxygen saturation was 86.1% +/- 2.1% with aspirin and 85.7 % +/- 2.8% with placebo (P =.66). However, subjects in the aspirin group developed headache at saturation values less than or equal to 86%, while those in the placebo group developed headache at saturation values less than 90%.


CONCLUSIONS
Although the prophylactic intake of about 1 gram of aspirin reduced the headache incidence when exercising during acute high-altitude exposure, the incidence of headache was higher than previously shown for resting conditions. Aspirin resulted in tolerance to lower arterial oxygen saturation without development of headache; exercise had the opposite effect.
Burtscher
M
M
Department of Sport Science, Medical Section, University of Innsbruck, Austria.
Likar
R
R
Nachbauer
W
W
Philadelphy
M
M
Pühringer
R
R
Lämmle
T
T
D000208:Acute Disease; D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000150:complications* / Q000503:physiopathology; D001241:Aspirin / Q000627:therapeutic use*; D004311:Double-Blind Method; D015444:Exercise / Q000502:physiology; D005260:Female; D006261:Headache / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000502:physiology; D010100:Oxygen / Q000097:blood
D001241:Aspirin; D010100:Oxygen