title: Aging, High Altitude, and Blood Pressure: A Complex Relationship.
abstract: Parati, Gianfranco, Juan Eugenio Ochoa, Camilla Torlasco, Paolo Salvi, Carolina Lombardi, and Grzegorz Bilo. Aging, high altitude, and blood pressure: A complex relationship. High Alt Biol Med 16:97-109, 2015.--Both aging and high altitude exposure may induce important changes in BP regulation, leading to significant increases in BP levels. By inducing atherosclerotic changes, stiffening of large arteries, renal dysfunction, and arterial baroreflex impairment, advancing age may induce progressive increases in systolic BP levels, promoting development and progression of arterial hypertension. It is also known, although mainly from studies in young or middle-aged subjects, that exposure to high altitude may influence different mechanisms involved in BP regulation (i.e., neural central and reflex control of sympathetic activity), leading to important increases in BP levels. The evidence is less clear, however, on whether and to what extent advancing age may influence the BP response to acute or chronic high altitude exposure. This is a question not only of scientific interest but also of practical relevance given the consistent number of elderly individuals who are exposed for short time periods (either for leisure or work) or live permanently at high altitude, in whom arterial hypertension is frequently observed. This article will review the evidence available on the relationship between aging and blood pressure levels at high altitude, the pathophysiological mechanisms behind this complex association, as well as some questions of practical interest regarding antihypertensive treatment in elderly subjects, and the effects of antihypertensive drugs on blood pressure response during high altitude exposure.
authors.affiliation: 1 Cardiovascular Medicine, Department of Health Sciences, University of Milan-Bicocca , Milan, Italy .|2 Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano , Milan, Italy .
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.affiliation: 2 Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano , Milan, Italy .
authors.forename: Juan Eugenio
authors.initials: JE
authors.lastname: Ochoa
authors.affiliation: 1 Cardiovascular Medicine, Department of Health Sciences, University of Milan-Bicocca , Milan, Italy .|2 Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano , Milan, Italy .
authors.forename: Camilla
authors.initials: C
authors.lastname: Torlasco
authors.affiliation: 2 Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano , Milan, Italy .
authors.forename: Paolo
authors.initials: P
authors.lastname: Salvi
authors.affiliation: 2 Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano , Milan, Italy .
authors.forename: Carolina
authors.initials: C
authors.lastname: Lombardi
authors.affiliation: 2 Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano , Milan, Italy .
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Bilo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000531:Altitude; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents