Influence of recent altitude exposure on sea level sympathetic neural & hemodynamic responses to orthostasis

Although it has been shown that muscle sympathetic nerve activity increases during high altitude exposure, mechanisms of sympathoexcitation and blood pressure control after return from altitude are not well described. We hypothesized that: (1) living for 12 days at 4300 m (Pikes Peak, Colorado) would result in increased muscle sympathetic nerve activity 24 h after return to sea level; (2) post-Pikes Peak sympathetic neural and hemodynamic responses to orthostasis would be decreased due to a potential 'ceiling effect' on sympathetic activity; and (3) the magnitude of individual increases in sympathetic nerve activity post-Pikes Peak would be inversely related to baseline sympathetic nerve activity before traveling to altitude. Muscle sympathetic nerve activity, heart rate and blood pressure were measured in 9 healthy individuals (24 ± 8 years) in supine, 30° and 45° head-up tilt positions. Measurements were conducted twice at sea level, once before (pre-Pikes Peak) a 12 day residence at 4300 m, and once within 24 h of return (post-Pikes Peak). Supine muscle sympathetic nerve activity was higher (post: 27 ± 5 vs pre: 17 ± 6 bursts/min) upon return from altitude (p < 0.05). Individual values for pre-Pikes Peak sympathetic activity were inversely related to post-altitude sympathoexcitation (r = − 0.69, p < 0.05). There were no differences in neural or cardiovascular responses to tilt between pre and post- Pikes Peak (p > 0.05). We conclude that 12 days' residence at 4300 m causes a sustained sympathoexcitation which does not impair the ability of muscle sympathetic nerves to respond appropriately to orthostasis.