Active ascent accelerates the time course but not the overall incidence and severity of acute mountain sickness at 3,600 m

• Published in: Journal of applied physiology (1985) Vol. 135; no. 2; pp. 436 - 444
• Main Authors: Beidleman, Beth A, Figueiredo, Peter S, Landspurg, Steven D, Femling, Jon K, Williams, Jason D, Staab, Janet E, Buller, Mark J, Karl, J Philip, Reilly, Aaron J, Mayschak, Trevor J, Atkinson, Emma Y, Mesite, Timothy J, Hoyt, Reed W
• Format: Journal Article
• Language: English
• Published: United States American Physiological Society 01-08-2023
• Subjects: Acute Disease; Adult; Altitude; Altitude Sickness - epidemiology; Exercise - physiology; Humans; Incidence; Time Factors; Young Adult; hypoxia; exercise; hypobaric hypoxia; unacclimatized lowlanders; ascent rate
• ISSN: 8750-7587; 1522-1601; 1522-1601
• DOI: 10.1152/japplphysiol.00216.2023

Acute mountain sickness (AMS) typically peaks following the first night at high altitude (HA) and resolves over the next 2-3 days, but the impact of active ascent on AMS is debated. To determine the impact of ascent conditions on AMS, 78 healthy Soldiers (means ± SD; age = 26 ± 5 yr) were tested at baseline residence, transported to Taos, NM (2,845 m), hiked (
= 39) or were driven (
= 39) to HA (3,600 m), and stayed for 4 days. AMS-cerebral (AMS-C) factor score was assessed at HA twice on
(HA1), five times on
and
(HA2 and HA3), and once on
(HA4). If AMS-C was ≥0.7 at any assessment, individuals were AMS susceptible (AMS+;
= 33); others were nonsusceptible (AMS-;
= 45). Daily peak AMS-C scores were analyzed. Ascent conditions (active vs. passive) did not impact the overall incidence and severity of AMS at HA1-HA4. The AMS+ group, however, demonstrated a higher (
< 0.05) AMS incidence in the active vs. passive ascent cohort on HA1 (93% vs. 56%), similar incidence on HA2 (60% vs. 78%), lower incidence (
< 0.05) on HA3 (33% vs. 67%), and similar incidence on HA4 (13% vs. 28%). The AMS+ group also demonstrated a higher (
< 0.05) AMS severity in the active vs. passive ascent cohort on HA1 (1.35 ± 0.97 vs. 0.90 ± 0.70), similar score on HA2 (1.00 ± 0.97 vs. 1.34 ± 0.70), and lower (
< 0.05) score on HA3 (0.56 ± 0.55 vs. 1.02 ± 0.75) and HA4 (0.32 ± 0.41 vs. 0.60 ± 0.72). Active compared with passive ascent accelerated the time course of AMS with more individuals sick on HA1 and less individuals sick on HA3 and HA4.
This research demonstrated that active ascent accelerated the time course but not overall incidence and severity of acute mountain sickness (AMS) following rapid ascent to 3,600 m in unacclimatized lowlanders. Active ascenders became sicker faster and recovered quicker than passive ascenders, which may be due to differences in body fluid regulation. Findings from this well-controlled large sample-size study suggest that previously reported discrepancies in the literature regarding the impact of exercise on AMS may be related to differences in the timing of AMS measurements between studies.