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Viagra for Mountaineers  
Here is some interesting news for all you climbers out there. A new use for Viagra may be in the works. The erectile dysfunction drug may help protect against lung problems resulting from high altitudes.....

Distribution Source : Viagracures.com
Date : May 18, 2005

Here is some interesting news for all you climbers out there. A new use for Viagra may be in the works. The erectile dysfunction drug may help protect against lung problems resulting from high altitudes, say French researchers.

Now sildenafil, better known by its trade name, Viagra, is gaining popularity for a different use among skiers and mountain climbers. Their concern: avoiding high-altitude pulmonary edema, a potentially deadly condition in which excess fluid collects in the lungs.

Research has been accumulating about sildenafil's value in non sex-related uses. The drug has been shown to help some people with high blood pressure in arteries supplying the lungs, a condition known as pulmonary hypertension. Viagra (sildenafil) helped stop dangerous high-altitude health conditions.

High-altitude pulmonary edema (HAPE) occurs when high altitude and low air pressure causes fluid to leak from blood vessels and builds up in the lungs. The fluid in the lungs interferes with effective oxygen exchange. As the condition becomes more severe, the level of oxygen in the bloodstream decreases, and this can lead to cyanosis, impaired cerebral function, walking and sleeping, as well as listlessness and death. HAPE has a mortality rate of 44% if untreated. . One of the methods for testing for HAPE is to check recovery time after exertion. Recovery time refers to the time after exertion that it takes for heart rate and respiration to return to near normal. An increase in this time may mean fluid is building up in the lungs. If a case of HAPE is suspected an immediate descent is a necessary life-saving measure (2,000 - 4,000 feet). Anyone suffering from HAPE must be evacuated to a medical facility for proper follow-up treatment. Early data suggests that nifedipine may have a protective effect against high altitude pulmonary edema (University of Iowa, 1995). Confusion and irrational behavior are signs that insufficient oxygen is reaching the brain. It's triggered by intense physical exertion at high altitudes that people aren't accustomed to.

Experiment with Viagra and placebo

Half of the men received Viagra. The rest were given a placebo. The Viagra group took 40 milligrams of the drug three times a day, starting on their first day on the mountain.

At first, both groups struggled to adjust. "Subjects suffered from acute mountain sickness until day four," say the researchers.

High altitudes caused a lot of problems. Their blood pressure rose 29% higher than at sea level. Dizziness and stomach problems were similar in both groups.

After one or two days, the Viagra group's blood pressure started to normalize. By the sixth day, it was 6% lower than before the experiment.
But for the placebo group, it remained high, leveling off about 21% higher than normal.

As expected, high altitude made breathing rougher for all of the men. But the Viagra group had less of a setback at rest and during exercise than the placebo group. Side effects were minor, such as muscle pain, say the researchers.

Signs and symptoms of HAPE include any of the following:

- Extreme fatigue
- Breathlessness at rest
- Fast, shallow breathing
- Cough, possibly productive of frothy or pink sputum
- Gurgling or rattling breaths
- Chest tightness, fullness, or congestion
- Blue or gray lips or fingernails
- Drowsiness

HAPE can be confused with a number of other respiratory conditions:

High Altitude Cough and Bronchitis are both characterized by a persistent cough with or without sputum production. There is no shortness of breath at rest, no severe fatigue. Normal oxygen saturations (for the altitude) will be measured if a pulse oximeter is available.

Pneumonia can be difficult to distinguish from HAPE. Fever is common with HAPE and does not prove the patient has pneumonia. Coughing up green or yellow sputum may occur with HAPE, and both can cause low blood levels of oxygen. The diagnostic test (and treatment) is descent - HAPE will improve rapidly. If the patient does not improve with descent, then consider antibiotics. HAPE is much more common at altitude than pneumonia, and more dangerous; many climbers have died of HAPE when they were mistakenly treated for pneumonia.

Asthma might also be confused with HAPE. Fortunately, asthmatics seem to do better at altitude than at sea-level. If you think it's asthma, try asthma medications, but if the person does not improve fairly quickly assume it is HAPE and treat it accordingly.

Treatment for HAPE victims

Treatment typically involves supplemental oxygen and the drug nifedipine (Adalat, Procardia), which lowers pulmonary artery pressure.

In the lungs, sildenafil keeps the blood vessels dilated. Pressure doesn't build, and the vessels don't leak fluid into the lungs' tiny air sacs.

For mountain climbers, a typical dose of sildenafil is 50 milligrams every eight hours, to treat erectile dysfunction, the usual dose is 50 milligrams before sex.

Unwanted sexual arousal usually is not a problem, there has to be sexual stimulation, which is usually not available on a mountain-climbing expedition.

Scientists have found that the same enzyme that constricts blood flow to the penis, preventing erections, also produces breathlessness at high altitudes by constricting the arteries in the lungs.

When Viagra is taken it inhibits the action of this enzyme, known as phosphodiesterase.

In the lungs this is crucial, as nitric oxide has the ability to dilate blood vessels and reduce blood pressure allowing people to avoid high altitude sickness. In the past nitric oxide has been used to relieve the symptoms of altitude.

More work needs to be done on Sildenafil (Viagra!) for treatment and prevention of HAPE, but the preliminary work look very promising.

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