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Sildenafil has no clinical benefit of increasing exercise capacity at Mount Everest Base Camp
Submit responseThe study has beyond doubt proved that seldenafil enhanced exercise capacity at low altitude when person is exposed to acute normobaric hypoxia. To say, sildenafil also increased exercise capacity during hypobaric hypoxia at Mount Everest Base Camp is over exaggeration. Increased in exercise capacity in placebo vs sildenafil group in the Base camp is statistically but not clinically significant (12%)[1}.
Headache is a common and deemed cardinal symptom of acute mountain sickness. It's good to know that with long term sildenafil intake up to 150 mg per day has no incidence of headache. But, trekkers and mountaineers who go to high altitude is basically for recreational purpose and their stay is short-term. So, it wouldn't be wrong to say sildenafil has potential of masking effect on symptoms of acute mountain sickness making sildenafil dangerous choice for mountaineers and hikers willing to take sildenafil as performance-enhancing drug. As early recognition and immediate descent is key to management of acute mountain sickness.
1. Ghofrani HA, Reichenberger F, Kohstall MG, Mrosek EH, Seeger T, Olschewski H, et al. Sildenafil increased exercise capacity during hypoxia at low altitudes and at Mount Everest base camp. A randomized, double- blind, placebo-controlled crossover trial. Ann Intern Med. 2004;141:169-77
Conflict of Interest:
None declared
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An ethical issue?
Submit responseThe recent study by Ghofrani et al published in the Annals was indeed a technical and logistic tour de force. However if they did obtain permission from the Nepal Health Research Council ( NHRC), they did not think it important enough to mention this in the text of their article.
Clearly involving the NHRC would have meant more paper work, but this step would have enabled some young Nepali researher ( as the NHRC rule mandates this) to be involved with the fascinating set of experiments performed by the authors of the study in the Mount Everest region of Nepal.
If the authors had done this,this study would also have been a moral tour de force. Interestingly I reckon it would be impossible for a Nepali team to arrive with ethical clearance from Nepal and carry out studies of this nature in Germany.
Conflict of Interest:
None declared