Distinguishing Therapeutic Hypoxia from Pathogenic Hypoxia: Benefits for Cardiac Patients

Abstract

Kieran Oldfield, Rohan Jayasinghe and Gillian Renshaw*

Therapeutic intermittent hypoxia is a non-pharmacological lab-based intervention with the demonstrated benefits of ascent to moderate altitude. Depending on the dose or severity of therapeutic intermittent hypoxia or high-altitude, hypoxic exposure can stabilise master gene regulators to instigate beneficial adaptations. Therapeutic intermittent hypoxia has been demonstrated to initiate adaptive phenotypic changes such as: decreased sympathetic input with a decrease in systolic blood pressure; increased haemoglobin and red blood cell count; altered substrate metabolism to favour increased glucose uptake and fatty acid metabolism with decreased fatty acid synthesis; increased antioxidant defence; decreased inflammatory cytokines. Such beneficial adaptive changes to therapeutic intermittent hypoxia serve not only to diminish the impact of cardiovascular pathology but also to increase exercise tolerance.

Several lines of evidence indicate that therapeutic intermittent hypoxia may provide a new treatment modality for people affected by heart failure with a reduced ejection fraction. This review aims to identify links in the literature between heart failure pathophysiology and the beneficial adaptations induced by TIH.