Intermittent Hypoxic Conditioning in Healthy Elderly Subjects Proposal

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Many of the natural processes that occur in the body and have damaging effects are viewed only in terms of adverse effects. Until recently — until Kaelin, Ratcliffe, and Semenza received the 2019 Nobel Prize in Medicine for discovering the mechanism of cellular response to fluctuating oxygen changes — hypoxia was also evaluated only in terms of harmful morphofunctional effects on tissue. However, modern science has questioned this statement in light of the potential benefits of interval hypoxia on cardiovascular activity.

Because the elderly are an a priori vulnerable clinical cohort, it is appropriate to review the advances of modern medicine concerning hypoxic interval conditioning. Tobin et al. (2020) showed that intermittent hypoxia, implemented with an individually calculated dose, reliably improved patients’ quality of hematological parameters. Fundamentally important is that such a procedure does not lead to myocardial damage and does not create an extreme stress situation for the body, reducing the risk of myocardial infarction. A mediated effect was found in the study of Dale et al. (2014), who showed that erythropoietin and the erythropoietin receptor, which perform neuroprotective functions for the hippocampus, tend to accumulate due to the use of interval hypoxic conditioning. As a consequence of the increase in EPO and EPO-R, there is an intensification of vascularization and an increase in hemoglobin concentration. Schmutz et al. (2010) previously described the preventive effect of hypoxic training and investigated the relationship between oxygen deprivation and cell resistance. Intermittent hypoxia has been shown to have positive effects on cell resistance and, remarkably, reduced vulnerability to free-radical processes. Since free radicals accumulate in the older person and lead to cardiomyopathy and heart failure, hypoxic conditioning is a clinical solution to this problem. Thus, for healthy elderly patients, hypoxic interval conditioning has reliable, evidence-based efficacy if the methodological framework is followed.

References

Dale, E. A., Ben Mabrouk, F., & Mitchell, G. S. (2014). Unexpected benefits of intermittent hypoxia: Enhanced respiratory and nonrespiratory motor function. Physiology, 29(1), 39-48.

Schmutz, S., Däpp, C., Wittwer, M., Durieux, A. C., Mueller, M., Weinstein, F.,… & Flück, M. (2010). A hypoxia complement differentiates the muscle response to endurance exercise. Experimental Physiology, 95(6), 723-735.

Tobin, B., Costalat, G., & Renshaw, G. M. (2020). Intermittent, not continuous, hypoxia provoked hematological adaptations in healthy seniors: Hypoxic pattern may hold the key. European Journal of Applied Physiology, 120(3), 707-718.

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