Abstract | OBJECTIVES: Over the last 20 years a number of small trials have reported that spironolactone effectively prevents acute mountain sickness (AMS), but to date there have been no large randomized trials investigating the efficacy of spironolactone in prevention of AMS. Hence, a prospective, double-blind, randomized, placebo-controlled trial was conducted to evaluate the efficacy of spironolactone in the prevention of AMS. METHODS: Participants were sampled from a diverse population of western trekkers recruited at 4300 m on the Mount Everest base camp approach (Nepal side) en route to the study endpoint at 5000 m. Three hundred and eleven healthy trekkers were enrolled, and 251 completed the trial from October to November 2007. Participants were randomly assigned to receive at least 3 doses of spironolactone 50 mg BID, acetazolamide 250 mg BID, or visually matched placebo. A Lake Louise AMS Score of 3 or more, together with the presence of headache and 1 other symptom, was used to evaluate the incidence and severity of AMS. Secondary outcome measures were blood oxygen content and the incidence and severity of high altitude headache (HAH). RESULTS: CONCLUSIONS:
Spironolactone (50 mg BID) was ineffective in comparison to acetazolamide (250 mg BID) in the prevention of AMS in partially acclimatized western trekkers ascending to 5000 m in the Nepali Himalaya.
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Authors | Buddha Basnyat, Peter S Holck, Matiram Pun, Stephen Halverson, Piotr Szawarski, Jeffrey Gertsch, Mike Steif, Skip Powell, Subhash Khanal, Anip Joshi, Ravi Shankar, Jamie Karambay, Hattie D Alexander, Allyson Stone, Candice Morrissey, Beth H Thompson, Jeremy Farrar, SPACE Trial Group |
Journal | Wilderness & environmental medicine
(Wilderness Environ Med)
Vol. 22
Issue 1
Pg. 15-22
(Mar 2011)
ISSN: 1545-1534 [Electronic] United States |
PMID | 21377114
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2011 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Spironolactone
- Acetazolamide
- Oxygen
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Topics |
- Acetazolamide
(administration & dosage)
- Adult
- Altitude Sickness
(epidemiology, prevention & control)
- Double-Blind Method
- Female
- Headache
(epidemiology, prevention & control)
- Humans
- Male
- Mountaineering
- Nepal
(epidemiology)
- Oxygen
(blood)
- Prospective Studies
- Spironolactone
(administration & dosage)
- Treatment Outcome
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