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MINI REVIEW article

Front. Physiol.

Sec. Environmental, Aviation and Space Physiology

Volume 16 - 2025 | doi: 10.3389/fphys.2025.1642777

This article is part of the Research TopicPhysiological and Pathological Responses to Hypoxia and High Altitude, Volume IIIView all 16 articles

Changes and monitoring technology of human heart rate and blood oxygen saturation under high-altitude hypoxia

Provisionally accepted
  • 1College of Pharmacy, Chengdu University, Chengdu, China
  • 2Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, China

The final, formatted version of the article will be published soon.

High-altitude hypoxia affects human physiology and primarily regulates the cardiovascular system by hypoxia-inducible factor and relative factors. This review introduces physiological changes in heart rate and blood oxygen saturation, commonly used monitoring techniques, and their limitations for the diagnosis of acute mountain sickness (AMS). Under acute hypoxia, peripheral oxygen saturation (SpO2) decreases, and heart rate increases; under subacute hypoxia, SpO2 rebound but remain below sea level baseline values, and heart rate gradually decreases; under long-term hypoxia heart rate returns to baseline values at sea level, but SpO2 remains below them. Tibetans exhibit lower heart rate than Han Chinese at identical altitudes, while Andeans show elevated heart rate versus lowlanders. SpO2 reductions persist in Tibetans/Andeans but approach lowlander levels in Ethiopians. Cerebral oxygen saturation is also used as a complementary indicator of blood oxygen saturation and could be applied to the monitoring of high-altitude hypoxic level, but there are fewer studies in this area. Current heart rate and blood oxygen saturation monitoring mainly relies on photoplethysmography (PPG). Researchers are aiming to use more objective monitoring of PPG to diagnose AMS, mainly focused on heart rate and blood oxygen saturation. While they have been identified as potential early warning indicators of AMS, significant individual variability leads to use them as definitive criteria for AMS diagnosis difficultly. Future research requires enhanced monitoring precision, exploring how individual genetic differences impact hypoxic responses, and developing personalized prevention and treatment strategies in order to provide new insights into high-altitude medicine.

Keywords: high-altitude, hypoxia, Heart Rate, Blood oxygen saturation, Photoplethysmography, acute mountain sickness

Received: 07 Jun 2025; Accepted: 21 Aug 2025.

Copyright: © 2025 Liao, Lu and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dianxiang Lu, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, China
Jin Yang, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, China

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