Travel Health Evidence

Evidence map

Altitude: what the evidence base looks like

21 publications, 8 of them trials and 8 syntheses. This page describes the shape of that literature rather than summarising its conclusions.

Updated 3 min read 21 citations

Waiting area of an airport departure hall with rows of seats and daylight from above
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What the evidence on altitude is made of Of 21 publications on this topic, the breakdown by study type: 8 meta-analysis, 8 randomised trial, 4 review, 1 other. 884meta-analysis (8)randomised trial (8)review (4)other (1)
21 publications, by study type. Volume is not strength — the same count can be a settled question or a pile of commentary, and which one it is depends almost entirely on this breakdown. Harvested from PubMed and Crossref; publication type as recorded by the source.

What this literature is made of

This is a well-developed evidence base: multiple syntheses sitting on a substantial body of trials. Questions here are usually about applicability rather than about whether an effect exists.

The distinction that matters most is between synthesis and primary research. A meta-analysis pools trials and is the closest thing to a settled answer a field produces. A narrative review is one group's reading of the same material and can be selective without being dishonest. Counting them together, which most citation counts do, obscures exactly the thing you want to know.

When the altitude literature was published Publication years for the 21 papers on this topic, grouped into bands from before 2015 through to 2023 onwards. 2023 onwards7 papersBefore 20156 papers2015-20195 papers2020-20223 papers
Still active. The most recent paper here is from 2026, so this is a field where an answer written today may not hold for long. Publication years as recorded by PubMed and Crossref.

How this page is built

Everything above is computed from the citations this site harvested from PubMed and Crossref, not written by hand. When the weekly harvest finds a new paper on this topic, these counts change and the characterisation changes with them. That is the point: a hand-written claim about how strong an evidence base is starts decaying the day it is written.

Publication type is taken as the source records it. That is imperfect — journals label inconsistently, and a paper indexed as a "review" may be a systematic one — so treat the bands as approximate. They are accurate enough to distinguish a trial literature from a commentary literature, which is the distinction that matters.

Covered platforms and tracks at Wrocław Główny station under an arched roof
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The strongest work on this topic

Ordered by study design first, then recency. The full set is listed in the references below.

  1. Comparative effects of pharmacological interventions for the prevention of acute mountain sickness: A systematic review and Bayesian network meta-analysis — Wang J, Lian N, Tang K et al., 2025, meta-analysis
  2. Effect of nitrate supplementation on oxygen saturation levels for acute mountain sickness prevention: A systematic review and meta-analysis — Nafi'an MRT, Sabirin RM, Wibowo RA et al., 2024, meta-analysis
  3. Ibuprofen versus acetazolamide for prevention of acute mountain sickness — Schilling M, Irarrázaval S, 2020, meta-analysis
  4. Acetazolamide for the treatment of acute mountain sickness — Tapia L, Irarrázaval S, 2019, meta-analysis
  5. Ginkgo biloba extract for prevention of acute mountain sickness: a systematic review and meta-analysis of randomised controlled trials — Tsai TY, Wang SH, Lee YK et al., 2018, meta-analysis
  6. Dexamethasone for the prevention of acute mountain sickness: systematic review and meta-analysis — Tang E, Chen Y, Luo Y, 2014, meta-analysis
  7. Acetazolamide for the prevention of acute mountain sickness--a systematic review and meta-analysis — Ritchie ND, Baggott AV, Andrew Todd WT, 2012, meta-analysis
  8. Altitude sickness — Murdoch D, 2010, systematic review
  9. Gut microbiota-targeted dietary supplementation with fermentable fibers and polyphenols prevents hypobaric hypoxia-induced increases in intestinal permeability — Karl JP, Fagnant HS, Radcliffe PN et al., 2025, randomised controlled trial
  10. Effects of acetazolamide combined with remote ischemic preconditioning on risk of acute mountain sickness: a randomized clinical trial — Liu M, Jiao X, Li R et al., 2024, randomised controlled trial
How much research is there on altitude?
21 publications are indexed here, of which 8 are trials and 8 are syntheses.
Does more research mean a stronger conclusion?
No. Composition matters more than volume — five randomised trials support a claim far better than fifty commentaries, and citation counts do not distinguish between them.
How current is this?
The most recent paper indexed here is from 2026. The set is refreshed weekly from PubMed and Crossref.
Why does this page not tell me the answer?
Because summarising a literature into a conclusion requires reading it, and doing that automatically is how confident nonsense gets published. This page tells you how much weight a conclusion could bear; the articles on this site do the interpreting.

References

Every citation below links to the original peer-reviewed record on PubMed or via DOI. Nothing here is a substitute for medical advice.

  1. Comparative effects of pharmacological interventions for the prevention of acute mountain sickness: A systematic review and Bayesian network meta-analysis Wang J, Lian N, Tang K, et al. · Travel medicine and infectious disease · 2025 · Meta-analysis DOIPubMed 40383249
  2. Effect of nitrate supplementation on oxygen saturation levels for acute mountain sickness prevention: A systematic review and meta-analysis Nafi'an MRT, Sabirin RM, Wibowo RA, et al. · Nitric oxide : biology and chemistry · 2024 · Meta-analysis DOIPubMed 39002891
  3. Ibuprofen versus acetazolamide for prevention of acute mountain sickness Schilling M, Irarrázaval S · Medwave · 2020 · Meta-analysis DOIPubMed 32604398
  4. Acetazolamide for the treatment of acute mountain sickness Tapia L, Irarrázaval S · Medwave · 2019 · Meta-analysis DOIPubMed 31891352
  5. Ginkgo biloba extract for prevention of acute mountain sickness: a systematic review and meta-analysis of randomised controlled trials Tsai TY, Wang SH, Lee YK, et al. · BMJ open · 2018 · Meta-analysis DOIPubMed 30121603Full text
  6. Dexamethasone for the prevention of acute mountain sickness: systematic review and meta-analysis Tang E, Chen Y, Luo Y · International journal of cardiology · 2014 · Meta-analysis DOIPubMed 24679688
  7. Acetazolamide for the prevention of acute mountain sickness--a systematic review and meta-analysis Ritchie ND, Baggott AV, Andrew Todd WT · Journal of travel medicine · 2012 · Meta-analysis DOIPubMed 22943270
  8. Altitude sickness Murdoch D · BMJ clinical evidence · 2010 · Systematic review PubMed 21718562Full text
  9. Gut microbiota-targeted dietary supplementation with fermentable fibers and polyphenols prevents hypobaric hypoxia-induced increases in intestinal permeability Karl JP, Fagnant HS, Radcliffe PN, et al. · American journal of physiology. Regulatory, integrative and comparative physiology · 2025 · Randomised controlled trial DOIPubMed 40701649
  10. Effects of acetazolamide combined with remote ischemic preconditioning on risk of acute mountain sickness: a randomized clinical trial Liu M, Jiao X, Li R, et al. · BMC medicine · 2024 · Randomised controlled trial DOIPubMed 38166913Full text
  11. Effects of acetazolamide on pulmonary artery pressure and prevention of high-altitude pulmonary edema after rapid active ascent to 4,559 m Berger MM, Sareban M, Schiefer LM, et al. · Journal of applied physiology (Bethesda, Md. : 1985) · 2022 · Randomised controlled trial DOIPubMed 35511718
  12. Acetazolamide does not alter endurance exercise performance at 3,500-m altitude Bradbury KE, Yurkevicius BR, Mitchell KM, et al. · Journal of applied physiology (Bethesda, Md. : 1985) · 2020 · Randomised controlled trial DOIPubMed 31804890
  13. Altitude Sickness Prevention with Ibuprofen Relative to Acetazolamide Burns P, Lipman GS, Warner K, et al. · The American journal of medicine · 2019 · Randomised controlled trial DOIPubMed 30419226
  14. Budesonide Versus Acetazolamide for Prevention of Acute Mountain Sickness Lipman GS, Pomeranz D, Burns P, et al. · The American journal of medicine · 2018 · Randomised controlled trial DOIPubMed 28668540
  15. Acute mountain sickness; prophylactic benefits of antioxidant vitamin supplementation at high altitude Bailey DM, Davies B · High altitude medicine & biology · 2001 · Randomised controlled trial DOIPubMed 11252695
  16. The incidence, importance, and prophylaxis of acute mountain sickness Hackett PH, Rennie D, Levine HD · Lancet (London, England) · 1976 · Randomised controlled trial DOIPubMed 62991
  17. Altitude hypoxia and hypoxemia: pathogenesis and management Cai C, Ni G, Chen L, et al. · Signal transduction and targeted therapy · 2026 · Review DOIPubMed 41571626Full text
  18. High Altitude Berger MM, Luks AM · Seminars in respiratory and critical care medicine · 2023 · Review DOIPubMed 37816346
  19. Acute high-altitude sickness Luks AM, Swenson ER, Bärtsch P · European respiratory review : an official journal of the European Respiratory Society · 2017 · Review DOIPubMed 28143879Full text
  20. Acute mountain sickness: pathophysiology, prevention, and treatment Imray C, Wright A, Subudhi A, et al. · Progress in cardiovascular diseases · 2010 · Review DOIPubMed 20417340
  21. Wilderness Medical Society Clinical Practice Guidelines for the Prevention, Diagnosis, and Treatment of Acute Altitude Illness: 2024 Update Luks AM, Beidleman BA, Freer L, et al. · Wilderness & environmental medicine · 2024 · Journal article DOIPubMed 37833187