Blood Pressure in Inhabitants of High Altitude of Western Nepal

Shrestha, Suvash; Shrestha, Amrit Kumar; Bhattarai, Dharmagat

doi:10.31729/jnma.371

Cited by 21 publications

(20 citation statements)

References 13 publications

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“…The prevalence of HT (or those on anti-hypertensive medication) in participants in the present study is higher than in other studies carried out in HA populations in Nepal using a similar definition [26][27][28] .…”

Section: Discussioncontrasting

confidence: 84%

Blood pressure and hypertension in people living at high altitude in Nepal

et al. 2018

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This study aimed to describe blood pressure (BP) and hypertension (HT) in samples of high altitude populations of Nepal and to explore associations of systolic and diastolic BP with altitude. This was a cross-sectional survey of cardiovascular disease and associated risk factors among 521 people living at four different altitude levels, all above 2800 m, in the Mustang and Humla districts of Nepal. Data on BP was available for all 521 participants. Systolic and diastolic BP levels were highest at the altitude of 3620 m (the highest area surveyed) but did not consistently increase with altitude. Using the cut-point of ≥140/90 mmHg (systolic/diastolic), the prevalence of HT (or on anti-hypertensive medication) was 46.1%, 40.9%, and 54.5% respectively at 2800 m, 3270 m and 3620 m of Mustang district, and 29.1% at 2890 m of Humla district. In a multivariate model adjusting for potential confounders there was strong evidence of a relationship between systolic BP and altitude; mean systolic BP increased by 15.6 mmHg (95% CI 4.0 to 27.2), P=0.009 for every 1000 m elevation. Although diastolic BP and the probability for HT or on anti-hypertensive medication also tended to increase with increasing altitude levels, there was no evidence of a relationship. In the present study three out of four communities living at higher altitude levels showed a greater prevalence of HT among those aged 30 years or older compared with the overall national data. These findings indicate a probable high risk of raised BP in high altitude populations in Nepal.

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Section: Discussioncontrasting

confidence: 84%

Blood pressure and hypertension in people living at high altitude in Nepal

et al. 2018

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“…Contradicting results have been found in studies of the relationship between BP and chronic hypoxic-hypobaric conditions in individuals living at high altitude. One study performed in Nepalese individuals living at high altitude in a rural location found a lower prevalence of hypertension, suggesting that BP decreased with the increase in altitude [5]. However, previous research performed by our group showed that BP levels were significantly higher in children living at 3750 m compared with children from a community of a similar background but living at a lower altitude (1400 m) [6].…”

Section: Introductioncontrasting

confidence: 51%

Blood pressure level increase with altitude in three argentinean indigenous communities

et al. 2019

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ObjectiveTo compare blood pressure (BP) levels in three groups of Argentinean Indigenous schoolchildren from similar ethnic backgrounds but living at three different altitudes.MethodsA cross-sectional study compared 185 (83 females) children aged 5–14 years from San Antonio de los Cobres (SAC), 3750 m above sea level; 46 (23 females) from Cobres, 3450 m; and 167 (83 females) from Chicoana (CH), 1400 m. Anthropometric and BP measurements were performed.ResultsThe prevalence of overweight/obesity was lower in SAC (6.5% [12]) and Cobres (4.3% [2]) than in CH (24% [24]) (BMI > 85 percentile per CDC norms). Systolic BP increased significantly with altitude: (SAC 86 mm Hg, Cobres 77 mm Hg, and CH 69 mm Hg). Similar results were obtained with diastolic BP (SAC 57 mm Hg, Cobres 51 mm Hg, and CH 47 mm Hg) and with median arterial pressure (MAP) (SAC 67 mm Hg, Cobres 60 mm Hg, and CH 55 mm Hg). Multiple linear regression analyses showed that altitude was significantly and independently associated with children's systolic BP (beta 10.56; R2 = 0.40), diastolic BP (beta 6.27; R2 = 0.25) and MAP (beta 7.69; R2 = 0.32); adjusted for age, sex, and BMI.ConclusionsWe found that as altitude increased, BP levels increased significantly in indigenous children from similar backgrounds living permanently at different altitudes.

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“…For example, a systematic review analysed different cross-sectional surveys from Tibet and suggested a positive correlation between altitude and the prevalence of hypertension 22. Conversely, lower rates of hypertension have been observed in individuals from high-altitude rural areas of Nepal 23. There is evidence that blood pressure does not vary in response to short-term hypoxic exposure;24 and increased blood pressure during altitude adaptation is explained by sympathetic nervous system activation 25.…”

Section: Discussionmentioning

confidence: 99%

Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension

Bernabé‐Ortiz

Carrillo‐Larco

Gilman

et al. 2017

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BackgroundMost of the data regarding the burden of hypertension in low-income and middle-income countries comes from cross-sectional surveys instead of longitudinal studies. We estimated the incidence of, and risk factors for, hypertension in four study sites with different degree of urbanisation and altitude.MethodsData from the CRONICAS Cohort Study, conducted in urban, semiurban and rural areas in Peru, was used. An age-stratified and sex-stratified random sample of participants was taken from the most updated census available in each site. Hypertension was defined as systolic blood pressure ≥140 mm Hg, or diastolic blood pressure ≥90 mm Hg, or self-report physician diagnosis and current treatment. The exposures were study site and altitude as well as modifiable risk factors. Incidence, incidence rate ratios (IRRs), 95% CIs and population-attributable fractions (PAFs) were estimated using generalised linear models.ResultsInformation from 3237 participants, mean age 55.8 (SD±12.7) years, 48.4% males, was analysed. Overall baseline prevalence of hypertension was 19.7% (95% CI 18.4% to 21.1%). A total of 375 new cases of hypertension were recorded, including 5266 person-years of follow-up, with an incidence of 7.12 (95% CI 6.44 to 7.88) per 100 person-years. Individuals from semiurban site were at higher risk of hypertension compared with highly urbanised areas (IRR=1.76; 95% CI 1.39 to 2.23); however, those from high-altitude sites had a reduced risk (IRR=0.74; 95% CI 0.58 to 0.95). Obesity was the leading risk factor for hypertension with a great variation according to study site with PAF ranging from 12.5% to 42.4%.ConclusionsOur results suggest heterogeneity in the progression towards hypertension depending on urbanisation and site altitude.

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Blood Pressure in Inhabitants of High Altitude of Western Nepal

Cited by 21 publications

References 13 publications

Blood pressure and hypertension in people living at high altitude in Nepal

Blood pressure and hypertension in people living at high altitude in Nepal

Blood pressure level increase with altitude in three argentinean indigenous communities

Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension

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