Mini review of high altitude health problems in Ladakh

Norboo²,

Biomedicine & Pharmacotherapy

et al. 2005

The effect of aging on blood pressure (BP) and heart rate (HR) was investigated in a cross-sectional study in the high-altitude community of Leh, Ladakh (altitude: 3524 m) and a Japanese community in U town, Hokkaido (altitude: 25 m). BP and HR were obtained in a sitting position from 332 subjects 13-81 years of age in Ladakh, and from 216 Japanese citizens, 24-79 years of age. Measurements were taken after a 2-min rest, using a semi-automated BP device (UA-767 PC, A&D Co. LTD, Tokyo). High-altitude people showed higher diastolic BP and HR values than lowland people (83.2 vs. 76.9 mmHg and 78.6 vs. 69.2 bpm, P < 0.001), but no difference in systolic BP. Highland people also showed a steeper BP increase with age than the lowland people (systolic BP: 0.7476 vs. 0.3179 mmHg/year, P < 0.0005; diastolic BP: 0.3196 vs. 0.0750 mmHg/year, P < 0.001). This chronoecologic investigation in Ladakh examined the circulation as a physiological system at highaltitude. Our data indicate the need for a more comprehensive cardiovascular assessment for a better diagnosis and a more fruitful treatment. Longitudinal observations of effects of socio-ecologic factors on the cardiovascular system should help prevent strokes and other cardiovascular events, especially at high altitude.

Section: Discussionmentioning

confidence: 99%

Effect of aging on blood pressure in Leh, Ladakh, a high-altitude (3524 m) community, by comparison with a Japanese town

Norboo²,

Biomedicine & Pharmacotherapy

et al. 2005

Archives of Environmental & Occupational Health

“…[3][4][5][6][7][8][9][10][11][12] The World Bank has estimated that indoor air pollution is responsible for almost half the burden of disease in developing countries. 2,13 In India alone, it is estimated that 400,000 to 550,000 premature deaths can be contributed to the use of biomass fuels.14 In Ladakh, Indian Himalaya, research has shown a prevalence of chronic cough, chronic phlegm, nonoccupational pneumoconiosis, and respiratory morbidity.15, 16 We studied a unique population of nomadic people living at elevations greater than 4500 m (approximately 240 km southeast of Leh, Ladakh, India). These nomads rely on their animal herds for subsistence, and they use biomass (brush and animal dung) for fuel for cooking and heating.…”

mentioning

confidence: 99%

Respiratory Health and Indoor Air Pollution at High Elevation

Rosati

Yoneda²,

Wood³

et al. 2005

Self Cite

In this research, the authors sought to provide experimental data on indoor air quality, and the resulting respiratory impact, for a high-elevation (4550 m), rural community in Ladakh, India. This community is of interest because the primarily nomadic residents burn biomass inside the home for heating and cooking. The concentrations of particulate matter (PM), endotoxin, and carbon monoxide were determined for 6 homes. Lung function data and induced sputum samples were collected for 9 female test-home subjects. In addition, lung function data were collected for 84 additional Ladakhi highlanders at this location. Sputum from 3 visiting scientists (sojourners) was collected and analyzed as well. The average PM concentration ranged from 2 mg/m 3 to 7 mg/m 3 , with 85% of the sampled PM sized as respirable. The average endotoxin concentration ranged from 2.4 ng/m 3 to 19 ng/m 3 , and average carbon monoxide levels ranged from 50 ppm to 120 ppm. Lung function values for the highlander population and the test-home subjects were equal to or greater than predicted, despite the highlanders' significant exposure to indoor pollutants. An induced sputum analysis revealed a significantly greater total inflammatory cell count (M ± SD, 10 5 cell/mg) in the Ladakhi natives than in the sojourners (107.5 ± 75.2 vs 7.1 ± 8.1, p .01). Although the high levels of indoor pollutants did not correlate with significant decrements in lung function, the induced sputum analysis revealed marked airway inflammation dominated by macrophages and neutrophils. It appears that augmented lung mechanics of this high-altitude population are adaptive to reduce the work of breathing; thus, decrements in lung function go undetected because the true predicted values are greater than expected.Keywords biomass combustion; high-altitude population; indoor air quality; lung functionThe World Health Organization estimates that 20% to 30% of all respiratory diseases are caused by ambient and indoor air pollution.1 Globally, indoor air contaminants are of Request for reprints should be sent to Jacky Ann Rosati, PhD, USEPA, Office of Research and Development, National Homeland Security Research Center, E-343−06, 109 TW Alexander Drive, Research Triangle Park, NC 27711. E-mail: rosati.jacky@epa.gov. HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript concern because nearly 50% of the world's population burns biomass for domestic purposes such as cooking and heating.1,2 In developing nations, indoor exposure to biomass combustion byproducts has been associated with an increased incidence of respiratory disease as well as an increased rate of mortality.3-12 The World Bank has estimated that indoor air pollution is responsible for almost half the burden of disease in developing countries.2,13 In India alone, it is estimated that 400,000 to 550,000 premature deaths can be contributed to the use of biomass fuels.14 In Ladakh, Indian Himalaya, research has shown a prevalence of chronic cough, chronic phlegm, nonoccupational...

Translational Research in Environmental and Occupational Stress

“…Some research laboratories are actively engaged in such identification process through candidate gene association studies [21,22,44,61,63,71,75,79,82]. Very little evidence is available for familial pattern of genetic transmission of susceptibility [39,47,55]. Highlander population has developed different adaptive strategies for coping with highaltitude environment [10,11].…”

Section: Genetic Basis For Altitude Illnessmentioning

confidence: 98%

High-Altitude Medicine: The Path from Genomic Insight to Clinical Applications

Sarkar

2014

Translation of research findings into clinical practice is an important aspect of medical progress. In context of high-altitude medical research, understanding the functions of all genes and their regulation under highaltitude environment is far from complete, and translation of genomics research findings into clinical practice is yet an unexplored domain. With advancement and accessibility to genomic and genomewide data sets, understanding of the role of genes and environment under high altitude will get accelerated which can potentially get converted to translational research.