Systemic Hypertension at High Altitude

Narvaez‐Guerra, Offdan; Herrera‐Enriquez, Karela; Medina‐Lezama, Josefina; Chirinos, Julio A.

doi:10.1161/hypertensionaha.118.11140

Cited by 60 publications

(67 citation statements)

References 111 publications

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“…Moreover, Uttarakhand is mainly occupied Brahmin and Kshatriya populations [ 33 ], mainly from east Eurasia [ 34 ] and may have different genetic background, compared with Tajiks. Therefore, different ethnicity can also have a role on the prevalence of hypertension [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Awareness, Treatment, Control, and Related Factors of Hypertension among Tajik Nomads Living in Pamirs at High Altitude

Wang

Heizhati

et al. 2020

International Journal of Hypertension

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Background. Hypertension is a global problem, for which high-altitude residents exhibit higher burden. Hypertension in Tajik nomads from Pamirs with an average altitude above 4000 m remains less studied. We aimed to determine the prevalence, awareness, treatment, control, and risk factors associated with hypertension among Tajik population in Pamirs. Methods. A cross-sectional survey was conducted between August and September 2015 using stratified three-stage random sampling in Taxkorgan county, Pamirs, China. Hypertension is defined as mean systolic and/or diastolic blood pressure (SBP, DBP) ≥140/90 mmHg and/or taking antihypertensive medication within the past two weeks. The prevalence (SBP ≥130 or DBP ≥80 mmHg) was also estimated using the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. The awareness, treatment, and control of hypertension and associated factors were evaluated. Results. Totally, 797 subjects aged ≥18 years were enrolled with 46.3% men and 88.8% nomads with the mean age of 42.3 ± 15.2 years. The prevalence of hypertension was 24.2% (140/90 mmHg), and the prevalence was as high as 40.3%, based on the 2017 ACC/AHA guideline. Overall awareness, treatment, and control of hypertension were 52.8%, 40.9%, and 9.3%, respectively. In multivariate logistic regression, BMI ≥24.0 kg/m2 (OR: 2.41, 95% CI: 1.44–4.04) was a risk factor for prehypertension, and age ≥60 years (OR: 2.04, 95% CI: 1.15–3.61), BMI ≥24.0 kg/m2 (OR: 2.04, 95% CI: 1.15–3.61), and abdominal obesity (OR: 1.87, 95% CI: 1.09–3.22) were risk factors for hypertension. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were the most commonly used antihypertensive medication (45.4%) as monotherapy, and 13.6% of treated hypertensive patients used two drugs. Conclusions. There is a considerable prevalence of hypertension with low awareness, treatment, and control rates among Tajik nomads in Pamirs, where health programs improving the hypertension status are urgently needed, with the excess weight loss as a strategy.

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Section: Discussionmentioning

confidence: 99%

Prevalence, Awareness, Treatment, Control, and Related Factors of Hypertension among Tajik Nomads Living in Pamirs at High Altitude

Wang

Heizhati

et al. 2020

International Journal of Hypertension

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“…We found that oxygen saturation decreased in a way characteristic for HA sojourn in both participants (Baertschi, Dayhaw‐Barker, & Flammer, 2016). Arterial blood pressure showed a characteristic increase at HA (Narvaez‐Guerra, Herrera‐Enriquez, Medina‐Lezama, & Chirinos, 2018). The mean arterial pressure was the variable that showed the most expressive upward trends.…”

Section: Discussionmentioning

confidence: 99%

Case studies in physiology: Nocturnal cardiorespiratory adaptive differences between an Italian trekker and a Nepali guide

2020

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The cardiopulmonary system is a physiological cornerstone in the adaptive response to hypobaric hypoxia. Portable devices make it feasible nowadays to precisely assess the response to high altitude (HA) expeditions. In this study, we investigated breathing and arterial blood pressure responses during a Himalayan trek from 665 m to 4,780 m altitude in a white European (Italian) sojourner and a native Nepali (Tamang) guide, both healthy males. Resting diurnal and nocturnal data were acquired by means of ambulatory blood pressure monitoring (ABPM) and sleep apnea monitoring. We found an increase in the mean diurnal arterial blood pressure. Nocturnal blood pressure dipping was confirmed at all altitudes. Oxygen saturation decreased at altitude, with its additional nocturnal fall. Sleep apneic episodes, present in the Italian only, increased with altitude. We conclude that the nocturnal, more than diurnal, cardiorespiratory function is affected by HA hypoxia. Further studies should address the role of ethnicity, medications, and sociodemographic factors in the cardiorespiratory responses to hypobaric hypoxia.

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“…Significant differences between highlanders and lowlanders are observed among the most commonly identified comorbidities ( 10 ) of COVID-19, with residence at higher elevation associated with lower incidence of cardiovascular disease and mortality ( 60 ), diabetes mellitus ( 83 ), obesity ( 84 ), and metabolic syndrome ( 51 ), which have all been linked to higher risk of severe COVID-19 infection and mortality ( 88 ). In contrast, hypertension appears to be higher in HA populations ( 2 , 58 , 61 ), although it is not possible to determine whether this puts these populations at a greater risk for COVID-19 infection, as there is still wide debate about whether the association between hypertension and COVID-19 embodies a causal relationship, or if it is simply indicative of the age and wider health status of those who are worst affected by COVID-19 ( 32 , 70 ).…”

Section: Environmental Factorsmentioning

confidence: 93%

Geographic components of SARS-CoV-2 expansion: a hypothesis

Joyce

Weaver

Lucas

2020

Journal of Applied Physiology

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The emergence of COVID-19 infection (caused by the SARS-CoV-2 virus) in Wuhan, China in the latter part of 2019 has, within a relatively short time, led to a global pandemic. Amidst the initial spread of SARS-CoV-2 across Asia, an epidemiologic trend emerged in relation to high altitude (HA) populations. Compared to the rest of Asia, SARS-CoV-2 exhibited attenuated rates of expansion with limited COVID-19 infection severity along the Tibetan plateau. These characteristics were soon evident in additional HA regions across Bolivia, central Ecuador, Nepal, Bhutan, and the Sichuan province of mainland China. This mini-review presents a discussion surrounding attributes of the HA environment, aspects of HA physiology, as well as, genetic variations among HA populations which may provide clues for this pattern of SARS-CoV-2 expansion and COVID-19 infection severity. Explanations are provided in the hypothetical, albeit relevant historical evidence is provided to create a foundation for future research.

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Systemic Hypertension at High Altitude

Cited by 60 publications

References 111 publications

Prevalence, Awareness, Treatment, Control, and Related Factors of Hypertension among Tajik Nomads Living in Pamirs at High Altitude

Prevalence, Awareness, Treatment, Control, and Related Factors of Hypertension among Tajik Nomads Living in Pamirs at High Altitude

Case studies in physiology: Nocturnal cardiorespiratory adaptive differences between an Italian trekker and a Nepali guide

Geographic components of SARS-CoV-2 expansion: a hypothesis

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