Tripathy Vikal, Gupta Ranjan
Biological Anthropology Unit, Indian Statistical Institute, Kolkata, India.
Ann Hum Biol. 2007 Jul-Aug;34(4):470-83. doi: 10.1080/03014460701412284.
Age-related increase in blood pressure (BP) throughout adulthood have been commonly observed in industrialized and developing populations which is generally not observed in traditional populations. Based on studies in the Andes, Tien Shan, Pamir and US highlands, BP values are generally lower in high- than low-altitude populations. At present, Tibetans are residing at different altitudes in India and little is known about BP variation for this population.
This study reports BP variation among Tibetans in India in view of the hypothesis of age-related increase and of lower BP at high altitude.
BP, height, weight, triceps skinfold thickness (SFT), mid-upper arm circumference (MUAC), and haemoglobin and haematocrit level were obtained from 1091 individuals (508 males, 583 females) at four different settlements, one being at high altitude (Choglamsar, Leh; altitude: 3521 m) and three at low altitudes (Bylakuppe, Chandragiri and Delhi; altitude: less than 1000 m), which were pooled. Comparison between altitudes was carried out separately for the two sexes and for the two age groups: children and adolescents 10-19 years of age; and adults 20 years and above. Those independent variables that could significantly explain the variance in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in stepwise regression were controlled for while comparing high and low altitudes using analysis of covariance (ANCOVA).
The three low-altitude samples showed similar values for adult BP after controlling for age and other BP correlates. Age was highly correlated to adult BP for both males and females after adjusting for anthropometric and haematological variables. A similar analysis for children and adolescents showed lower BP values at high altitude.
Lower BP values among Tibetan children and adolescents at high altitude suggest that altitude affects BP as previously hypothesized, but only in youth. Similar BP in adults at low and high altitudes may reflect the effects of other variables on BP. Measures of adiposity (SFT, BMI and MUAC) have a significant effect on BP. Increase in BP with adult age is observed in Tibetans, which is similar to the pattern observed among populations undergoing modernization.
在工业化和发展中人群中，成年期血压（BP）随年龄增长的现象普遍存在，而传统人群中通常未观察到这种现象。基于对安第斯山脉、天山、帕米尔和美国高地的研究，高海拔人群的血压值通常低于低海拔人群。目前，藏族人居住在印度的不同海拔地区，对于该人群的血压变化知之甚少。
鉴于年龄相关血压升高以及高海拔地区血压较低的假设，本研究报告了印度藏族人的血压变化情况。
从四个不同定居点的1091名个体（508名男性，583名女性）中获取血压、身高、体重、肱三头肌皮褶厚度（SFT）、上臂中部周长（MUAC）以及血红蛋白和血细胞比容水平，其中一个定居点位于高海拔地区（查姆拉萨尔，列城；海拔：3521米），三个位于低海拔地区（拜拉库佩、钱德拉吉里和德里；海拔：低于1000米），这些数据进行了汇总。对两个性别以及两个年龄组分别进行海拔之间的比较：10 - 19岁的儿童和青少年；20岁及以上的成年人。在使用协方差分析（ANCOVA）比较高海拔和低海拔时，控制了那些在逐步回归中能够显著解释收缩压（SBP）和舒张压（DBP）方差的自变量。
在控制年龄和其他血压相关因素后，三个低海拔样本的成人血压值相似。在调整人体测量学和血液学变量后，年龄与男性和女性的成人血压高度相关。对儿童和青少年进行的类似分析显示，高海拔地区的血压值较低。
高海拔地区藏族儿童和青少年的血压值较低表明，海拔如先前假设的那样影响血压，但仅在青少年中如此。低海拔和高海拔地区成年人相似的血压可能反映了其他变量对血压的影响。肥胖指标（SFT、BMI和MUAC）对血压有显著影响。藏族人随着成年年龄的增长血压升高，这与在经历现代化的人群中观察到的模式相似。
