Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, BH1 3LT, UK.
Department of Medicine, University of Otago, Wellington, New Zealand.
Hypertens Res. 2019 Feb;42(2):284-291. doi: 10.1038/s41440-018-0138-x. Epub 2018 Nov 21.
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, 3270 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: 4.0-27.2), 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.
本研究旨在描述尼泊尔高海拔人群的血压（BP）和高血压（HT）情况，并探讨收缩压和舒张压与海拔高度的关系。这是一项横断面调查，研究了尼泊尔 Mustang 和 Humla 地区四个不同海拔高度（均高于 2800 米）的 521 名居民的心血管疾病及相关危险因素。所有 521 名参与者均有血压数据。在海拔 3620 米（调查的最高区域），收缩压和舒张压水平最高，但并未随海拔高度持续升高。在使用≥140/90mmHg（收缩压/舒张压）的切点时，在 Mustang 地区海拔 2800、3270 和 3620 米的 HT（或服用抗高血压药物）患病率分别为 46.1%、40.9%和 54.5%，在 Humla 地区海拔 2890 米的 HT 患病率为 29.1%。在调整潜在混杂因素的多变量模型中，收缩压与海拔之间存在很强的关系；每升高 1000 米，收缩压平均升高 15.6mmHg（95%CI：4.0-27.2），P=0.009。虽然舒张压和 HT 或服用抗高血压药物的概率也随着海拔高度的增加而升高，但没有证据表明存在关系。在本研究中，生活在高海拔地区的四个社区中，有三个社区的 30 岁及以上人群中 HT 的患病率高于全国总体数据。这些发现表明尼泊尔高海拔人群的血压升高风险可能较高。
