Duke Charles B, Sallade T Douglas, Starling Jennifer, Pant Sushil, Sheets Alison, McElwee Matthew K, Young David S, Taylor Richard Andrew, Keyes Linda E
Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
Department of Emergency Medicine, Geisinger Medical Center, Danville, PA.
Wilderness Environ Med. 2020 Jun;31(2):157-164. doi: 10.1016/j.wem.2020.01.004. Epub 2020 Mar 21.
A history of preexisting hypertension is common in people participating in mountain activities; however, the relationship between blood pressure (BP), preexisting hypertension, and acute mountain sickness (AMS) is not well studied. We sought to determine these relationships among trekkers in the Everest region of Nepal.
This was a prospective observational cohort study of a convenience sample of adult, nonpregnant volunteers trekking in the Everest Base Camp region in Nepal. We recorded Lake Louise Scores for AMS and measured BP at 2860 m, 3400 m, and 4300 m. The primary outcome was AMS.
A total of 672 trekkers (including 60 with history of preexisting hypertension) were enrolled at 2860 m. We retained 529 at 3400 m and 363 at 4300 m. At 3400 m, 11% of participants had AMS, and 13% had AMS at 4300 m. We found no relationship between AMS and measured BP values (P>0.05), nor was there any relation of BP to AMS severity as measured by higher Lake Louise Scores (P>0.05). Preexisting hypertension (odds ratio [OR] 0.16; 95% CI 0.025-0.57), male sex (OR 0.59; 95% CI 0.37-0.96), and increased SpO (OR 0.93; 95% CI 0.87-0.98) were associated with reduced rates of AMS in multivariate analyses adjusting for known risk factors for AMS.
AMS is common in trekkers in Nepal, even at 3400 m. There is no relationship between measured BP and AMS. However, a medical history of hypertension may be associated with a lower risk of AMS. More work is needed to confirm this novel finding.
既往有高血压病史在参与登山活动的人群中很常见；然而，血压（BP）、既往高血压与急性高原病（AMS）之间的关系尚未得到充分研究。我们试图确定尼泊尔珠穆朗玛峰地区徒步旅行者之间的这些关系。
这是一项对尼泊尔珠穆朗玛峰大本营地区成年非孕妇志愿者便利样本进行的前瞻性观察队列研究。我们记录了AMS的路易斯湖评分，并在2860米、3400米和4300米处测量了血压。主要结局是AMS。
共有672名徒步旅行者（包括60名有既往高血压病史者）在2860米处入组。在3400米处我们保留了529名，在4300米处保留了363名。在3400米处，11%的参与者患有AMS，在4300米处13%的参与者患有AMS。我们发现AMS与测量的血压值之间没有关系（P>0.05），血压与通过较高的路易斯湖评分衡量的AMS严重程度之间也没有任何关系（P>0.05）。在对已知的AMS危险因素进行调整的多变量分析中，既往高血压（比值比[OR]0.16；95%可信区间0.025 - 0.57）、男性（OR 0.59；95%可信区间0.37 - 0.96）和SpO升高（OR 0.93；95%可信区间0.87 - 0.98）与AMS发生率降低相关。
AMS在尼泊尔的徒步旅行者中很常见，即使在3400米处也是如此。测量的血压与AMS之间没有关系。然而，高血压病史可能与较低的AMS风险相关。需要更多的研究来证实这一新颖的发现。
