Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, PR China.
Hypertens Res. 2022 Aug;45(8):1225-1239. doi: 10.1038/s41440-022-00955-8. Epub 2022 Jun 15.
This systematic review and meta-analysis synthesized the pooled prevalence of hypertension at high altitudes and explored its correlation with altitude using studies published in Chinese and English from database inception to February 2021. A systematic literature search was conducted among bibliographic databases (PubMed, Embase, and Web of Science) and three Chinese databases (CNKI, VIP, and Wanfang data) to identify eligible studies. A random-effects model was used to calculate the overall pooled prevalence of hypertension. The I statistic was used to assess heterogeneity across studies. Random-effects meta-regression was conducted to investigate covariates that may have influenced between-study heterogeneity. The pooled prevalence of hypertension among the general population in high-altitude areas was 33.0% (95% CI: 29.0-38.0%), with high between-study heterogeneity (I = 99.4%, P < 0.01). Subgroup analyses showed the pooled prevalence of hypertension in Tibetan individuals was significantly higher than that in non-Tibetan individuals living in the Himalayas and Pamir Mountains (41% vs. 18%). A trend toward an increase in the prevalence of hypertension was found with every 100-m increase in elevation (coefficient: 0.012, 95% CI: -0.001 to 0.025, P = 0.069) only in Tibetan individuals. In addition, in these individuals, we found an increase in mean diastolic BP with each 100-m increase in altitude (coefficient: 0.763, 95% CI: 0.122-1.403, P = 0.025). Our meta-analysis suggests that the pooled prevalence of hypertension among the general population in high-altitude areas is 33.0%. Subjects of Tibetan ethnicity were more prone to developing hypertension at high altitudes. However, a very weak relationship between altitude and the prevalence of hypertension was found only in Tibetan individuals.
这篇系统综述和荟萃分析综合了高海拔地区高血压的患病率，并使用从数据库开始到 2021 年 2 月发表的中英文研究探讨了其与海拔的相关性。在书目数据库（PubMed、Embase 和 Web of Science）和三个中文数据库（CNKI、VIP 和万方数据）中进行了系统的文献检索，以确定符合条件的研究。使用随机效应模型计算高血压的总体患病率。I ² 统计量用于评估研究之间的异质性。进行随机效应荟萃回归分析，以探讨可能影响研究间异质性的协变量。高海拔地区一般人群高血压的患病率为 33.0%（95%CI：29.0-38.0%），研究间异质性较大（I=99.4%，P<0.01）。亚组分析显示，居住在喜马拉雅山脉和帕米尔高原的藏族个体高血压患病率明显高于非藏族个体（41%比 18%）。仅在藏族个体中，随着海拔每升高 100 米，高血压的患病率呈上升趋势（系数：0.012，95%CI：-0.001 至 0.025，P=0.069）。此外，在这些个体中，我们发现随着海拔每升高 100 米，舒张压均值升高（系数：0.763，95%CI：0.122-1.403，P=0.025）。我们的荟萃分析表明，高海拔地区一般人群高血压的患病率为 33.0%。藏族个体在高海拔地区更容易发生高血压。然而，仅在藏族个体中发现海拔与高血压患病率之间存在非常微弱的关系。
