Chen Yu, Ren Yong, Zhang Xin, Zhou Wen-Bao, Zhang Wen-Tao, Lv Juan, Rao Xi-Yang, Zi Rui-Xi, Wang Si-Jie, Wang Li-Sha, Bao Chun-Ping, Yang Li-Xia, He Gong-Hao, Shi Yan-Kun
Department of Cardiology, 920th Hospital of Joint Logistics Support Force of PLA, Kunming, China.
Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China.
Front Pharmacol. 2025 Aug 21;16:1659041. doi: 10.3389/fphar.2025.1659041. eCollection 2025.
High-altitude hypoxia is known to impair cardiac microvascular function, a pathophysiological state recognized as coronary microvascular disease (CMVD). This study aimed to investigate the independent association between serum potassium levels and the risk of developing CMVD, after controlling for traditional cardiovascular risk factors such as hypertension, dyslipidemia, and smoking.
This case-control study enrolled 1,175 trainees with long-term exposure to high altitude (≥3,000 m), comprising 235 patients with CMVD (cases) and 940 healthy controls. We employed multivariable logistic regression analysis to systematically evaluate the associations of traditional risk factors and serum potassium levels with the risk of CMVD.
A key finding from our analysis was a significant inverse association between serum potassium levels and the odds of CMVD (OR = 0.26; 95% CI, 0.14-0.47). Specifically, higher potassium concentrations were correlated with a substantially lower disease risk. This inverse association was more prominent in individuals with a moderate body mass index and in smokers.
This is the first study to demonstrate that a higher serum potassium level is independently associated with lower odds of CMVD in populations exposed to high altitudes. This finding provides a new direction for developing targeted health screening and preventive strategies in high-altitude regions, holding significant potential for protecting specific at-risk groups such as individuals with a particular BMI, and smokers.
已知高原缺氧会损害心脏微血管功能，这种病理生理状态被认为是冠状动脉微血管疾病（CMVD）。本研究旨在在控制高血压、血脂异常和吸烟等传统心血管危险因素后，调查血清钾水平与发生CMVD风险之间的独立关联。
这项病例对照研究纳入了1175名长期暴露于高原（≥3000米）的受训者，其中包括235例CMVD患者（病例组）和940名健康对照者。我们采用多变量逻辑回归分析系统地评估传统危险因素和血清钾水平与CMVD风险的关联。
我们分析的一个关键发现是血清钾水平与CMVD的比值比之间存在显著的负相关（OR = 0.26；95% CI，0.14 - 0.47）。具体而言，较高的钾浓度与显著较低的疾病风险相关。这种负相关在体重指数适中的个体和吸烟者中更为突出。
这是第一项表明在高原暴露人群中，较高的血清钾水平与较低的CMVD发病几率独立相关的研究。这一发现为在高原地区制定有针对性的健康筛查和预防策略提供了新方向，对于保护特定高危人群（如具有特定BMI的个体和吸烟者）具有重要潜力。
