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The association between altitude and the prevalence of hypertension among permanent highlanders

Hypertension Research volume 45, pages 1754–1762 (2022)Cite this article

A Comment to this article was published on 22 August 2022

Abstract

Hypertension (HTN) is a growing contributor to the global disease burden, and it is prevalent among people living at high altitudes (H-ALTs). This study aimed to explore the relationship between altitude and the prevalence of HTN among inhabitants living at H-ALTs. We searched electronic databases, including PubMed, Embase, and Web of Science, up to April 30, 2022. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) checklist for prevalence studies. A total of 1273 articles were screened, and 32 studies (86,487 participants) were eligible for further analyses. The pooled prevalence among highlanders was 28.7%. General additive model (GAM)-based meta-regression analysis was conducted to explore the association between altitude and the prevalence of HTN. A curve-shaped line was found between altitude and the prevalence of HTN (β = 0.998, p = 0.039) after adjusting for factors including publication year, sample size, age, sex, ethnic group, body mass index (BMI), smoking and alcohol consumption. The turning point was observed at 3300 m. The predictive parameter indicated that the smoothness and goodness of model fit were good (GCV = 0.014, R2 = 0.60, respectively). The findings may provide clues for further mechanistic studies that can improve HTN prevention among highlanders.

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Acknowledgements

We gratefully acknowledge all research assistants for their contributions to this study. This study was supported by the Social Science Foundation of the Ministry of Education of China [grant number: 18XJC910001].

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Authors and Affiliations

  1. Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, China

    Yuewen Zhang, Yanan Yang, Xiuming Wu, Ang Mao, Weizhong Chen & Ziqian Zeng

  2. Department of Preventive Medicine, Chengdu Medical College, Chengdu, China

    Bin Han

  3. Department of Epidemiology and Biostatistics center, First Affiliated Hospital, Army Medical University, Chongqing, China

    Dongqing Gu

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Contributions

ZZQ and ZYW were responsible for data extraction, data analyses, and writing the manuscript. GDQ and CWZ were involved in conducting data analyses and revising the manuscript. MA, YYN, WXM and HB contributed to the data interpretation. ZZQ and CWZ contributed equally.

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Correspondence to Ziqian Zeng.

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Zhang, Y., Yang, Y., Wu, X. et al. The association between altitude and the prevalence of hypertension among permanent highlanders. Hypertens Res 45, 1754–1762 (2022). https://doi.org/10.1038/s41440-022-00985-2

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