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“Phenotypic variations of hypertension at high altitude”

Hypertension Research volume 46, pages 544–545 (2023)Cite this article

We read with great interest the paper by Zhang et al. [1]. In the article, the authors explored the relationship between altitude and the prevalence of hypertension among high-altitude (H-ALT) dwellers, found a pooled prevalence of hypertension of 28.7%, and described a curve-shaped relationship between altitude and hypertension prevalence after adjusting for multiple variables.

Despite the cutoff defining H-ALT as > 2500 meters above sea level (mASL) in basic and clinical research [2], the authors included studies with participants living above 2000 mASL [1]. The authors hypothesized that the relationship between the prevalence of hypertension and H-ALT might be nonlinear; thus, a meta-regression analysis with adjustment of the degree of freedom to achieve a higher degree of smoothness was conducted, and it revealed a concave downward curve-shaped relationship, with a turning point at 3300 mASL. Although interesting insights of the mechanisms of hypertension at H-ALT were mentioned, the authors did not provide an explanation or hypothesis that accounts for the decrease in blood pressure at extreme H-ALT or the degree of dispersion of blood pressure data beyond 4500 mASL seen in Figure 2 [1].

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References

  1. Zhang Y, Yang Y, Wu X, Han B, Mao A, Gu D, et al. The association between altitude and the prevalence of hypertension among permanent highlanders. Hypertens Res. 2022;45:1754–62.

  2. Narvaez-Guerra O, Herrera-Enriquez K, Medina-Lezama J, Chirinos JA. Systemic hypertension at high altitude. Hypertension. 2018;72:567–78.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts School of Medicine, Worcester, MA, USA

    Offdan Narvaez-Guerra

  2. Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Karela Herrera-Enriquez

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  1. Offdan Narvaez-Guerra
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  2. Karela Herrera-Enriquez
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Correspondence to Offdan Narvaez-Guerra.

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Narvaez-Guerra, O., Herrera-Enriquez, K. “Phenotypic variations of hypertension at high altitude”. Hypertens Res 46, 544–545 (2023). https://doi.org/10.1038/s41440-022-01100-1

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