Impact of Haemoglobin and Haematocrit on the Incidence of Thrombosis in the Individuals Exposed to High-Altitude

Authors

  • Muhammad Ahmer Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Hassan Saeed Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Raheel Iftikhar Armed Forces Bone Marrow Transplant Centre (AFBMTC)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Shahzeb Satti Pak Emirates Military Hospital)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Hira Tariq
  • Farrukh Saeed National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.10972

Keywords:

Haemoglobin, Haematocrit, High-altitude, Thrombosis

Abstract

Objective: To investigate the association among high haemoglobin (Hb), high hematocrit (HCT), and thrombosis in individuals exposed to high-altitude (HA) environments, contributing to our understanding of haematological changes and thrombotic risk associated with HA exposure.

Study Design: Retrospective longitudinal study

Place and Duration of Study: High Altitude Medical and Research Cell (HALMARC) Pakistan, from Jan 2021 and Dec 2022.

Methodology: The total number of 91 participants who were exposed to high-altitude were included. All age groups were included. Participants were categorized based on altitude, stay duration, Hb, and HCT levels. All types of thrombotic events were recorded.

Results: Participants were exposed to altitudes ranging from less than 15,000 feet to greater than 18,000 feet, with varying durations of stay. The majority of the male participants were non-smokers. The mean Hb was 16.76±2.03 g/dl, and the mean HCT was 52.17±6.1%. More than half (53%) of the participants experienced thrombosis, with most cases involving brain thrombosis. However, there was no significant effect of elevated Hb (p=0.10) or HCT (p=0.75) on the incidence of thrombosis.

Conclusion: Extended stays at high altitudes were associated with elevated hematocrit levels. However, no direct association was found between high Hb and HCT levels and the incidence of thrombosis. Thrombotic events at high altitudes are likely influenced by multifactorial factors beyond haematological parameters, including individual variations in blood coagulation, genetics, and environmental influences.

Downloads

Download data is not yet available.

References

Zhang R, Yu X, Shen Y, Yang C, Liu F, Ye S, et al. Correlation between RBC changes and coagulation parameters in high altitude population. Hematology 2019; 24(1): 325-330.

https://doi.org/10.1080/16078454.2019.1568658

Rocke AS, Paterson GG, Barber MT, Jackson AIR, Main SE, Stannett C, et al. Thromboelastometry and Platelet Function during Acclimatization to High Altitude. Thromb Haemost 2018 ; 118(1): 63-71. https://doi.org/10.1160/th17-02-0138

Singh I, Chohan IS. Blood coagulation changes at high altitude predisposing to pulmonary hypertension. Br Heart J 1972; 34(6): 611-617. https://doi.org/10.1136/hrt.34.6.611

Zhong R, Wu X, Liu Z, He Z, Zhang X, Liu J, et al. A study on the correlation between hemoglobin concentration and the storage quality of suspended red blood cells prepared from the whole blood of Tibetan male residents. Front Med 2023; 9: 1062778. https://doi.org/10.3389/fmed.2022.1062778

Griesshammer M, Kiladjian JJ, Besses C. Thromboembolic events in polycythemia vera. Ann Hematol 2019; 98(5): 1071-1082. https://doi.org/10.1007/s00277-019-03625-x

Basak N, Norboo T, Mustak MS, Thangaraj K. Heterogeneity in Hematological Parameters of High and Low Altitude Tibetan Populations. J Blood Med 2021;12:287-298.

https://doi.org/10.2147/JBM.S294564

Nair V, Singh S, Ashraf MZ, Yanamandra U, Sharma V, Prabhakar A, et al. Epidemiology and pathophysiology of vascular thrombosis in acclimatized lowlanders at high altitude: A prospective longitudinal study. Lancet Reg Health Southeast Asia 2022; 3: 100016.

https://doi.org/10.1016/j.lansea.2022.05.005

Jiang P, Wang Z, Yu X, Qin Y, Shen Y, Yang C, et al. Effects of long-term high-altitude exposure on fibrinolytic system. Hematology 2021; 26(1): 503-509.

https://doi.org/10.1080/16078454.2021.1946265

Choudry QU-N, Iftikhar R, Qadir M, Satti TM, Omair G, Mehmood SK, et al. High Altitude And Venous Thrombosis: Frequency And Risk Factors. Pak Armed Forces Med J 2021;71(1):107-111. https://doi.org/10.51253/pafmj.v71i1.3173

Bilal M, Ullah I, Shah SA, Khan Z, Khan TM, Shaheen G, et al Prevalence, distribution and determinants of deep vein thrombosis in adult indoor stroke population of Peshawar Division, Pakistan. Gomal J Med Sci 2020; 18(2): 59-67.

https://doi.org/10.46903/gjms/18.02.851

Folsom AR, Wang W, Parikh R, Lutsey PL, Beckman JD, Cushman M, et al. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Hematocrit and incidence of venous thromboembolism. Res Pract Thromb Haemost 2020; 4(3): 422-428. https://doi.org/10.1002/rth2.12325

Braekkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Hansen JB. Hematocrit and risk of venous thromboembolism in a general population. The Tromso study. Haematologica 2010 ;95(2):270-275. https://doi.org/10.3324/haematol.2009.008417

Windsor JS, Rodway GW. Heights and haematology: the story of haemoglobin at altitude. Postgrad Med J 2007; 83(977): 148-151. https://doi.org/10.1136/pgmj.2006.049734

Gassmann M, Mairbäurl H, Livshits L, Seide S, Hackbusch M, Malczyk M, et al. The increase in hemoglobin concentration with altitude varies among human populations. Ann N Y Acad Sci 2019; 1450(1): 204-220. https://doi.org/10.1111/nyas.14136

Malenica M, Prnjavorac B, Bego T, Dujic T, Semiz S, Skrbo S, et al Effect of Cigarette Smoking on Haematological Parameters in Healthy Population. Med Arch 2017; 71(2): 132-136.

https://doi.org/10.5455/medarh.2017.71.132-136

Inal B, Hacıbekiroglu T, Cavus B, Musaoglu Z, Demir H, Karadag B, et al. Effects of smoking on healthy young men's hematologic parameters. North Clin Istanb 2014; 1(1): 19-25. https://doi.org/10.14744/nci.2014.39974

Sharma AJ, Addo OY, Mei Z, Suchdev PS. Reexamination of hemoglobin adjustments to define anemia: altitude and smoking. Ann N Y Acad Sci 2019; 1450(1): 190-203.

https://doi.org/10.1111/nyas.14167

Anand AC, Jha SK, Saha A, Sharma V, Adya CM. Thrombosis as a complication of extended stay at high altitude. Natl Med J India 2001; 14(4): 197-201.

Downloads

Published

29-04-2024

Issue

Section

Original Articles

How to Cite

1.
Ahmer M, Saeed H, Iftikhar R, Satti S, Tariq H, Saeed F. Impact of Haemoglobin and Haematocrit on the Incidence of Thrombosis in the Individuals Exposed to High-Altitude. Pak Armed Forces Med J [Internet]. 2024 Apr. 29 [cited 2024 Dec. 26];74(2):530-4. Available from: https://pafmj.org/PAFMJ/article/view/10972