Does Increasing Haemoglobin At High Altitude Alone Cause A Rise In Coronary Artery Disease; A Prospective Study

Authors

  • Manzoor Qadir Department of Medicine, Combined Military Hospital Skardu / National University of Medical Sciences (NUMS) Pakistan
  • Sajid Ali Shah Department of Paediatrics, Combined Military Hospital Skardu / National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Zaman Department of HCA, Combined Military Hospital Skardu / National University of Medical Sciences (NUMS) Pakistan
  • Atif Latif Department of Radiology, Combined Military Hospital Skardu / National University of Medical Sciences (NUMS) Pakistan
  • Atif Latif Radiologist
  • Qurrat ul Ain Department of Pathology, Combined Military Hospital Skardu / National University of Medical Sciences (NUMS) Pakistan
  • Shahzad Ali Department of Ophthalmology, Combined Military Hospital Skardu / National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i1.3445

Keywords:

High altitude sickness, Coronary artery disease, Brain edema, Hemoglobin, Blood pressure, Skardu

Abstract

Objective: To study the effect of high altitude on haemoglobin concentration with coronary artery disease.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Combined Military Hospital, Skardu Pakistan, from Jan to Dec 2018

Methodology: All individuals working at high altitudes diagnosed with coronary artery disease (CAD) were included.
Haemoglobin concentration was measured by doing a complete blood picture.

Results: The total number of patients diagnosed with coronary artery disease in the study was 34 (all males). 16(47%) of the
patients with coronary artery disease were evacuated from the height of 8000 to 13000 feet, 16(47%) from the height of 13001 to 18000 feet and 2(6%) patients were evacuated from the height of more than 18000 feet. The mean haemoglobin (Hb) of patients evacuated from the height of 8000 to 13000 feet was 15.7±1.4gm/dl; of patients evacuated from a height of 13001 to 18000 feet was 16.3±1.5gm/dl, and of patients evacuated from more than 18000 feet was 18.3±1.2gm/dl.

Conclusion: Persistent rise in haemoglobin was noted with increasing altitude. However, most of the patients with coronary
artery disease were from a height of 13000 to 18000 feet.

Downloads

Download data is not yet available.

References

Barolia R, Sayani AH. Risk factors of cardiovascular disease and

its recommendations in Pakistani context. J Pak Med Assoc

; 67(11): 1723-1729.

Jafar TH, Qadri Z, Chaturvedi N. Coronary artery disease

epidemic in Pakistan: more electrocardiographic evidence of

ischaemia in women than in men. Heart 2008; 94(4): 408-413.

https://doi.org/10.1136/hrt.2007.120774

Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et

al; INTERHEART Study Investigators. Effect of potentially

modifiable risk factors associated with myocardial infarction in

countries (the INTERHEART study): case-control study.

Lancet 2004; 364(9438): 937-952.

https://doi.org/10.1016/S0140-6736(04)17018-9

Aggarwal A, Aggarwal S, Sarkar PG, Sharma V. Predisposing

factors to premature coronary artery disease in young (age ≤ 45

years) smokers: a single center retrospective case control study

from India. J Cardiovasc Thorac Res 2014; 6(1): 15-19.

https://doi.org/10.5681/jcvtr.2014.003

Zand S, Shafiee A, Boroumand M, Jalali A, Nozari Y. Serum

uric Acid is not an independent risk factor for premature

coronary artery disease. Cardiorenal Med 2013; 3(4): 246-253.

https://doi.org/10.1159/000355484

Chandler HC, Mellor A. Sudden onset hemiplegia at high

altitude. J R Army Med Corps 2016; 162(6): 470-472.

https://doi.org/10.1136/jramc-2014-000372

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

; 118(1): 63-71. https://doi.org/ 10.1160/TH17-02-0138.

Erratum in: Thromb Haemost 2018 ;118(4):801.

Johnson NJ, Luks AM. High-Altitude Medicine. Med Clin

North Am 2016; 100(2): 357-69.

https://doi.org/10.1016/j.mcna.2015.09.002

He Y, Qi X, Liu S, Li J, Zhang H, Bai C, et al. Blunted nitric

oxide regulation in Tibetans under high-altitude hypoxia. Nat

Sci Rev 2018; 5(4): 516-529.

https://doi.org/10.1093/nsr/nwy037

Ge RL, Simonson TS, Gordeuk V, Prchal JT, McClain DA.

Metabolic aspects of high-altitude adaptation in Tibetans. Exp

Physiol 2015; 100(11): 1247-1255.

https://doi.org/10.1113/EP085292

Zhao Y, Zhang Z, Liu L, Zhang Y, Fan X, Ma L, et al.

Associations of high altitude polycythemia with

polymorphisms in EPAS1, ITGA6 and ERBB4 in Chinese Han

and Tibetan populations. Oncotarget 2017; 8(49): 86736-86746.

https://doi.org/10.18632/oncotarget.21420

Syed MJ, Alamgir W, Wasay M. Cerebral venous thrombosis at

high altitude. Pak J Neurol Sci 2018; 13(3): 44-51.

Davis C, Hackett P. Advances in the Prevention and Treatment

of High Altitude Illness. Emerg Med Clin North Am 2017; 35(2):

-260. https://doi.org/10.1016/j.emc.2017.01.002

Villafuerte FC, Simonson TS, Bermudez D, León-Velarde F.

High-Altitude Erythrocytosis: Mechanisms of Adaptive and

Maladaptive Responses. Physiology 2022; 37(4).

https://doi.org/10.1152/physiol.00029.2021

Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, et

al. Clinical recommendations for high altitude exposure of

individuals with pre-existing cardiovascular conditions: A joint

statement by the European Society of Cardiology, the Council

on Hypertension of the European Society of Cardiology, the

European Society of Hypertension, the International Society of

Mountain Medicine, the Italian Society of Hypertension and the

Italian Society of Mountain Medicine. Eur Heart J 2018; 39(17):

-1554. https://doi.org/10.1093/eurheartj/ehx720

Savla JJ, Levine BD, Sadek HA. The Effect of Hypoxia on

Cardiovascular Disease: Friend or Foe? High Alt Med Biol 2018;

(2): 124-130. https://doi.org/10.1089/ham.2018.0044

Chonchol M, Nielson C. Hemoglobin levels and coronary artery

disease. Am Heart J 2008; 155(3): 494-498.

https://doi.org/10.1016/j.ahj.2007.10.031

León-Velarde F, Gamboa A, Chuquiza JA, Esteba WA, RiveraChira M, Monge CC. Hematological parameters in high altitude

residents living at 4,355, 4,660, and 5,500 meters above sea level.

High Alt Med Biol 2000; 1(2): 97-104.

https://doi.org/10.1089/15270290050074233

Siqués P, Brito J, León-Velarde F, Barrios L, De La Cruz JJ,

López V, et al. Hematological and lipid profile changes in sealevel natives after exposure to 3550-m altitude for 8 months.

High Alt Med Biol 2007; 8(4): 286-95.

https://doi.org/10.1089/ham.2007.8405

Cabrera de-León A, González DA, Méndez LI, Aguirre-Jaime A,

del Cristo Rodríguez Pérez M, Coello SD, et al. Leptin and

altitude in the cardiovascular diseases. Obes Res 2004; 12(9):

-1498. https://doi.org/10.1038/oby.2004.186

Gotoh S, Hata J, Ninomiya T, Hirakawa Y, Nagata M, Mukai N,

et al. Hematocrit and the risk of cardiovascular disease in a

Japanese community: The Hisayama Study. Atherosclerosis

; 242(1): 199-204.

https://doi.org/10.1016/j.atherosclerosis.2015.07.014

Downloads

Published

28-02-2024

Issue

Section

Original Articles

How to Cite

1.
Qadir M, Shah SA, Zaman M, Latif A, Latif A, Qurrat ul Ain, et al. Does Increasing Haemoglobin At High Altitude Alone Cause A Rise In Coronary Artery Disease; A Prospective Study. Pak Armed Forces Med J [Internet]. 2024 Feb. 28 [cited 2024 Nov. 22];74(1):117-20. Available from: https://pafmj.org/PAFMJ/article/view/3445