Does Increasing Haemoglobin At High Altitude Alone Cause A Rise In Coronary Artery Disease; A Prospective Study
DOI:
https://doi.org/10.51253/pafmj.v74i1.3445Keywords:
High altitude sickness, Coronary artery disease, Brain edema, Hemoglobin, Blood pressure, SkarduAbstract
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.
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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.
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