Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders

Noemí Corante, Cecilia Anza-Ramírez, Rómulo Figueroa-Mujíca, José Luis MacArlupú, Gustavo Vizcardo-Galindo, Grzegorz Bilo, Gianfranco Parati, Jorge L. Gamboa, Fabiola León-Velarde, Francisco C. Villafuerte

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Cardiovascular diseases are the main cause of death worldwide. Life under high-altitude (HA) hypoxic conditions is believed to provide highlanders with a natural protection against cardiovascular and metabolic diseases compared with sea-level inhabitants. However, some HA dwellers become intolerant to chronic hypoxia and develop a progressive incapacitating syndrome known as chronic mountain sickness (CMS), characterized by excessive erythrocytosis (EE; Hb ≥21 g/dL in men, Hb ≥19 g/dL in women). Evidence from HA studies suggests that, in addition to CMS typical signs and symptoms, these highlanders may also suffer from metabolic and cardiovascular disorders. Thus, we hypothesize that this syndrome is also associated to the loss of the cardiometabolic protection observed in healthy highlanders (HH), and therefore to a higher cardiovascular risk (CVR). The aim of the present work was to evaluate the association between EE and CVR calculated using the Framingham General CVR Score and between EE and CVR factors in male highlanders. This cross-sectional study included 342 males from Cerro de Pasco, Peru at 4340 m (HH = 209, CMS = 133). Associations were assessed by multiple logistic regressions adjusted for potential confounders (BMI, pulse oxygen saturation and age). The adjusted models show that the odds of high CVR (>20%) in highlanders with EE was 3.63 times the odds in HH (CI 95%:1.22-10.78; p = 0.020), and that EE is associated to hypertension, elevated fasting serum glucose, insulin resistance, and elevated fasting serum triglycerides. Our results suggest that individuals who suffer from EE are at increased risk of developing cardiovascular events compared with their healthy counterparts.

Original languageEnglish
Pages (from-to)221-231
Number of pages11
JournalHigh Altitude Medicine and Biology
Volume19
Issue number3
DOIs
Publication statusPublished - Sep 1 2018

Fingerprint

Polycythemia
Altitude Sickness
Fasting
Cardiovascular Diseases
Peru
Metabolic Diseases
Serum
Oceans and Seas
Signs and Symptoms
Insulin Resistance
Cause of Death
Triglycerides
Cross-Sectional Studies
Logistic Models
Oxygen
Hypertension
Glucose

Keywords

  • andean highlanders
  • cardiovascular risk
  • chronic mountain sickness
  • excessive erythrocytosis

ASJC Scopus subject areas

  • Physiology
  • Public Health, Environmental and Occupational Health

Cite this

Corante, N., Anza-Ramírez, C., Figueroa-Mujíca, R., MacArlupú, J. L., Vizcardo-Galindo, G., Bilo, G., ... Villafuerte, F. C. (2018). Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders. High Altitude Medicine and Biology, 19(3), 221-231. https://doi.org/10.1089/ham.2017.0123

Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders. / Corante, Noemí; Anza-Ramírez, Cecilia; Figueroa-Mujíca, Rómulo; MacArlupú, José Luis; Vizcardo-Galindo, Gustavo; Bilo, Grzegorz; Parati, Gianfranco; Gamboa, Jorge L.; León-Velarde, Fabiola; Villafuerte, Francisco C.

In: High Altitude Medicine and Biology, Vol. 19, No. 3, 01.09.2018, p. 221-231.

Research output: Contribution to journalArticle

Corante, N, Anza-Ramírez, C, Figueroa-Mujíca, R, MacArlupú, JL, Vizcardo-Galindo, G, Bilo, G, Parati, G, Gamboa, JL, León-Velarde, F & Villafuerte, FC 2018, 'Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders', High Altitude Medicine and Biology, vol. 19, no. 3, pp. 221-231. https://doi.org/10.1089/ham.2017.0123
Corante N, Anza-Ramírez C, Figueroa-Mujíca R, MacArlupú JL, Vizcardo-Galindo G, Bilo G et al. Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders. High Altitude Medicine and Biology. 2018 Sep 1;19(3):221-231. https://doi.org/10.1089/ham.2017.0123
Corante, Noemí ; Anza-Ramírez, Cecilia ; Figueroa-Mujíca, Rómulo ; MacArlupú, José Luis ; Vizcardo-Galindo, Gustavo ; Bilo, Grzegorz ; Parati, Gianfranco ; Gamboa, Jorge L. ; León-Velarde, Fabiola ; Villafuerte, Francisco C. / Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders. In: High Altitude Medicine and Biology. 2018 ; Vol. 19, No. 3. pp. 221-231.
@article{d9cad2910fb1473c9b314d2d4676caa6,
title = "Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders",
abstract = "Cardiovascular diseases are the main cause of death worldwide. Life under high-altitude (HA) hypoxic conditions is believed to provide highlanders with a natural protection against cardiovascular and metabolic diseases compared with sea-level inhabitants. However, some HA dwellers become intolerant to chronic hypoxia and develop a progressive incapacitating syndrome known as chronic mountain sickness (CMS), characterized by excessive erythrocytosis (EE; Hb ≥21 g/dL in men, Hb ≥19 g/dL in women). Evidence from HA studies suggests that, in addition to CMS typical signs and symptoms, these highlanders may also suffer from metabolic and cardiovascular disorders. Thus, we hypothesize that this syndrome is also associated to the loss of the cardiometabolic protection observed in healthy highlanders (HH), and therefore to a higher cardiovascular risk (CVR). The aim of the present work was to evaluate the association between EE and CVR calculated using the Framingham General CVR Score and between EE and CVR factors in male highlanders. This cross-sectional study included 342 males from Cerro de Pasco, Peru at 4340 m (HH = 209, CMS = 133). Associations were assessed by multiple logistic regressions adjusted for potential confounders (BMI, pulse oxygen saturation and age). The adjusted models show that the odds of high CVR (>20{\%}) in highlanders with EE was 3.63 times the odds in HH (CI 95{\%}:1.22-10.78; p = 0.020), and that EE is associated to hypertension, elevated fasting serum glucose, insulin resistance, and elevated fasting serum triglycerides. Our results suggest that individuals who suffer from EE are at increased risk of developing cardiovascular events compared with their healthy counterparts.",
keywords = "andean highlanders, cardiovascular risk, chronic mountain sickness, excessive erythrocytosis",
author = "Noem{\'i} Corante and Cecilia Anza-Ram{\'i}rez and R{\'o}mulo Figueroa-Muj{\'i}ca and MacArlup{\'u}, {Jos{\'e} Luis} and Gustavo Vizcardo-Galindo and Grzegorz Bilo and Gianfranco Parati and Gamboa, {Jorge L.} and Fabiola Le{\'o}n-Velarde and Villafuerte, {Francisco C.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1089/ham.2017.0123",
language = "English",
volume = "19",
pages = "221--231",
journal = "High Altitude Medicine and Biology",
issn = "1527-0297",
publisher = "Mary Ann Liebert Inc.",
number = "3",

}

TY - JOUR

T1 - Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders

AU - Corante, Noemí

AU - Anza-Ramírez, Cecilia

AU - Figueroa-Mujíca, Rómulo

AU - MacArlupú, José Luis

AU - Vizcardo-Galindo, Gustavo

AU - Bilo, Grzegorz

AU - Parati, Gianfranco

AU - Gamboa, Jorge L.

AU - León-Velarde, Fabiola

AU - Villafuerte, Francisco C.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Cardiovascular diseases are the main cause of death worldwide. Life under high-altitude (HA) hypoxic conditions is believed to provide highlanders with a natural protection against cardiovascular and metabolic diseases compared with sea-level inhabitants. However, some HA dwellers become intolerant to chronic hypoxia and develop a progressive incapacitating syndrome known as chronic mountain sickness (CMS), characterized by excessive erythrocytosis (EE; Hb ≥21 g/dL in men, Hb ≥19 g/dL in women). Evidence from HA studies suggests that, in addition to CMS typical signs and symptoms, these highlanders may also suffer from metabolic and cardiovascular disorders. Thus, we hypothesize that this syndrome is also associated to the loss of the cardiometabolic protection observed in healthy highlanders (HH), and therefore to a higher cardiovascular risk (CVR). The aim of the present work was to evaluate the association between EE and CVR calculated using the Framingham General CVR Score and between EE and CVR factors in male highlanders. This cross-sectional study included 342 males from Cerro de Pasco, Peru at 4340 m (HH = 209, CMS = 133). Associations were assessed by multiple logistic regressions adjusted for potential confounders (BMI, pulse oxygen saturation and age). The adjusted models show that the odds of high CVR (>20%) in highlanders with EE was 3.63 times the odds in HH (CI 95%:1.22-10.78; p = 0.020), and that EE is associated to hypertension, elevated fasting serum glucose, insulin resistance, and elevated fasting serum triglycerides. Our results suggest that individuals who suffer from EE are at increased risk of developing cardiovascular events compared with their healthy counterparts.

AB - Cardiovascular diseases are the main cause of death worldwide. Life under high-altitude (HA) hypoxic conditions is believed to provide highlanders with a natural protection against cardiovascular and metabolic diseases compared with sea-level inhabitants. However, some HA dwellers become intolerant to chronic hypoxia and develop a progressive incapacitating syndrome known as chronic mountain sickness (CMS), characterized by excessive erythrocytosis (EE; Hb ≥21 g/dL in men, Hb ≥19 g/dL in women). Evidence from HA studies suggests that, in addition to CMS typical signs and symptoms, these highlanders may also suffer from metabolic and cardiovascular disorders. Thus, we hypothesize that this syndrome is also associated to the loss of the cardiometabolic protection observed in healthy highlanders (HH), and therefore to a higher cardiovascular risk (CVR). The aim of the present work was to evaluate the association between EE and CVR calculated using the Framingham General CVR Score and between EE and CVR factors in male highlanders. This cross-sectional study included 342 males from Cerro de Pasco, Peru at 4340 m (HH = 209, CMS = 133). Associations were assessed by multiple logistic regressions adjusted for potential confounders (BMI, pulse oxygen saturation and age). The adjusted models show that the odds of high CVR (>20%) in highlanders with EE was 3.63 times the odds in HH (CI 95%:1.22-10.78; p = 0.020), and that EE is associated to hypertension, elevated fasting serum glucose, insulin resistance, and elevated fasting serum triglycerides. Our results suggest that individuals who suffer from EE are at increased risk of developing cardiovascular events compared with their healthy counterparts.

KW - andean highlanders

KW - cardiovascular risk

KW - chronic mountain sickness

KW - excessive erythrocytosis

UR - http://www.scopus.com/inward/record.url?scp=85053895646&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053895646&partnerID=8YFLogxK

U2 - 10.1089/ham.2017.0123

DO - 10.1089/ham.2017.0123

M3 - Article

VL - 19

SP - 221

EP - 231

JO - High Altitude Medicine and Biology

JF - High Altitude Medicine and Biology

SN - 1527-0297

IS - 3

ER -