Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China

Bibliographic Details
Title: Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China
Authors: Yu Xia, Linhong Pang, MingJing Tang, Zhiling Luo, Min Ma, Huadan Wang, Liping He, Lin Duo, Da Zhu, Xiangbin Pan
Source: BMC Public Health, Vol 24, Iss 1, Pp 1-12 (2024)
Publisher Information: BMC, 2024.
Publication Year: 2024
Collection: LCC:Public aspects of medicine
Subject Terms: Hypertension, Altitude, Cardiovascular disease, Mortality, Public aspects of medicine, RA1-1270
More Details: Abstract Background Available evidence falls short in assessing the risk of long-term outcomes among individuals with hypertension residing at various altitudes. We aimed to investigate the association between residential altitude and the risk of all-cause and cardiovascular disease (CVD) mortality among hypertensive patients. Methods This cohort study encompassed 67,275 hypertensive patients aged ≥35 years who participated in China’s Basic Public Health Service Program in 2018. Participants were categorized into four groups based on their residence altitude: 2,500 m. The associations between residential altitude and the risks of all-cause and CVD mortality were analyzed using Cox proportional hazards regression models. The dose-response relationship was performed by the restricted cubic spline with multivariable adjusted models. Results Among the 67,275 hypertensive patients included in the study (mean age of 63.9 years, with 45.3% male), 8,768 deaths were recorded, of which 5,666 were attributed to CVD. Following multivariate adjustment, when compared to the group residing at altitudes 2,500 m exhibited significantly risks of all-cause mortality [HR = 1.45 (95% CI: 1.36–1.54), 1.35 (95% CI: 1.28–1.43), and 1.41 (95% CI: 1.28–1.54), respectively] and CVD mortality [HR = 1.47 (95% CI: 1.35–1.58), 1.42 (95% CI: 1.33–1.52), and 1.46 (95% CI: 1.31–1.62), respectively]. The restricted cubic spline curves revealed a nonlinear relationship between residential altitude and all-cause and CVD mortality. The risk of mortality was higher among participants with poorly controlled blood pressure, aged 65 years and above, and living in rural areas. Conclusions This study demonstrated a significant association between long-term residential high-altitude exposure and increased risks of all-cause and CVD mortality among hypertension patients. The implications of the findings call for a prioritization of public health resource allocation and early intervention efforts, especially for those living at high altitudes and in low-income areas where hypertension is prevalent.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2458
Relation: https://doaj.org/toc/1471-2458
DOI: 10.1186/s12889-024-20891-1
Access URL: https://doaj.org/article/e1e60ed83daf4cc295f078230f7c2cf8
Accession Number: edsdoj.1e60ed83daf4cc295f078230f7c2cf8
Database: Directory of Open Access Journals
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More Details
ISSN:14712458
DOI:10.1186/s12889-024-20891-1
Published in:BMC Public Health
Language:English