Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China
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...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-12-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-024-20891-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850134718699274240 |
|---|---|
| author | Yu Xia Linhong Pang MingJing Tang Zhiling Luo Min Ma Huadan Wang Liping He Lin Duo Da Zhu Xiangbin Pan |
| author_facet | Yu Xia Linhong Pang MingJing Tang Zhiling Luo Min Ma Huadan Wang Liping He Lin Duo Da Zhu Xiangbin Pan |
| author_sort | Yu Xia |
| collection | DOAJ |
| description | 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: <500 m, 500-1,499 m, 1,500-2,500 m, and > 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 < 500 m, the groups living at altitudes of 500-1,499 m, 1500-2,500 m, and > 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. |
| format | Article |
| id | doaj-art-e1e60ed83daf4cc295f078230f7c2cf8 |
| institution | OA Journals |
| issn | 1471-2458 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-e1e60ed83daf4cc295f078230f7c2cf82025-08-20T02:31:39ZengBMCBMC Public Health1471-24582024-12-0124111210.1186/s12889-024-20891-1Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest ChinaYu Xia0Linhong Pang1MingJing Tang2Zhiling Luo3Min Ma4Huadan Wang5Liping He6Lin Duo7Da Zhu8Xiangbin Pan9Department of Scientific Research and Chronic Disease Management, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversityDepartment of Scientific Research and Chronic Disease Management, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversityDepartment of Scientific Research and Chronic Disease Management, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversityDepartment of Echocardiogram, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversityDepartment of Scientific Research and Chronic Disease Management, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversityDepartment of Scientific Research and Chronic Disease Management, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversitySchool of Public Health, Kunming Medical UniversityDepartment of Scientific Research and Chronic Disease Management, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversityDepartment of Scientific Research and Chronic Disease Management, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical UniversityDepartment of Structural Heart Disease, National Center for Cardiovascular Disease, China and State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, National Clinical Research Center for Cardiovascular DiseasesAbstract 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: <500 m, 500-1,499 m, 1,500-2,500 m, and > 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 < 500 m, the groups living at altitudes of 500-1,499 m, 1500-2,500 m, and > 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.https://doi.org/10.1186/s12889-024-20891-1HypertensionAltitudeCardiovascular diseaseMortality |
| spellingShingle | Yu Xia Linhong Pang MingJing Tang Zhiling Luo Min Ma Huadan Wang Liping He Lin Duo Da Zhu Xiangbin Pan Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China BMC Public Health Hypertension Altitude Cardiovascular disease Mortality |
| title | Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China |
| title_full | Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China |
| title_fullStr | Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China |
| title_full_unstemmed | Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China |
| title_short | Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China |
| title_sort | association of altitude with all cause and cardiovascular mortality among patients with hypertension a cohort study in southwest china |
| topic | Hypertension Altitude Cardiovascular disease Mortality |
| url | https://doi.org/10.1186/s12889-024-20891-1 |
| work_keys_str_mv | AT yuxia associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT linhongpang associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT mingjingtang associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT zhilingluo associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT minma associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT huadanwang associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT lipinghe associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT linduo associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT dazhu associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina AT xiangbinpan associationofaltitudewithallcauseandcardiovascularmortalityamongpatientswithhypertensionacohortstudyinsouthwestchina |