Blood pressure levels among Indigenous children living at different altitudes

Abstract

The objective was to compare blood pressure (BP) levels in 2 groups of Indigenous Argentine school children from similar ethnic backgrounds but living at different altitudes. One hundred and fifty-two (46.3%) children (age, 4–14 years) from San Antonio de los Cobres (SAC), at 3750 m above sea level, and 176 children (53.7%) from Chicoana (CH), at 1400 m above sea level, participated in this cross-sectional study. Data for children’s anthropometry, BP, glucose, lipids, vitamin D, and insulin, as well as mothers’ height and weight were assessed. Hypertension was defined as BP ≥ 95th percentile. The prevalence of overweight/obesity among children was significantly lower in SAC (n = 17, 11.2%) than in CH (n = 74, 42%) (body mass index (BMI) > 85th percentile per US Centers for Disease Control and Prevention norms). However, the prevalence of hypertension was significantly higher among children in SAC (n = 15, 9.9%) than among those in CH (n = 2, 1.1%). Children were divided into 4 groups by mean arterial BP quartiles for comparison by ANOVA. As mean arterial BP increased, age, BMI, glucose, triglycerides, triglycerides/high-density lipoprotein cholesterol, and insulin levels increased significantly. Multiple linear regression analyses showed that children’s mean arterial BP was significantly associated with altitude adjusted for confounding variables (R2 = 0.42). Furthermore, when mean arterial BP was replaced by systolic BP (R2 = 0.51) or diastolic BP (R2 = 0.33), similar results were obtained. Our results suggest that Indigenous children who live permanently at high altitude have higher levels of BP, adjusted for confounding variables. Routine BP measurements conducted in the SAC community could be essential for the prevention of cardiovascular disease.

Reply to “Discussion of ‘Blood pressure levels among Indigenous children living at different altitudes’”

“…In addition, all these conditions were discussed in the discussion section. Furthermore, the third paragraph of the discussion session of our study suggested that aridity, cold and windy weather, or other environmental conditions associated with high altitude could have influenced the higher prevalence of hypertension in children living at high altitude (Hirschler et al 2019). Dr. G.-Y.…”

“…I thank Dr. G.-Y. Kang for his interest in our study regarding blood pressure levels among indigenous children living at different altitudes (Hirschler et al 2019;Kang 2019). We agree that lower ambient temperatures could be associated with an increase in blood pressure levels.…”

“…Consistently, we found that children's blood pressure was significantly associated with location, and children's body mass index, adjusted for confounding variables. Location included temperature, aridity, wind, atmospheric pressure, and other environmental variables (Hirschler et al 2019). In addition, all these conditions were discussed in the discussion section.…”

“…We completely agree with this comment, and the season was considered in the design of the study before starting the investigation. Therefore, the design of the study included the evaluation of both communities in the same season (spring season) to avoid the season bias (Hirschler et al 2019).…”

Discussion of “Blood pressure levels among Indigenous children living at different altitudes”

“…I read with great interest the extremely informative and wellperformed paper recently published in a recent issue of this Applied Physiology, Nutrition, and Metabolism by Hirschler and colleagues entitled "Blood pressure levels among Indigenous children living at different altitudes" (Hirschler et al 2019), demonstrating that blood pressure level of indigenous children living permanently at high altitudes was higher than others. The outcomes have been rightly adjusted for confounding variables.…”