Factors related to left ventricular hypertrophy in adult persons living at altitude

Abstract

Introducción: La hipertrofia ventricular izquierda se ha descrito en personas que viven a gran altura. Objetivo: Determinar los factores asociados a hipertrofia ventricular izquierda (HVI) en personas adultas. Métodos: Se realizó un estudio observacional, transversal y analítico en el Laboratorio de Ecocardiografía del Hospital Regional Docente Clínico Daniel Alcides Carrión (HRDCQ) de Huancayo, Perú; a 3 259 m.s.n.m. El muestreo fue aleatorio simple. Las variables fueron hipertrofia ventricular izquierda (dependiente), disfunción diastólica del ventrículo izquierdo, hipertensión arterial, diabetes mellitus, índice de masa corporal, dislipidemia, sedentarismo. Los datos fueron recolectados en una ficha. Para el análisis estadístico se aplicó la prueba chi cuadrado, t student, regresión logística binaria y multivariada, se halló el odds ratio, su intervalo de confianza al 95%. Se consideró significativo p<0,050. Resultados: Se incluyeron 488 pacientes, el promedio de edad fue de 64 años (rango: 18-98). En el 58,9% (370) fueron mujeres. Los factores asociados a HVI fueron la hipertensión arterial (OR=5,31; IC95% = 3,27 -8,61), la edad mayor a 60 años (OR=2,94; IC95% = 1,93 -4,50), la diabetes mellitus (OR= 3,33; IC95% = 1,15 -9,79), y la obesidad (OR=2,21; IC95% = 1,16 -4,19) en comparación a los pacientes sin HVI. En pacientes con HVI se encontró mayor índice del volumen auricular izquierdo y disfunción diastólica del ventrículo izquierdo.Conclusión: Los factores asociados a HVI en personas adultas fueron la hipertensión arterial, la edad avanzada, diabetes mellitus y obesidad.

Prevalence of hypertension in adults living at altitude in Latin America and the Caribbean: A systematic review and meta-analysis

“…The altitude level of residence of the study participants ranged from 1 500 to 5 390 m.a.s.l. The countries where the studies were carried out were: Peru, [ 29 – 31 , 36 , 38 – 44 , 46 , 49 , 50 , 52 , 53 , 55 ] Ecuador [ 57 – 59 ] Bolivia [ 60 – 62 ] Argentina [ 28 , 56 ], Chile [ 51 , 54 ], Colombia [ 63 ], Venezuela [ 64 ], and Mexico [ 65 ]. Twenty-seven studies were carried out in the general population [ 27 , 28 , 30 – 32 , 34 – 49 , 51 – 56 ], and three in hospitals [ 29 , 33 , 50 ].…”

“…The countries where the studies were carried out were: Peru, [ 29 – 31 , 36 , 38 – 44 , 46 , 49 , 50 , 52 , 53 , 55 ] Ecuador [ 57 – 59 ] Bolivia [ 60 – 62 ] Argentina [ 28 , 56 ], Chile [ 51 , 54 ], Colombia [ 63 ], Venezuela [ 64 ], and Mexico [ 65 ]. Twenty-seven studies were carried out in the general population [ 27 , 28 , 30 – 32 , 34 – 49 , 51 – 56 ], and three in hospitals [ 29 , 33 , 50 ]. Some studies evaluated the prevalence of hypertension in specific populations, such as: women [ 66 , 67 ]; older adults (65 years and older) [ 59 ]; patients with chronic cor pulmonale [ 62 ]; high school students, university students and mothers of elementary school students [ 68 ]; air force military [ 60 ]; rural, urban, and rural-to-urban migrant populations [ 69 ]; and patients who have echocardiographic studies [ 29 ].…”

“…Twenty-seven studies were carried out in the general population [ 27 , 28 , 30 – 32 , 34 – 49 , 51 – 56 ], and three in hospitals [ 29 , 33 , 50 ]. Some studies evaluated the prevalence of hypertension in specific populations, such as: women [ 66 , 67 ]; older adults (65 years and older) [ 59 ]; patients with chronic cor pulmonale [ 62 ]; high school students, university students and mothers of elementary school students [ 68 ]; air force military [ 60 ]; rural, urban, and rural-to-urban migrant populations [ 69 ]; and patients who have echocardiographic studies [ 29 ]. On the other hand, only 2 studies specified that their populations were comprised of individuals who were "natives," meaning they were born and raised in the area where they currently reside [ 70 , 71 ].…”

“…Different blood pressure cut-off points were used for the definition of arterial hypertension. Twenty studies defined it as a blood pressure of ≥140/90 mmHg [ 29 – 32 , 35 – 37 , 39 – 42 , 44 , 47 , 49 – 54 , 56 ], 7 studies as ≥130/85 mmHg [ 57 , 60 , 61 , 67 , 68 , 73 , 74 ]; and 4 studies as ≥130/80 mmHg [ 36 , 45 , 49 , 55 ]. In addition, 11 studies took into account the use of antihypertensive drugs for the definition of hypertension [ 29 , 32 , 34 – 36 , 40 , 43 , 51 , 75 ].…”

“…Twenty-seven studies were carried out in the general population [27, 28, 30-32, 34-49, 51-56], and three in hospitals [29,33,50]. Some studies evaluated the prevalence of hypertension in specific populations, such as: women [66,67]; older adults (65 years and older) [59]; patients with chronic cor pulmonale [62]; high school students, university students and mothers of…”