Observations on the Blood Pressure of Tibetans

Sehgal, Ashwini; I, Krishan; Malhotra, Rajeev; Gupta, Himanshu

doi:10.1161/01.cir.37.1.36

Cited by 27 publications

(11 citation statements)

References 27 publications

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“…Although the present study's finding of multivariate adjusted associations between BP and age, alcohol intake, and urban lifestyle is consistent with past research the inverse relationship between self-reported daily salt consumption and BP is not 22,23 . High consumption of salt as a traditional dietary habit has been identified as one of the key factors for high BP in HA Tibetan populations 24,25 . The method used in the present study of self-report to calculate salt consumption could have systematically led to underestimation of salt intake in those with the highest salt intake.…”

Section: Discussionmentioning

confidence: 99%

Blood pressure and hypertension in people living at high altitude in Nepal

et al. 2018

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This study aimed to describe blood pressure (BP) and hypertension (HT) in samples of high altitude populations of Nepal and to explore associations of systolic and diastolic BP with altitude. This was a cross-sectional survey of cardiovascular disease and associated risk factors among 521 people living at four different altitude levels, all above 2800 m, in the Mustang and Humla districts of Nepal. Data on BP was available for all 521 participants. Systolic and diastolic BP levels were highest at the altitude of 3620 m (the highest area surveyed) but did not consistently increase with altitude. Using the cut-point of ≥140/90 mmHg (systolic/diastolic), the prevalence of HT (or on anti-hypertensive medication) was 46.1%, 40.9%, and 54.5% respectively at 2800 m, 3270 m and 3620 m of Mustang district, and 29.1% at 2890 m of Humla district. In a multivariate model adjusting for potential confounders there was strong evidence of a relationship between systolic BP and altitude; mean systolic BP increased by 15.6 mmHg (95% CI 4.0 to 27.2), P=0.009 for every 1000 m elevation. Although diastolic BP and the probability for HT or on anti-hypertensive medication also tended to increase with increasing altitude levels, there was no evidence of a relationship. In the present study three out of four communities living at higher altitude levels showed a greater prevalence of HT among those aged 30 years or older compared with the overall national data. These findings indicate a probable high risk of raised BP in high altitude populations in Nepal.

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Section: Discussionmentioning

confidence: 99%

Blood pressure and hypertension in people living at high altitude in Nepal

et al. 2018

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“…Living separately from other ethnic populations, minorities thus provide an ideal genetically homogeneous population to investigate the contribution of hereditary factors to specific disease. Given the fact that Tibetans have high dietary salt intake [Sehgal et al, ], we decided to study the genetic influence of the water‐sodium metabolism pathway on Tibetan hypertension, rather than the presumably activated RAS system on high‐altitude circumstance [Parati et al, ] .…”

Section: Discussionmentioning

confidence: 99%

Association of with‐no‐lysine kinase 1 and Serine/Threonine kinase 39 gene polymorphisms and haplotypes with essential hypertension in Tibetans

Shi

et al. 2017

Environ and Mol Mutagen

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Tibetans have a higher essential hypertension prevalence compared with other ethnics in China. The reason might be due to their unique environmental influence, as well as genetic factor. However, limited studies focus on Tibetan genetics and its association with hypertension. The aim of this study was to investigate the association between With-No-Lysine (K) Kinase 1 (WNK1), Serine/Threonine kinase 39(STK39) genes variants and hypertension in the Tibetan population. 204 Tibetan hypertensive patients and 305 normotensive controls were recruited in an epidemiological survey conducted at 2 sites in the Ganzi Tibetan autonomous region. Patients were genotyped for nineteen WNK1 candidate tag single nucleotide polymorphisms (SNPs) and three STK39 SNPs, and haplotype analysis was performed. Results showed that the allele A in rs1468326 was overrepresented in hypertensive patients versus control (53.4% vs 42.9%, P < 0.05). The multivariable-adjusted odds ratio (OR) for hypertension among CA + AA genotypes carriers was 1.60 (95% CI: 1.02-2.62, P < 0.05), and they also had a higher systolic blood pressure (136.5 ± 28.6 vs 131.7 ± 24.8 mmHg, P < 0.05). However, the TT genotype ratio in rs6749447 was lower in hypertensives (5.4% vs 10.8%, P < 0.05), and the hypertension risk for the TT genotype carriers in rs6749447 decreased after adjustment (OR 0.49, 95% CI 0.19-0.95, P < 0.05). Subjects with haplotype AGACAGGAATCGT showed 1.57 times higher risk of hypertension (95% CI 1.02-2.41, P < 0.05). In conclusion, SNP rs1468326 of WNK1, rs6749447 of STK39, and WNK1 haplotype AGACAGGAATCGT were associated with hypertension in Tibetan individuals. Environ. Mol. Mutagen. 59:151-160, 2018. © 2017 Wiley Periodicals, Inc.

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“…Tibetans have been reported to consume ‘traditional salty butter tea’ whose salt content is four to five times the amount recommended by the WHO. 7 46 Indeed, the result of a recent study showed that a low-sodium, high-potassium salt-substitute intervention caused a dramatic fall in BP in hypertensive Tibetans. 47 …”

Section: Discussionmentioning

confidence: 99%

Relationship between altitude and the prevalence of hypertension in Tibet: a systematic review

Mingji

Onakpoya

Perera

et al. 2015

Heart

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IntroductionHypertension is a leading cause of cardiovascular disease, which is the cause of one-third of global deaths and is a primary and rising contributor to the global disease burden. The objective of this systematic review was to determine the prevalence and awareness of hypertension among the inhabitants of Tibet and its association with altitude, using the data from published observational studies.MethodsWe conducted electronic searches in Medline, Embase, ISI Web of Science and Global Health. No gender or language restrictions were imposed. We assessed the methodological characteristics of included studies using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. Two reviewers independently determined the eligibility of studies, assessed the methodology of included studies and extracted the data. We used meta-regression to estimate the degree of change in hypertension prevalence with increasing altitude.ResultsWe identified 22 eligible articles of which eight cross-sectional studies with a total of 16 913 participants were included. The prevalence of hypertension ranged between 23% and 56%. A scatter plot of altitude against overall prevalence revealed a statistically significant correlation (r=0.68; p=0.04). Meta-regression analysis revealed a 2% increase in the prevalence of hypertension with every 100 m increase in altitude (p=0.06). The locations and socioeconomic status of subjects affected the awareness and subsequent treatment and control of hypertension.ConclusionsThe results from cross-sectional studies suggest that there is a significant correlation between altitude and the prevalence of hypertension among inhabitants of Tibet. The socioeconomic status of the inhabitants can influence awareness and management of hypertension. Very little research into hypertension has been conducted in other prefectures of Tibet where the altitude is much higher. Further research examining the impact of altitude on blood pressure is warranted.

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Observations on the Blood Pressure of Tibetans

Cited by 27 publications

References 27 publications

Blood pressure and hypertension in people living at high altitude in Nepal

Blood pressure and hypertension in people living at high altitude in Nepal

Association of with‐no‐lysine kinase 1 and Serine/Threonine kinase 39 gene polymorphisms and haplotypes with essential hypertension in Tibetans

Relationship between altitude and the prevalence of hypertension in Tibet: a systematic review

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