The Effect of Residing Altitude on Levels of High-Density Lipoprotein Cholesterol

Riyami, Nafila B. Al; Banerjee, Yajnavalka; Al-Waili, Khalid; Rizvi, Syed; Al‐Yahyaee, Said; Hassan, Mohammed O.; Albarwani, Sulayma; Al-Rasadi, Khalid; Bayoumi, Riad

doi:10.1177/0003319714544355

Cited by 11 publications

(11 citation statements)

References 35 publications

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“…Living at high altitude areas requires physiological adaptations, which in turn may provide additional avenues for explanations. Literature reports that higher HDL-c levels have been observed in high altitude compared to low-altitude groups, but this is contradictory to our findings [43] .…”

Section: Discussioncontrasting

confidence: 99%

Low HDL cholesterol as a cardiovascular risk factor in rural, urban, and rural-urban migrants: PERU MIGRANT cohort study

et al. 2016

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IntroductionWhilst the relationship between lipids and cardiovascular mortality has been well studied and appears to be controversial, very little has been explored in the context of rural-to-urban migration in low-resource settings.ObjectiveDetermine the profile and related factors for HDL-c patterns (isolated and non-isolated low HDL-c) in three population-based groups according to their migration status, and determine the effect of HDL-c patterns on the rates of cardiovascular outcomes (i.e. non-fatal stroke and non-fatal myocardial infarction) and mortality.MethodsCross-sectional and 5-year longitudinal data from the PERU MIGRANT study, designed to assess the effect of migration on cardiovascular risk profiles and mortality in Peru. Two different analyses were performed: first, we estimated prevalence and associated factors with isolated and non-isolated low HDL-c at baseline. Second, using longitudinal information, relative risk ratios (RRR) of composite outcomes of mortality, non-fatal stroke and non-fatal myocardial infarction were calculated according to HDL-c levels at baseline.ResultsData from 988 participants, rural (n = 201), rural-to-urban migrants (n = 589), and urban (n = 199) groups, was analysed. Low HDL-c was present in 56.5% (95%CI: 53.4%–59.6%) without differences by study groups. Isolated low HDL-c was found in 36.5% (95%CI: 33.5–39.5%), with differences between study groups. In multivariable analysis, urban group (vs. rural), female gender, overweight and obesity were independently associated with isolated low HDL-c. Only female gender, overweight and obesity were associated with non-isolated low HDL-c. Longitudinal analyses showed that non-isolated low HDL-c increased the risk of negative cardiovascular outcomes (RRR = 3.46; 95%CI: 1.23–9.74).ConclusionsIsolated low HDL-c was the most common dyslipidaemia in the study population and was more frequent in rural subjects. Non-isolated low HDL-c increased three-to fourfold the 5-year risk of cardiovascular outcomes.

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Section: Discussioncontrasting

confidence: 99%

Low HDL cholesterol as a cardiovascular risk factor in rural, urban, and rural-urban migrants: PERU MIGRANT cohort study

et al. 2016

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“…7 These studies showed crude estimates and did not adjust by potential confounders nor by BMI, limiting the comparability with our findings. A separate study from Oman, in the Arabian peninsula, compared HDL-c levels in families living at different altitudes, that is, 2000 vs 700 m.a.s.l., and found that this marker was lower in the population living at higher altitude in the order of –0.39 mmol/L (15 mg/dL), 8 a difference that may not have much clinical relevance. In our study, we did not observe an association between low HDL-c and altitude.…”

Section: Discussionmentioning

confidence: 94%

“…relative to those who live at sea level. 8 These studies denote that the controversial results in the association between high altitude and dyslipidemia patterns and does not account for the rural/urban effect that is also be present even at different altitudes.…”

Section: Introductionmentioning

confidence: 94%

Urbanization, mainly rurality, but not altitude is associated with dyslipidemia profiles

Lazo-Porras

Bernabé‐Ortiz

Quispe

et al. 2017

Journal of Clinical Lipidology

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BackgroundGeographical and environmental features such as urbanization and altitude may influence individual's lipid profiles because of the diversity of human-environment interactions including lifestyles.ObjectiveTo characterize the association between altitude and urbanization and lipid profile among Peruvian adults aged ≥35 years.MethodsCross-sectional analysis of the CRONICAS Cohort Study. The outcomes of interest were 6 dyslipidemia traits: hypertriglyceridemia, high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol (HDL-c), nonisolated low HDL-c, isolated low HDL-c, and high non-HDL-c. The exposures of interest were urbanization level (highly urban, urban, semi-urban, and rural) and altitude (high altitude vs sea level). Prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were calculated using Poisson regression models with robust variance adjusting for potential confounders.ResultsData from 3037 individuals, 48.5% males, mean age of 55.6 (standard deviation ±12.7) years, were analyzed. The most common dyslipidemia pattern was high non-HDL-c with a prevalence of 88.0% (95% CI: 84.9%–90.7%) in the rural area and 96.0% (95% CI: 94.5%–97.1%) in the semi-urban area. Relative to the highly urban area, living in rural areas was associated with a lower prevalence of hypertriglyceridemia (PR = 0.75; 95% CI: 0.56–0.99) and high non-HDL-c (PR = 0.96; 95% CI: 0.93–0.99), whereas living in semi-urban areas was associated with higher prevalence high low-density lipoprotein cholesterol (PR = 1.37; 95% CI: 1.11–1.67). Compared with sea level areas, high-altitude areas had lower prevalence of high non-HDL-c (PR = 0.97; 95% CI: 0.95–0.99).ConclusionUrbanization but not altitude was associated to several dyslipidemia traits, with the exception of high non-HDL-c in high altitude settings.

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“…A cross sectional study from the United States shows that adults living at altitudes of 1500-3500 m are less likely to have diabetes and obesity compared with adults living at elevations of 0-499 m. After adjusting for factors such as age, physical activity, and obesity, the association between diabetes and altitude persisted (Woolcott et al, 2014). In terms of hyperlipidemia, a study of an Omani Arab population residing at high altitude demonstrates elevated high density lipoprotein cholesterol (HDL-C) levels, while a cross-sectional Turkish study shows that dyslipidemia is negatively associated with altitude (Bayram et al, 2014;Al Riyami et al, 2015). This effect is thought to be mediated through HIF1 in reducing cholesterol synthesis by 3-hydroxy-3-methylglutaryl-CoA reductase (Nguyen et al, 2007).…”

Section: Is Residence At Altitude Beneficial?mentioning

confidence: 99%

The Effect of Hypoxia on Cardiovascular Disease: Friend or Foe?

Savla

Levine

Sadek

2018

High Altitude Medicine & Biology

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Savla, Jainy J., Benjamin D. Levine, and Hesham A. Sadek. The effect of hypoxia on cardiovascular disease: Friend or foe? High Alt Med Biol. 19:124-130, 2018.-Over 140 million people reside at altitudes exceeding 2500 m across the world, resulting in exposure to atmospheric (hypobaric) hypoxia. Whether this chronic exposure is beneficial or detrimental to the cardiovascular system, however, is uncertain. On one hand, multiple studies have suggested a protective effect of living at moderate and high altitudes for cardiovascular risk factors and cardiovascular disease (CVD) events. Conversely, residence at high altitude comes at the tradeoff of developing diseases such as chronic mountain sickness and high-altitude pulmonary hypertension and worsens outcomes for diseases such as chronic obstructive pulmonary disease. Interestingly, recently published data show a potential role for severe hypoxia as a unique and unexpected therapy after myocardial infarction. In this review, we will discuss the current literature evaluating the effects of altitude exposure and the accompanying hypoxia on health and the potential therapeutic applications of hypoxia on CVD.

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The Effect of Residing Altitude on Levels of High-Density Lipoprotein Cholesterol

Cited by 11 publications

References 35 publications

Low HDL cholesterol as a cardiovascular risk factor in rural, urban, and rural-urban migrants: PERU MIGRANT cohort study

Low HDL cholesterol as a cardiovascular risk factor in rural, urban, and rural-urban migrants: PERU MIGRANT cohort study

Urbanization, mainly rurality, but not altitude is associated with dyslipidemia profiles

The Effect of Hypoxia on Cardiovascular Disease: Friend or Foe?

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