The prevalence and risk factors of high-altitude pulmonary hypertension among native Tibetans in Sichuan Province, China
Abstract Background High-altitude pulmonary hypertension (HAPH) remains a concern due to its high mortality, however, studies evaluating its prevalence and risk factors are lacking. Objective To determine the prevalence of HAPH and its correlated factors among the highlanders living at 3200 metres above sea level in Ganzi Tibetan Automous Prefecture, Sichuan Province, China. Methods This was a single-center cross-sectional study involved 1129 subjects (mean age 46.6±14 years, 39% men). Native Tibetans with HAPH were defined as mean pulmonary artery pressure >30mmHg achieved from transthoracic echocardiography. Results The crude prevalence of HAPH was 6.2%, and was more prevalent in men compared to women (8.6% vs 4.6%, P=0.005). The elder was more likely to develop HAPH (OR: 5.308, 95% CI: 2.562–10.993). Highlanders with HAPH had more severe metabolic abnormalities (including elevated blood pressure, blood glucose, blood lipids, BMI, etc. P value<0.05) and significantly increased hemoglobin level (P=0.001). On multivariate logistic regression analysis, independent risk factors for HAPH were metabolic syndrome (OR: 3.128, 95% CI: 1.110–8.818), age (>60 years vs <40 years) (OR: 2.924, 95% CI: 1.282–6.669), and decreased SpO2 (OR: 1.072 per 1-unit decrease; 95% CI: 1.010–1.136). Conclusion It could be concluded that HAPH was prevalent among 6.2% native Tibetans in Sichuan Province, China. Increasing age, metabolic syndrome and decreased SpO2 were independent predisposing factors for HAPH Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): This study was funded by one Science and Technology Pillar Programs in Sichuan Province (Grant no. 2017SZ0008).