A Retrospective Cross-Sectional Study on the Clinicopathologic Features of Essential Hypertension at High Altitude in China.

PURPOSE: The purpose of the study is to analyze the clinicopathological characteristics of essential hypertension (EH) in high-altitude regions of China and provide evidence-based guidance for rational diagnosis and treatment strategies in these areas.

METHODS

This cross-sectional retrospective study enrolled two cohorts of EH patients from Qinghai (high altitude, ≥ 2500 m) and Chengdu (low altitude, 500 m) between 2020 and 2022. Participants were stratified based on their residential altitude. Clinical parameters, biochemical markers, cardiac imaging data, and antihypertensive regimens were systematically compared. Statistical analyses were conducted using SPSS software (Version 26.0).

RESULTS

Compared with patients with EH at low altitude, high-altitude EH patients had a higher mean systolic/diastolic blood pressure and a lower percentage of compliance with blood pressure lowering and were more likely to have hyperuricemia (HUA) and abnormally elevated metabolic function (p = 0.03). Significant cardiac structural changes occurred in patients with high-altitude EH: increased pulmonary artery internal diameter (p < 0.001). In addition, the proportion of angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, β-blocker, and diuretic use was lower in patients with high-altitude EH, while the proportion of SPC combination use was higher; conversely, the proportion of diuretic use was higher in patients with high-altitude EH with comorbid HUA.

CONCLUSION

EH in high-altitude populations demonstrates distinct clinicopathological manifestations, including right ventricular overload and compensatory left cardiac adaptation. These findings underscore the necessity for altitude-specific clinical guidelines to optimize hypertension management in these regions.