Abstract
Aim of Study: Four hundred million people live at high altitude worldwide. Prevalence and risk factors for COPD in these populations are poorly documented. We examined the prevalence and risk factors for COPD in residents living at an altitude of 2,100–4,700 m.Methods: We performed a cross-sectional survey in Xinjiang and Tibet autonomous region. A multistage stratified sampling procedure was used to select a representative population aged 15 years or older from eight high altitude regions. All participants underwent pre- and post-bronchodilator measurement of forced expiratory volumes. COPD was diagnosed according to 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.Results: Between June, 2015 and August 2016, 4,967 subjects were included. Median age was 38.0 years (range: 15–91 years; inter-quartile range: 28–49 years); 51.4% participants were female. Overall prevalence of spirometry-defined COPD was 8.2% (95% CI 7.4–8.9%): 9.3% in male (95% CI 8.2–10.4%), and 7.1% in female (95% CI 6.1–8.2%). By multivariable logistic regression analysis, COPD was significantly associated with being aged ≥40 years (odds ratio: 2.25 [95% CI 1.72–2.95], P < 0.0001), exposure to household air pollution (OR: 1.34 [95% CI 1.01–1.79], P = 0.043), and a history of tuberculosis (OR: 1.79 [95% CI 1.23–2.61], P = 0.030), while living at a higher altitude (OR: 0.45 [95% CI 0.33–0.61], P < 0.0001) and having a higher educational level (OR: 0.64 [95% CI 0.43–0.95], P = 0.025) were associated with a lower prevalence of COPD.Conclusions: Our results show that the spirometry-defined COPD is a considerable health problem for residents living at high altitudes and COPD prevalence was inversely correlated with altitude. Preventing exposure to household air pollution and reducing the incidence of tuberculosis should be public health priorities for high altitude residents.
Highlights
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death from non-communicable diseases in the world, accounting for 5.4% of all deaths globally in 2016 [1,2,3]
We aimed to determine the prevalence of COPD and to explore potential risk factors for COPD in residents living at high altitude
This spirometry-based study in a representative sample of 4,967 residents shows that COPD is a major public health challenge at high altitudes (2,100–4,700 m): 8.2% of the highaltitude population aged more than 15 years had spirometrydefined COPD, making up for the gaps of region, altitude, and nationality
Summary
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death from non-communicable diseases in the world, accounting for 5.4% of all deaths globally in 2016 [1,2,3]. The Global Burden of Disease study estimated that there were 299 million adults with prevalent COPD worldwide in 2017 [5], and 99.9 million individuals aged ≥20 years with COPD in China in 2015 [6], causing a substantial clinical, economic, and societal burden. Living at high altitude results in exposure to colder temperatures, a lower humidity, and hypobaric hypoxic conditions. At 4,000 m, ambient arterial partial pressure of oxygen (PaO2) is ∼63% that of PaO2 measured at sea level [9, 10]. These variables may impact on respiratory health in general and prevalence of COPD in particular. The high altitude setting combines social-economic factors and environmental conditions which may affect respiratory health
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call