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Chronic Mountain Sickness in Tibet
Abstract
SUMMARY A clinical syndrome identical to the chronic mountain sickness of the Andes occurs commonly in Lhasa, Tibet. It affects, almost exclusively, the immigrant Han population and develops after an average of 15 years' residence at high altitude. The early symptoms are attributable to polycythaemia-headache, dizziness, loss of memory and fatigue being prominent. In the later stages of the disease, dyspnoea and peripheral oedema develop. Haemodynamic investigations show pulmonary hypertension with a normal cardiac output and dilatation of the right ventricle in the long-established case. Respiratory gas studies provide evidence of alveolar underventilation and ventilation: perfusion inhomogeneity. Both clinical and investigatory data suggest that the earlier stages of the disease are dominated by polycythaemia, while cardiopulmonary involvement increases withthe duration of the disease. The disease is rare in women and uncommon in Tibetans. Cigarette smoking appears to be a contributory factor.
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“In contrast, Tibetan residents of Han Chinese descent are much more frequently affected by CMS, which represents a major public health burden.”
From Regulation of erythropoiesis by hypoxia-inducible factors (2013) · cites this paper as [166]
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“While the disease is prevalent in the Andean population, it is less common in native Tibetans, who live at comparable altitude.”
From Regulation of erythropoiesis by hypoxia-inducible factors (2013) · cites this paper as [166]
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Beall, C. M., Cavalleri, G. L., Deng, L., Elston, R. C., Gao, Y., Knight, J., Li, C., Li, J. C., Liang, Y., McCormack, M., et al. (2010) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1002443107 · Cited by 845
Regulation of erythropoiesis by hypoxia-inducible factors
Haase, V. H. (2013) · Blood Reviews · doi:10.1016/j.blre.2012.12.003 · Cited by 787
Penaloza, D., & Arias-Stella, J. (2007) · Circulation · doi:10.1161/circulationaha.106.624544 · Cited by 643
Consensus Statement on Chronic and Subacute High Altitude Diseases
Lèon‐Velarde, F., Maggiorini, M., Reeves, J. Τ., Aldashev, A. A., Asmus, I., Bernardi, L., Ge, R.-L., Hackett, P. H., Kobayashi, T., MOORE, L. G., et al. (2005) · High Altitude Medicine & Biology · doi:10.1089/ham.2005.6.147 · Cited by 629
Physiological Adaptation of the Cardiovascular System to High Altitude
Naeije, R. (2010) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2010.03.004 · Cited by 403
Metadata
- Authors
- PEI, S. X., CHEN, X. J., SI REN, B. Z., LIU, Y. H., CHENG, X. S., HARRIS, E. M., ANAND, I. S., & C.HARRIS, P.
- Affiliations
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- National Heart and Lung Institute ‡ London
- Post Graduate Institute of Medical Education and Research (IN)
- Venue
- QJM: An International Journal of Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1989-06-01
- Volume
- 71
- Issue
- 3
- Pages
- 555-574
- ISSN
- 0033-5622 (ISSN-L)
- 1460-2393
- 1460-2725
- OpenAlex
- W2180411427
- Cited by
- 90
- References
- 0
- Citations by year
- 2026: 1 · 2022: 4 · 2021: 4 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 8 · 2012: 5
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- QJM (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › High Altitude and Hypoxia
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- chronic mountain sickness, high altitude, polycythemia, pulmonary hypertension, right ventricular dilatation, alveolar hyperventilation, ventilation-perfusion mismatch, dyspnea, peripheral edema, cigarette smoking, Lhasa, Tibet
- MeSH terms
- Adult, Aged, Altitude Sickness, Hypoxia, Carbon Dioxide, China, Chronic Disease, Echocardiography, Electrocardiography, Female, Hemodynamics, Humans, Male, Middle Aged, Oxygen, Smoking, Radiography, Thoracic
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