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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
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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
Population history and genomic signatures for high-altitude adaptation in Tibetan pigs
Ai, H., Yang, B. J., Li, J., Xie, X., Chen, H., & Ren, J. (2014) · BMC Genomics · doi:10.1186/1471-2164-15-834 · Cited by 166
Pathophysiology and Treatment of High-Altitude Pulmonary Vascular Disease
Wilkins, M. R., Ghofrani, H. A., Weißmann, N., Aldashev, A. A., & Zhao, L. (2015) · Circulation · doi:10.1161/circulationaha.114.006977 · Cited by 164
Time Domains of the Hypoxic Ventilatory Response and Their Molecular Basis
Pamenter, M. E., & Powell, F. L. (2016) · Comprehensive physiology · doi:10.1002/cphy.c150026 · Cited by 169
Stroke at High Altitude: Indian Experience
Jha, S. K., Anand, A. C., Sharma, V. V., Kumar, N., & Adya, C. M. (2002) · High Altitude Medicine & Biology · doi:10.1089/152702902753639513 · Cited by 142
Travel to high altitude with pre-existing lung disease
Luks, A. M., & Swenson, E. R. (2007) · European Respiratory Journal · doi:10.1183/09031936.00052606 · Cited by 135
Dietz, T. E., & Hackett, P. H. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-54696-6.00042-2 · Cited by 130
High-altitude pulmonary hypertension: a pathophysiological entity to different diseases
Maggiorini, M., & Lèon‐Velarde, F. (2003) · European Respiratory Journal · doi:10.1183/09031936.03.00052403 · Cited by 115
The Qinghai–Tibetan Plateau: How High Do Tibetans Live?
Wu, T. (2001) · High Altitude Medicine & Biology · doi:10.1089/152702901753397054 · Cited by 112
Ken Zafren, A., & Honigman, B. (1997) · Emergency Medicine Clinics of North America · doi:10.1016/s0733-8627(05)70291-1 · Cited by 109
High-altitude pulmonary hypertension: Table. 1—
Xu, X.-Q., & Jing, Z. (2009) · European Respiratory Review · doi:10.1183/09059180.00011104 · Cited by 105
Chronic Mountain Sickness and the Heart
Lèon‐Velarde, F., Villafuerte, F. C., & Richalet, J. (2010) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2010.02.012 · Cited by 100
Pulmonary hypertension and the right ventricle in hypoxia
Naeije, R., & Dedobbeleer, C. (2013) · Experimental Physiology · doi:10.1113/expphysiol.2012.069112 · Cited by 93
Clinical features of headache at altitude
Silber, E., Sonnenberg, P., Collier, D., Pollard, A. J., Murdoch, D. R., & Goadsby, P. J. (2003) · Neurology · doi:10.1212/01.wnl.0000055876.26737.b9 · Cited by 87
Adult subacute mountain sickness—a syndrome of congestive heart failure in man at very high altitude
Anand, I. S., Chandrashekhar, Y., Bali, H. K., Wahi, P. L., Jindal, S. K., Malhotra, R. M., Chauhan, S., & Bhandari, R. K. (1990) · The Lancet · doi:10.1016/0140-6736(90)90348-9 · Cited by 84
Self-citationAdaptations to local environments in modern human populations
Jeong, C., & Di Rienzo, A. (2014) · Current Opinion in Genetics & Development · doi:10.1016/j.gde.2014.06.011 · Cited by 80
Garruto, R. M., Chin, C., Weitz, C. A., Liu, J., Liu, R., & He, X. (2003) · American Journal of Physical Anthropology · doi:10.1002/ajpa.10283 · Cited by 66
Evidence for a Genetic Basis for Altitude-Related Illness
Rupert, J. L., & Koehle, M. S. (2006) · High Altitude Medicine & Biology · doi:10.1089/ham.2006.7.150 · Cited by 65
Gupta, M. L., Rao, K. S., Anand, I. S., Banerjee, A. K., & Ms, B. (1992) · American Review of Respiratory Disease · doi:10.1164/ajrccm/145.5.1201 · Cited by 64
Self-citationProtective Effects of Intermittent Hypoxic Adaptation on Myocardium and Its Mechanisms
Zhuang, J., & Zhou, Z.-N. (1999) · Neurosignals · doi:10.1159/000014602 · Cited by 64
A change of heart: Mechanisms of cardiac adaptation to acute and chronic hypoxia
Williams, A. M., Levine, B. D., & Stembridge, M. R. (2022) · The Journal of Physiology · doi:10.1113/jp281724 · Cited by 60
Ge, R., & Helun, G. (2001) · Wilderness and Environmental Medicine · doi:10.1580/1080-6032(2001)012[0190:ccocms]2.0.co;2 · Cited by 59
Ventilation and hypoxic ventilatory responsiveness in Chinese-Tibetan residents at 3,658 m
Curran, L. S., Zhuang, J., Sun, S. F., & MOORE, L. G. (1997) · Journal of Applied Physiology · doi:10.1152/jappl.1997.83.6.2098 · Cited by 58
Genetic association analysis of chronic mountain sickness in an Andean high-altitude population.
Mejía, O., Prchal, J. T., Lèon‐Velarde, F., Hurtado-Aréstegui, A., & Stockton, D. W. (2005) · PubMed · Cited by 54
Aging at high altitudes and the risk of chronic mountain sickness
Lèon‐Velarde, F., Arregui, A., Monge, C., & Ruiz, H. (1993) · Journal of Wilderness Medicine · doi:10.1580/0953-9859-4.2.183 · Cited by 53
Ventilatory Responses to Acute and Chronic Hypoxia
Bisgard, G. E., & Forster, H. V. (1996) · Comprehensive physiology · doi:10.1002/cphy.cp040252 · Cited by 53
Chronic Mountain Sickness and Chronic Lower Respiratory Tract Disorders
Lèon‐Velarde, F., Arregui, A., Vargas, M., Huicho, L., & Acosta, R. L. (1994) · CHEST Journal · doi:10.1378/chest.106.1.151 · Cited by 50
The impact of hypoxaemia on vascular function in lowlanders and high altitude indigenous populations
Tymko, M. M., Tremblay, J. C., Bailey, D. M., GREEN, D. J., & Ainslie, P. N. (2019) · The Journal of Physiology · doi:10.1113/jp277191 · Cited by 51
Smoking, acute mountain sickness and altitude acclimatisation: a cohort study
Wu, T., Ding, S.-Q., Liu, J., Jia, J.-H., Chai, Z. C., Dai, R., Zhao, J.-Z., Tang, Q. D., & Kayser, B. (2012) · Thorax · doi:10.1136/thoraxjnl-2011-200623 · Cited by 48
Syndromes of Subacute Mountain Sickness
Anand, I. S., & Wu, T. (2004) · High Altitude Medicine & Biology · doi:10.1089/1527029041352135 · Cited by 47
Self-citationStream, J. O., Luks, A. M., & Grissom, C. K. (2009) · Expert Review of Respiratory Medicine · doi:10.1586/ers.09.51 · Cited by 47
Symptomatic portal system thrombosis in soldiers due to extended stay at extreme altitude
Anand, A. C., SAHA, A., Seth, A. K., Chopra, G. S., Nair, V., & Sharma, V. V. (2005) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2005.03723.x · Cited by 45
Julian, C. G., Gonzales, M., Rodríguez, A., Bellido, D., Salmón, C. S., Ladenburger, A., Reardon, L., Vargas, E., & MOORE, L. G. (2015) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00296.2015 · Cited by 38
Lack of acclimatization to chronic hypoxia in humans in the Antarctica
Porcelli, S., Marzorati, M., Healey, B., Terraneo, L., Vezzoli, A., Bella, S. D., Dicasillati, R., & Samaja, M. (2017) · Scientific Reports · doi:10.1038/s41598-017-18212-1 · Cited by 35
Ph, H. (2013) · Elsevier eBooks · doi:10.1016/b978-0-323-10045-8.00001-3 · Cited by 35
Proposal for Scoring Severity in Chronic Mountain Sickness (Cms)
Lèon‐Velarde, F., McCullough, R. G., McCullough, R. E., & Reeves, J. Τ. (2003) · Advances in experimental medicine and biology · doi:10.1007/978-1-4419-8997-0_24 · Cited by 34
Wu, D., Liu, Y., Chen, W., Shao, J., Zhuoma, P., Zhao, D., Yu, Y., Liu, T., Yu, R., Gan, Y., et al. (2022) · Molecular Biology and Evolution · doi:10.1093/molbev/msac120 · Cited by 33
Self-citationDifferences in the control of breathing between Himalayan and sea‐level residents
Slessarev, M., Prisman, E., Ito, S., Watson, R. R., Jensen, D., Preiss, D. A., Greene, R., Norboo, T., Stobdan, T., Dolkar, D., et al. (2010) · The Journal of Physiology · doi:10.1113/jphysiol.2009.185504 · Cited by 32
Gonzales, G. F. (2013) · Asian Journal of Andrology · doi:10.1038/aja.2012.170 · Cited by 32
Negi, P. C., Asotra, S., Kumar, R., Marwah, R., Kandoria, A. K., Ganju, N., Sharma, R. K., & Bhardwaj, R. (2013) · High Altitude Medicine & Biology · doi:10.1089/ham.2012.1127 · Cited by 27
Hypoxia and the pulmonary circulation.
Anand, I. S. (1994) · Thorax · doi:10.1136/thx.49.suppl.s19 · Cited by 27
Self-citationSun, S.-R., Huang, S. Y., Zhang, J. G., Droma, T., Banden, G., McCullough, R. E., McCullough, R. G., Cymerman, A., Reeves, J. Τ., & MOORE, L. G. (1990) · American Review of Respiratory Disease · doi:10.1164/ajrccm/142.6_pt_1.1294 · Cited by 26
Liu, Y., Huang, H., Zhou, S.-M., Tian, H.-J., & Li, P. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00548 · Cited by 26
Self-citationECG observations in Tibetan and Han residents of Lhasa
Halperin, B. D., Sun, S., Zhuang, J., Droma, T., & MOORE, L. G. (1998) · Journal of Electrocardiology · doi:10.1016/s0022-0736(98)90139-x · Cited by 25
Hackett, P. H., & Roach, R. C. (2007) · Elsevier eBooks · doi:10.1016/b978-0-323-03228-5.50006-9 · Cited by 25
Pei, T., Li, X., Tao, F., Xu, H., You, H., Zhou, L., Liu, Y., & Gao, Y. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-401 · Cited by 24
Self-citationGonzales, G. F., & Villena, A. (2000) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(00)00270-8 · Cited by 24
Painschab, M., Malpartida, G., Dávila‐Román, V. G., Gilman, R. H., Kolb, T. M., Lèon‐Velarde, F., Miranda, J. J., & Checkley, W. (2015) · High Altitude Medicine & Biology · doi:10.1089/ham.2014.1086 · Cited by 21
The Cardiorespiratory fitness of children and adolescents in Tibet at altitudes over 3,500 meters
Fan, C., Sun, R.-Z., Nie, M., Wang, M., Yao, Z. J., Feng, Q., Xu, W., Yuan, R., Gao, Z., Cheng, Q., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0256258 · Cited by 21
Okumiya, K., Sakamoto, R., Kimura, Y., Ishine, M., Kosaka, Y., Wada, T., Wada, C., Nakatsuka, M., Ishimoto, Y., Hirosaki, M., et al. (2009) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/j.1447-0594.2009.00555.x · Cited by 19
DTI Study on Brain Structure and Cognitive Function in Patients with Chronic Mountain Sickness
Bao, H., Li, R., He, M., Kang, D., & Zhao, L. (2019) · Scientific Reports · doi:10.1038/s41598-019-55498-9 · Cited by 19
Limits on Inferring Genetic Adaptation to High Altitude in Himalayan and Andean Populations
Brutsaert, T. D. (2001) · High Altitude Medicine & Biology · doi:10.1089/152702901750265314 · Cited by 18
Responses of Han Migrants Compared to Tibetans at High Altitude
Weitz, C. A., Liu, J., He, X., Chin, C., & Garruto, R. M. (2013) · American Journal of Human Biology · doi:10.1002/ajhb.22368 · Cited by 18
Cardio-Pulmonary Interactions at High Altitude
Maggiorini, M. (2003) · Advances in experimental medicine and biology · doi:10.1007/978-1-4419-8997-0_13 · Cited by 17
Study of Brain Structure and Function in Chronic Mountain Sickness Based on fMRI
Bao, H., He, X., Wang, F., & Kang, D. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2021.763835 · Cited by 16
Mohan, R. M., Golding, S., & Paterson, D. J. (2001) · Acta Physiologica Scandinavica · doi:10.1046/j.1365-201x.2001.00851.x · Cited by 16
Pulmonary Hypertension in China
Zhai, Z., Wang, J., Zhao, L., Yuan, J. X. ‐., & Wang, C. (2010) · CHEST Journal · doi:10.1378/chest.09-2802 · Cited by 15
Altitude medicine and physiology including heat and cold: A review
Milledge, J. S. (2005) · Travel Medicine and Infectious Disease · doi:10.1016/j.tmaid.2005.06.007 · Cited by 14
Genetic and environmental adaptation in high altitude natives
Brutsaert, T. D. (2001) · Advances in experimental medicine and biology · doi:10.1007/978-1-4757-3401-0_10 · Cited by 13
Heath, D. (1989) · Thorax · doi:10.1136/thx.44.12.981 · Cited by 12
Problems of High Altitude Medicine and Biology
Aldashev, A. A., & Naeije, R. (2007) · Springer eBooks · doi:10.1007/978-1-4020-6300-8 · Cited by 10
Li, X., Pei, T., Xu, H., Tao, F., Haiyan, Y., Liu, Y., & Gao, Y. (2012) · Journal of Epidemiology · doi:10.2188/jea.je20110058 · Cited by 10
Self-citationHulme, C. W., Ingram, T. E., & Lonsdale-Eccles, D. A. (2003) · Wilderness and Environmental Medicine · doi:10.1580/1080-6032(2003)14[222:eefrhs]2.0.co;2 · Cited by 9
Ge, R., Shai, H.-R., Takeoka, M., Hanaoka, M., Koizumi, T., Matsuzawa, Y., Kubo, K., & Kobayashi, T. (2001) · Wilderness and Environmental Medicine · doi:10.1580/1080-6032(2001)012[0002:anparc]2.0.co;2 · Cited by 8
RV Is Doing Well at High Altitudes!—Always?∗
Naeije, R. (2013) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2013.09.011 · Cited by 8
Yuan, F., Guo, Z., Xu, Y., Wang, X., Bu, H., Zhong, N., Zhang, Y., & Zhou, Z.-N. (2008) · PubMed · Cited by 6
Naeije, R. (2018) · Revue des Maladies Respiratoires · doi:10.1016/j.rmr.2017.01.013 · Cited by 6
Szawarski, P., Tam, E. W., & Richards, P. (2012) · PubMed · Cited by 5
Gene Polymorphisms And High Altitude Pulmonary Hypertension
Aldashev, A. A. (2007) · Springer eBooks · doi:10.1007/978-1-4020-6300-8_11 · Cited by 4
Peñaloza, D. (2007) · Springer eBooks · doi:10.1007/978-1-4020-6300-8_2 · Cited by 3
Maggiorini, M., Bärtsch, P., & Swenson, E. R. (2013) · Springer eBooks · doi:10.1007/978-1-4614-8772-2_5 · Cited by 3
Das Respiratorische System auf großer Höhe: Pathophysiologie und neue Therapieoptionen
Trübsbach, S. S., Pircher, I., Treml, B., Löckinger, A., & Kleinsasser, A. T. (2011) · Wiener klinische Wochenschrift · doi:10.1007/s00508-010-1501-3 · Cited by 3
Quantitative Changes in Blood Cells
MBBS, F. B. J. B. (2014) · Wiley eBooks · doi:10.1002/9781118817322.ch6 · Cited by 3
Ward, M. P. (1991) · Journal of Wilderness Medicine · doi:10.1580/0953-9859-2.3.198 · Cited by 2
Quantitative Changes in Blood Cells
MBBS, F. B. J. B. (2006) · Wiley eBooks · doi:10.1002/9780470987551.ch6 · Cited by 2
Madea, B., Keil, W., Lunetta, P., & Kettner, M. (2022) · Wiley eBooks · doi:10.1002/9781119648628.ch22 · Cited by 2
Quantitative changes in blood cells
MBBS, F. B. J. B. (2021) · Wiley eBooks · doi:10.1002/9781119820307.ch6 · Cited by 1
PerspectiveVascular Disease: The Global Pulmonary Hypertension in China :
Zhai, Z., Wang, J., Zhao, L., & Wang, C. (2010)
The physiology and pathology of heat and cold
Milledge, J. S., West, J., & Schoene, R. (2007) · CRC Press eBooks · doi:10.1201/b13371-28
High Altitude and the Right Ventricle
Naeije, R. (2021) · Springer eBooks · doi:10.1007/978-3-030-78255-9_12
2009-2019: A comparative study on CMS of plateau migrants around ten yearsPreprint
Gao, Z., Xie, S., Gao, W., Yin, J., Ni, B. J., Gao, Y., He, W., & Chen, D. (2021) · Research Square · doi:10.21203/rs.3.rs-142873/v1
Exploration of the pulmonary circulation. Festschrift to Professor Donald Heath.
BMJ Publishing Group Ltd and British Thoracic Society (1994) · Thorax · doi:10.1136/thx.49.suppl.s1
Arenas, G. A., Herrera, E. A., Krause, B. J., Giussani, D. A., Julian, C. G., MOORE, L. G., & Lorca, R. A. (2026) · Physiological Reviews · doi:10.1152/physrev.00003.2026 · Cited by 1
Cardiopulmonary Adaptation to High Altitude
Richalet, J. (2012) · Springer eBooks · doi:10.1007/978-1-4614-5203-4_12
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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