title: Chronoecological health watch of arterial stiffness and neuro-cardio-pulmonary function in elderly community at high altitude (3524 m), compared with Japanese town.
abstract: Effects of high altitude on arterial stiffness and neuro-cardio-pulmonary function were studied. Blood pressure (BP) and heart rate (HR) were measured in a sitting position on resting Ladakhis, living at an altitude of 3250-4647 m (Phey village, 3250 m: 17 men and 55 women; Chumathang village, 4193 m: 29 men and 47 women; Sumdo village, 4540 m: 38 men and 57 women; and Korzok village, 4647 m: 84 men and 70 women). The neuro-cardio-pulmonary function, including the Kohs block design test, the Up and Go, the Functional Reach and the Button tests, was examined in 40 elderly subjects (19 men and 21 women, mean age: 74.7 +/- 3.3 years) in Leh, Ladakh (altitude: 3524 m), for comparison with 324 elderly citizens (97 men and 227 women, mean age: 80.7 +/- 4.7 years) of Tosa, Japan (altitude: 250 m). Cardio-Ankle Vascular Index (CAVI) was measured as the heart-ankle pulse wave velocity (PWV) in these subjects using a VaSera CAVI instrument (Fukuda Denshi, Tokyo). SpO(2) decreased while Hb and diastolic BP increased with increasing altitude. At higher altitude, residents were younger and leaner. Women in Leh vs. Tosa had a poorer cognitive function, estimated by the Kohs block design test (3.7 +/- 3.6 vs. 16.4 +/- 9.6 points, P < 0.0001) and poorer ADL functions (Functional Reach: 13.7 +/- 7.0 cm vs. 25.3 +/- 8.7 cm, P < 0.0001; Button test: 22.5 +/- 4.8 vs. 14.8 +/- 5.7 s, P < 0.0001). Time estimation was shorter at high altitude (60-s estimation with counting: 41.1% shorter in men and 23.0% shorter in women). A higher voltage of the QRS complex was observed in the ECG of Leh residents, but two times measurement of CAVI showed no statistically significant differences between Leh and Tosa (two times of CAVI measures; 9.49 vs. 10.01 m/s and 9.41 vs. 10.05 m/s, respectively), suggesting that most residents succeed to adapt sufficiently to the high-altitude environment. However, correlation of CAVI with age shows several cases who show an extreme increase in CAVI. Thus, for the prevention of stroke and other adverse cardiovascular outcomes, including dementia, CAVI may be very useful, especially at high altitude. In conclusion, elderly people living at high altitude have a higher risk of cardiovascular disease than low-latitude peers. To determine how these indices are associated with maintained cognitive function deserves further study by the longitudinal follow-up of these communities in terms of longevity and aging in relation to their neuro-cardio-pulmonary function.
authors.affiliation: Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan. otsukagm@dnh.twmu.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Otsuka
authors.forename: T
authors.initials: T
authors.lastname: Norboo
authors.forename: Y
authors.initials: Y
authors.lastname: Otsuka
authors.forename: H
authors.initials: H
authors.lastname: Higuchi
authors.forename: M
authors.initials: M
authors.lastname: Hayajiri
authors.forename: C
authors.initials: C
authors.lastname: Narushima
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Tsugoshi
authors.forename: S
authors.initials: S
authors.lastname: Murakami
authors.forename: T
authors.initials: T
authors.lastname: Wada
authors.forename: M
authors.initials: M
authors.lastname: Ishine
authors.forename: K
authors.initials: K
authors.lastname: Okumiya
authors.forename: K
authors.initials: K
authors.lastname: Matsubayashi
authors.forename: S
authors.initials: S
authors.lastname: Yano
authors.forename: T
authors.initials: T
authors.lastname: Chogyal
authors.forename: D
authors.initials: D
authors.lastname: Angchuk
authors.forename: K
authors.initials: K
authors.lastname: Ichihara
authors.forename: G
authors.initials: G
authors.lastname: Cornélissen
authors.forename: F
authors.initials: F
authors.lastname: Halberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged / Q000502:physiology*; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000531:Altitude; D001158:Arteries / Q000473:pathology*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002320:Cardiovascular Physiological Phenomena; D003071:Cognition / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007194:India / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008168:Lung / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009424:Nervous System Physiological Phenomena; D009483:Neuropsychological Tests; D015656:Respiratory Mechanics / Q000502:physiology
chemical_list: D006454:Hemoglobins