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Title: Stroke related mortality at different altitudes: A 17-year nationwide population-based analysis from Ecuador
Author: Ortiz-Prado, Esteban
Espinosa, Patricio S.
Borrero, Alfredo
Cordovez, Simone Pierina
Vásconez González, Jorge Eduardo
Barreto-Grimales, Alejandra
Coral-Almeida, Marco
Henríquez-Trujillo, Aquiles R.
Simbaña-Rivera, Katherine
Gomez-Barreno, Lenin
Viscor Carrasco, Ginés
Roderick, Paul
Keywords: Mortalitat
Influència de l'altitud
Influence of altitude
Issue Date: 30-Sep-2021
Publisher: Frontiers Media
Abstract: Worldwide, more than 5.7% of the population reside above 1,500m of elevation. It has been hypothesized that acute short-term hypoxia exposure could increase the risk of developing a stroke. Studies assessing the effect of altitude on stroke have provided conflicting results, some analyses suggest that long-term chronic exposure could be associated with reduced mortality and lower stroke incidence rates. An ecological analysis of all stroke hospital admissions, mortality rates and disability-adjusted life years in Ecuador was performed from 2001-2017. The cases and population at risk were categorized in low (<1,500m), moderate (1,500m -2,500m), high (2,500m -3,500m) and very high altitude (3,500-5,500m) according to the place of residence. The derived crude and direct standardized age-sex adjusted mortality and hospital admission rates were calculated. A total of 38,201 deaths and 75,893 stroke-related hospital admissions were reported. High altitude populations (HAP) had lower stroke mortality in men (OR: 0.91 [0.88 - 0.95]) and women (OR: 0.83 [0.79 - 0.86]). In addition, HAP had a significant lower risk of getting admitted to the hospital when compared with the low altitude group in men (OR: 0.55 [CI95% 0.54 - 0.56]) and women (OR: 0.65 [CI95% [0.64 - 0.66]). This is the first epidemiological study that aims to elucidate the association between stroke and altitude using four different elevation ranges. Our findings suggest that living at higher elevations offers a reduction or the risk of dying due to stroke as well as a reduction in the probability of being admitted to the hospital. Nevertheless, this protective factor has a stronger effect between 2,000m to 3,500 m.
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It is part of: Frontiers in Physiology, 2021, vol. 12, num. e733928, p. 1-14
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ISSN: 1664-042X
Appears in Collections:Articles publicats en revistes (Biologia Cel·lular, Fisiologia i Immunologia)

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