ArticleHeart (British Cardiac Society)2017
Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension.
Article in Heart (British Cardiac Society), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04751292 (HIGH Altitude CArdiovascular REsearch Latin America Population Study), which is not on this map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
HIGH Altitude CArdiovascular REsearch Latin America Population Study
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of hypertension in adults living at altitude in Latin America and the Caribbean: A systematic review and meta-analysis.PloS one · 2023Pooled it
- Screening strategies for hypertension.The Cochrane database of systematic reviews · 2020Pooled it
- Effect of salt substitution on community-wide blood pressure and hypertension incidence.Nature medicine · 2020Trial
- Article
- Hypertension and altitude in community-dwelling older adults: an epidemiological study in northwest China.BMJ open · 2026Article
- Population attributable fraction of modifiable risk factors for incident hypertension: an analysis of large-scale epidemiological cohort.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Physical activity patterns and environmental influences: Findings from the Kuwait diabetes epidemiology program.Global epidemiology · 2025Article
- Health-Related Physical Fitness Associated With Hypertension Risk in Adults Living in Sub-Plateau Environments.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Association between rural-to-urban migration and the onset of hypertension among middle-aged and older population: evidence from India.BMC public health · 2025Article
- Metabolic Syndrome in the Amazon: Customizing Diagnostic Methods for Urban Communities.Nutrients · 2025Article
- Combined effects of insulin resistance and altitude of residence on 10-year risk of atherosclerotic cardiovascular disease.Frontiers in cardiovascular medicine · 2025Article
- Association of altitude with all-cause and cardiovascular mortality among patients with hypertension: a cohort study in Southwest China.BMC public health · 2024Article
- Effectiveness of a Community Pharmacy-Based Health Promotion Program on Hypertension in Bangladesh and Pakistan: Study Protocol for a Cluster-Randomized Controlled Trial.Healthcare (Basel, Switzerland) · 2024Article
- Hypertension subtypes at high altitude in Peru: Analysis of the Demographic and Family Health Survey 2016-2019.PloS one · 2024Article
- Glucose metabolism disorders and changes in cardiovascular risk among adult Peruvian population.Wellcome open research · 2024Article
- Implementation of a salt substitute intervention using social marketing in resourced-limited communities in Peru: a process evaluation study.Frontiers in public health · 2023Article
- Peru - Progress in health and sciences in 200 years of independence.Lancet regional health. Americas · 2022Review
- Population-based stroke incidence estimates in Peru: Exploratory results from the CRONICAS cohort study.Lancet regional health. Americas · 2022Article
- Metabolic syndrome in rural Peruvian adults living at high altitudes using different cookstoves.PloS one · 2022Article
- Residential elevation and its effects on hypertension incidence among older adults living at low altitudes: a prospective cohort study.Environmental health and preventive medicine · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundMost of the data regarding the burden of hypertension in low-income and middle-income countries comes from cross-sectional surveys instead of longitudinal studies. We estimated the incidence of, and risk factors for, hypertension in four study sites with different degree of urbanisation and altitude.
methodsData from the CRONICAS Cohort Study, conducted in urban, semiurban and rural areas in Peru, was used. An age-stratified and sex-stratified random sample of participants was taken from the most updated census available in each site. Hypertension was defined as systolic blood pressure ≥140 mm Hg, or diastolic blood pressure ≥90 mm Hg, or self-report physician diagnosis and current treatment. The exposures were study site and altitude as well as modifiable risk factors. Incidence, incidence rate ratios (IRRs), 95% CIs and population-attributable fractions (PAFs) were estimated using generalised linear models.
resultsInformation from 3237 participants, mean age 55.8 (SD±12.7) years, 48.4% males, was analysed. Overall baseline prevalence of hypertension was 19.7% (95% CI 18.4% to 21.1%). A total of 375 new cases of hypertension were recorded, including 5266 person-years of follow-up, with an incidence of 7.12 (95% CI 6.44 to 7.88) per 100 person-years. Individuals from semiurban site were at higher risk of hypertension compared with highly urbanised areas (IRR=1.76; 95% CI 1.39 to 2.23); however, those from high-altitude sites had a reduced risk (IRR=0.74; 95% CI 0.58 to 0.95). Obesity was the leading risk factor for hypertension with a great variation according to study site with PAF ranging from 12.5% to 42.4%.
conclusionsOur results suggest heterogeneity in the progression towards hypertension depending on urbanisation and site altitude.
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