Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador

Background Cardiovascular diseases, including ischemic heart disease, are the leading cause of prema- ture death and disability worldwide. While traditional risk factors such as smoking, obesity, and diabetes have been thoroughly investigated, non-traditional risk factors like high-alti- tude exposu...

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Autores: Ortiz-Prado, Esteban, Izquierdo-Condoy, Juan S., Fernández Naranjo, Raúl, Vásconez González, Jorge Eduardo, Cano, Leonardo, González, Ana Carolina, Morales-Lapo, Estefanía, Guerrero-Castillo, Galo S., Duque, Erick, Davila Rosero, Maria Gabriela, Egas, Diego, Viscor Carrasco, Ginés
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/206703
Acesso em linha:https://hdl.handle.net/2445/206703
Access Level:acceso abierto
Palavra-chave:Isquèmia
Influència de l'altitud
Equador
Malalties del cor
Ischemia
Influence of altitude
Ecuador
Heart diseases
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spelling Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in EcuadorOrtiz-Prado, EstebanIzquierdo-Condoy, Juan S.Fernández Naranjo, RaúlVásconez González, Jorge EduardoCano, LeonardoGonzález, Ana CarolinaMorales-Lapo, EstefaníaGuerrero-Castillo, Galo S.Duque, ErickDavila Rosero, Maria GabrielaEgas, DiegoViscor Carrasco, GinésIsquèmiaInfluència de l'altitudEquadorMalalties del corIschemiaInfluence of altitudeEcuadorHeart diseasesBackground Cardiovascular diseases, including ischemic heart disease, are the leading cause of prema- ture death and disability worldwide. While traditional risk factors such as smoking, obesity, and diabetes have been thoroughly investigated, non-traditional risk factors like high-alti- tude exposure remain underexplored. This study aims to examine the incidence and mortal- ity rates of ischemic heart disease over the past decade in Ecuador, a country with a diverse altitude profile spanning from 0 to 4,300 meters. Methods We conducted a geographic distribution analysis of ischemic heart disease in Ecuador, uti- lizing hospital discharge and mortality data from the National Institute of Census and Statis- tics for the years 2011–2021. Altitude exposure was categorized according to two distinct classifications: the traditional division into low (< 2,500 m) and high (> 2,500 m) altitudes, as well as the classification proposed by the International Society of Mountain Medicine, which delineates low (< 1,500 m), moderate (1,500–2,500 m), high (2,500–3,500 m), and very high (3,500–5,800 m) altitudes. Findings From 2011–2021, we analyzed 49,765 IHD-related hospital admissions and 62,620 deaths. Men had an age-adjusted incidence rate of 55.08/100,000 and a mortality rate of 47.2/ 100,000, compared to 20.77/100,000 and 34.8/100,000 in women. Incidence and mortality surged in 2020 by 83% in men and 75% in women. Altitudinal stratification revealed higher IHD rates at lower altitudes (<2500 m), averaging 61.65 and 121.8 per 100,000 for incidence and mortality, which declined to 25.9 and 38.5 at elevations >2500 m. Men had more pronounced rates across altitudes, exhibiting 138.7% and 150.0% higher incidence at low and high altitudes respectively, and mortality rates increased by 48.3% at low altitudes and 23.2% at high altitudes relative to women. Conclusion Ecuador bears a significant burden of ischemic heart disease (IHD), with men being more affected than women in terms of incidence. However, women have a higher percentage of mortality post-hospital admission. Regarding elevation, our analysis, using two different alti- tude cutoff points, reveals higher mortality rates in low-altitude regions compared to high- altitude areas, suggesting a potential protective effect of high elevation on IHD risk. Never- theless, a definitive dose-response relationship between high altitude and reduced IHD risk could not be conclusively established.Public Library of Science (PLoS)2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/206703Articles publicats en revistes (Biologia Cel·lular, Fisiologia i Immunologia)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0295586PLoS One, 2023, vol. 18, num.12, p. 1-18https://doi.org/10.1371/journal.pone.0295586cc-by (c) Ortiz-Prado, E. et al., 2023http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2067032026-05-27T06:46:51Z
dc.title.none.fl_str_mv Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
title Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
spellingShingle Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
Ortiz-Prado, Esteban
Isquèmia
Influència de l'altitud
Equador
Malalties del cor
Ischemia
Influence of altitude
Ecuador
Heart diseases
title_short Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
title_full Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
title_fullStr Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
title_full_unstemmed Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
title_sort Epidemiological characterization of ischemic heart disease at different altitudes: a nationwide population-based analysis from 2011 to 2021 in Ecuador
dc.creator.none.fl_str_mv Ortiz-Prado, Esteban
Izquierdo-Condoy, Juan S.
Fernández Naranjo, Raúl
Vásconez González, Jorge Eduardo
Cano, Leonardo
González, Ana Carolina
Morales-Lapo, Estefanía
Guerrero-Castillo, Galo S.
Duque, Erick
Davila Rosero, Maria Gabriela
Egas, Diego
Viscor Carrasco, Ginés
author Ortiz-Prado, Esteban
author_facet Ortiz-Prado, Esteban
Izquierdo-Condoy, Juan S.
Fernández Naranjo, Raúl
Vásconez González, Jorge Eduardo
Cano, Leonardo
González, Ana Carolina
Morales-Lapo, Estefanía
Guerrero-Castillo, Galo S.
Duque, Erick
Davila Rosero, Maria Gabriela
Egas, Diego
Viscor Carrasco, Ginés
author_role author
author2 Izquierdo-Condoy, Juan S.
Fernández Naranjo, Raúl
Vásconez González, Jorge Eduardo
Cano, Leonardo
González, Ana Carolina
Morales-Lapo, Estefanía
Guerrero-Castillo, Galo S.
Duque, Erick
Davila Rosero, Maria Gabriela
Egas, Diego
Viscor Carrasco, Ginés
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Isquèmia
Influència de l'altitud
Equador
Malalties del cor
Ischemia
Influence of altitude
Ecuador
Heart diseases
topic Isquèmia
Influència de l'altitud
Equador
Malalties del cor
Ischemia
Influence of altitude
Ecuador
Heart diseases
description Background Cardiovascular diseases, including ischemic heart disease, are the leading cause of prema- ture death and disability worldwide. While traditional risk factors such as smoking, obesity, and diabetes have been thoroughly investigated, non-traditional risk factors like high-alti- tude exposure remain underexplored. This study aims to examine the incidence and mortal- ity rates of ischemic heart disease over the past decade in Ecuador, a country with a diverse altitude profile spanning from 0 to 4,300 meters. Methods We conducted a geographic distribution analysis of ischemic heart disease in Ecuador, uti- lizing hospital discharge and mortality data from the National Institute of Census and Statis- tics for the years 2011–2021. Altitude exposure was categorized according to two distinct classifications: the traditional division into low (< 2,500 m) and high (> 2,500 m) altitudes, as well as the classification proposed by the International Society of Mountain Medicine, which delineates low (< 1,500 m), moderate (1,500–2,500 m), high (2,500–3,500 m), and very high (3,500–5,800 m) altitudes. Findings From 2011–2021, we analyzed 49,765 IHD-related hospital admissions and 62,620 deaths. Men had an age-adjusted incidence rate of 55.08/100,000 and a mortality rate of 47.2/ 100,000, compared to 20.77/100,000 and 34.8/100,000 in women. Incidence and mortality surged in 2020 by 83% in men and 75% in women. Altitudinal stratification revealed higher IHD rates at lower altitudes (<2500 m), averaging 61.65 and 121.8 per 100,000 for incidence and mortality, which declined to 25.9 and 38.5 at elevations >2500 m. Men had more pronounced rates across altitudes, exhibiting 138.7% and 150.0% higher incidence at low and high altitudes respectively, and mortality rates increased by 48.3% at low altitudes and 23.2% at high altitudes relative to women. Conclusion Ecuador bears a significant burden of ischemic heart disease (IHD), with men being more affected than women in terms of incidence. However, women have a higher percentage of mortality post-hospital admission. Regarding elevation, our analysis, using two different alti- tude cutoff points, reveals higher mortality rates in low-altitude regions compared to high- altitude areas, suggesting a potential protective effect of high elevation on IHD risk. Never- theless, a definitive dose-response relationship between high altitude and reduced IHD risk could not be conclusively established.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/206703
url https://hdl.handle.net/2445/206703
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0295586
PLoS One, 2023, vol. 18, num.12, p. 1-18
https://doi.org/10.1371/journal.pone.0295586
dc.rights.none.fl_str_mv cc-by (c) Ortiz-Prado, E. et al., 2023
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Ortiz-Prado, E. et al., 2023
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Biologia Cel·lular, Fisiologia i Immunologia)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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