Chest
Volume 106, Issue 1, July 1994, Pages 151-155
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Clinical Investigations
Physiology
Chronic Mountain Sickness and Chronic Lower Respiratory Tract Disorders

https://doi.org/10.1378/chest.106.1.151Get rights and content

To determine whether chronic lower respiratory tract disorders contributed to the development of chronic mountain sickness (CMS), we compared hemoglobin (Hb), oxygen saturation (SaO2), peak expiratory flow rate (PEFR), and CMS scores (CMSsco) in 97 normal men at high altitude with those of men at high altitude with acute (ARD; n=12), chronic upper (CURD; n=33), and chronic lower (CLRD; n=34) respiratory diseases. The clinical diagnosis of the different types of respiratory disorders was based on the results of a questionnaire and physical examination performed during an epidemiologic study. The CLRD group had higher CMSsco and Hb concentrations, and lower SaO2 and PEFR values when compared with the other groups. The frequency of low PEFR and SaO2 and high Hb and CMSsco was substantially higher in men with CLRD when compared with normal subjects. The results support the hypothesis that there is an association between signs and symptoms of CMS, as measured by the CMSsco, and CLRD. The chronic hypoxemia, product of chronic lung diseases, would cause excessive erythrocytosis and increase the signs and symptoms of CMS. Studies of Hb, PEFR, pulse oximetry, and CMSsco are recommended for early detection of high-altitude natives at risk of developing CMS.

Section snippets

Methods

An epidemiologic survey was conducted among adult men (46.3 percent of the total male population) with permanent residence (born, 87 percent, or living more than 10 years, 13 percent) in the mining town of Cerro de Pasco (4,300 m; total population: 70,000). The sampling frame was constructed from updated maps that were detailed at the block level. A two-stage cluster sample was chosen. The first stage was a simple random sampling of blocks. The second stage was a simple random sampling of one

Results

Men with CLRD had higher Hb values and CMSsco, and lower PEFRs and SaO2 values when compared with normal men or men with ARD (Table 1). We compared the frequencies (percent) of men with excessive erythrocytosis (Hb >21.3 g/dl), low SaO2 values (SaO2 <81.5 percent), low PEFR values (PEFR <276 L/min), and high CMSsco (CMSsco >21) among the normal, ARD, CURD, and CLRD groups. The low SaO2 value of 81.5 percent was used, based on the analysis of the SaO2 and Hb concentrations of the normal

Discussion

Our results support the notion that, at high altitude, chronic lower respiratory diseases are strongly associated with the development of CMS, while acute and chronic upper respiratory disorders are not. Previous evidence for this interaction comes from studies that showed that some patients with CMS had moderate obstructive lung disease.20 These studies hypothesized that alveolar hypoventilation together with chronic lung disease could be involved in the exaggerated hypoxemia characteristic of

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