El sistema cardiovascular y la exposición a gran altitud: desde la adaptación a la enfermedad. Parte I

Manuel Chacón-Díaz; Marco Antonio Lazo Soldevilla; Aníbal Díaz-Lazo; Ofelia Araoz Tarco; Ana C. Gonzales-Luna; Carlos Rubén Barrientos; Fernando Gamio Vega Centeno; Sofía Robles Cabellos; Jorge Luis Sotomayor-Perales

doi:10.47487/apcyccv.v7i1.564

Authors

Manuel Chacón-Díaz Unidad Cardiovascular, Clínica Delgado-AUNA, Lima, Perú. https://orcid.org/0000-0002-5554-7578
Marco Antonio Lazo Soldevilla Hospital Nacional Ramiro Priale Priale, Huancayo, Perú; Universidad Nacional del Centro del Perú, Huancayo, Perú. https://orcid.org/0000-0002-1654-5123
Aníbal Díaz-Lazo Hospital Nacional del Centro Daniel Alcides Carrión, Huancayo, Perú; Facultad de Medicina Humana, Universidad Peruana Los Andes. Huancayo, Perú. https://orcid.org/0000-0002-9282-9435
Ofelia Araoz Tarco Instituto Nacional Cardiovascular (INCOR), EsSalud. Lima, Perú. https://orcid.org/0000-0001-7755-8174
Ana C. Gonzales-Luna Instituto Nacional Cardiovascular (INCOR), EsSalud. Lima, Perú. https://orcid.org/0000-0002-8575-1596
Carlos Rubén Barrientos Hospital Nacional del Centro Daniel Alcides Carrión, Huancayo, Perú; Universidad Continental, Huancayo, Perú. https://orcid.org/0000-0003-4652-8655
Fernando Gamio Vega Centeno Facultad de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Perú; Hospital III EsSalud, Juliaca, Perú. https://orcid.org/0009-0004-1971-6401
Sofía Robles Cabellos Universidad Nacional del Centro del Perú, Huancayo, Perú. https://orcid.org/0009-0008-9210-9885
Jorge Luis Sotomayor-Perales Hospital III EsSalud, Juliaca, Perú. https://orcid.org/0000-0001-6150-4673

DOI:

https://doi.org/10.47487/apcyccv.v7i1.564

Keywords:

Hypoxia, Altitude, Physiological Adaptation, Cardiovascular Diseases, Pulmonary Hypertension

Abstract

Exposure to high altitude constitutes a complex physiological challenge, driven primarily by hypobaric hypoxia and, in some settings, by extreme environmental conditions such as severe cold and increased ultraviolet radiation. At the cardiovascular level, this exposure elicits a range of acute and chronic adaptations, including activation of the sympathetic nervous system, pulmonary vasoconstriction, and vascular and ventricular remodelling. In the Andean region, millions of people live at elevations above 2,500 metres above sea level, rendering them particularly susceptible to these physiological adaptations and the associated cardiovascular alterations. This manuscript represents the first part of a narrative review and aims to synthesise the available scientific evidence on mechanisms of adaptation to high altitude, as well as the characteristics of pulmonary hypertension, heart failure, and congenital heart disease observed in both native high-altitude populations and individuals originating from low-altitude areas. In addition, it seeks to identify existing gaps in current knowledge of these conditions in order to promote the development of specific diagnostic, preventive, and therapeutic strategies aimed at improving cardiovascular health among populations residing at or temporarily exposed to high altitude.

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