High Altitude, Erythropoiesis, and Cardiovascular Risk: A Hematological Perspective

The study by İmre evaluated the relationship between altitude and cardiovascular mortality rates across 81 provinces in Türkiye and demonstrated a weak but statistically significant inverse correlation between altitude and cardiovascular mortality. The article highlights the possible protective effect of living at higher altitude and discusses the potential contribution of environmental and lifestyle-related factors to this association. However, hematological adaptation to chronic hypoxia may also represent an important biological mechanism underlying this relationship. Reduced oxygen pressure at high altitude stimulates erythropoietin production and erythropoiesis, leading to increased hemoglobin and hematocrit levels. Although these adaptations may improve oxygen delivery, they may also increase blood viscosity and thereby influence cardiovascular risk. Therefore, future studies may benefit from incorporating hematological parameters such as hemoglobin, hematocrit, erythropoietin activity, and blood viscosity markers to better clarify the biological pathways linking altitude and cardiovascular outcomes.