ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Cardiovascular and Smooth Muscle Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1659041
Inverse Association between Pre-High-Altitude Potassium Levels and Coronary Microvascular Disease at High Altitude: A Case-Control Study
Provisionally accepted
Yu Chen1*
Yong Ren2
Xin Zhang3Wen-Bao Zhou3
Wentao Zhang3Juan Lv3Xi- Yang Rao3Rui-Xi Zi2Si-Jie Wang3Li-Sha Wang3Chun-Ping Bao3Li-Xia Yang3
Gong-Hao He3Yan-Kun Shi3- 1Department of Cardiology, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, Kunming, China
- 2Dali University, Dali, China
- 3920th Hospital of People's Liberation Army Joint Logistic Support Force, Kunming, China
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High-altitude hypoxia is known to impair cardiac microvascular function, a pathophysiological state recognized as coronary microvascular disease (CMVD). This study aimed to investigate the independent association between serum potassium levels and the risk of developing CMVD, after controlling for traditional cardiovascular risk factors such as hypertension, dyslipidemia, and smoking.This case-control study enrolled 1,175 trainees with long-term exposure to high altitude (≥3,000 meters), comprising 235 patients with CMVD (cases) and 940 healthy controls.We employed multivariable logistic regression analysis to systematically evaluate the associations of traditional risk factors and serum potassium levels with the risk of CMVD.A key finding from our analysis was a significant inverse association between serum potassium levels and the odds of CMVD (OR = 0.26; 95% CI, 0.14-0.47). Specifically, higher potassium concentrations were correlated with a substantially lower disease risk. This inverse association was more prominent in individuals with a moderate body mass index and in smokers.This is the first study to demonstrate that a higher serum potassium level is independently associated with lower odds of CMVD in populations exposed to high altitudes. This finding provides a new direction for developing targeted health screening and preventive strategies in high-altitude regions, holding significant potential for protecting specific at-risk groups such as individuals with a particular BMI, and smokers.
Keywords: Altitude exposure, Coronary microvascular disease, Risk factors, Epidemiology, case-control study
Received: 03 Jul 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Chen, Ren, Zhang, Zhou, Zhang, Lv, Rao, Zi, Wang, Wang, Bao, Yang, He and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yu Chen, Department of Cardiology, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China, Kunming, China
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