Altitude, life expectancy and mortality from ischaemic heart disease, stroke, COPD and cancers: national population-based analysis of US counties

  1. Majid Ezzati,
  2. Mara E M Horwitz,
  3. Deborah S K Thomas,
  4. Ari B Friedman,
  5. Robert Roach,
  6. Timothy Clark,
  7. Christopher J L Murray,
  8. Benjamin Honigman
    • The aim of this study was to examine the association of ife expectancy and mortality from selected diseases with altitude.

  • Results Counties above 1500 m had longer life expectancies than those within 100 m of sea level by 1.2–3.6 years for men and 0.5–2.5 years for women. The association between altitude and life expectancy became non-significant for women and non-significant or negative for men in multivariate analysis. After adjustment, altitude had a beneficial association with IHD mortality and harmful association with COPD, with a dose–response relationship. IHD mortality above 1000 m was 4–14 per 10 000 people lower than within 100 m of sea level; COPD mortality was higher by 3–4 per 10 000. The adjusted associations for stroke and cancers were not statistically significant.

    Conclusions Living at higher altitude may have a protective effect on IHD and a harmful effect on COPD. At least in part due to these two opposing effects, living at higher altitude appears to have no net effect on life expectancy.