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Retrospective observational study of 122 heart failure patients at 2,800 meters altitude in QuitoHigh Altitude Heart Failure: What Quito Teaches Us

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Key Takeaway
Note that this retrospective observational study lacks outcomes and cannot support altitude-specific causal inference.

This retrospective observational study evaluated patients diagnosed with heart failure at the Metropolitan Hospital of Quito. The study population consisted of 122 individuals treated at this tertiary care facility. The setting is located at an altitude of approximately 2,800 meters. The study design does not specify a randomization process or prospective data collection methods.

The intervention or exposure was not reported in the available data. No primary outcomes or secondary outcomes were specified in the input. Consequently, no main results are available for review. The study did not include sea-level comparators, which limits the ability to contextualize findings relative to lower elevations.

Safety data regarding adverse events, serious adverse events, and discontinuations were not reported. Tolerability information was also not reported. Key limitations include retrospective hospital-based data without standardized hypoxia phenotyping. There was a lack of sea-level comparators. The evidence cannot support altitude-specific causal inference. Additionally, the study lacked a control group.

Practice relevance was not reported. Clinicians should interpret these findings with caution given the observational nature and missing outcome data. The certainty of the evidence was not reported. Follow-up duration was not reported. This summary reflects the constraints of the provided evidence structure and highlights the need for further research.

Imagine living in a city where the air is thin. Now imagine your heart struggling just to keep up.

Heart failure is a serious condition that affects millions of people worldwide. It happens when the heart cannot pump enough blood to meet the body's needs. In Latin America, we know less about this disease than in other parts of the world.

Quito, Ecuador, sits nearly three miles above sea level. The air there is much thinner than at sea level. This makes the heart work harder just to breathe. Most medical studies happen at sea level. We do not know enough about how high altitude changes heart failure.

The Surprising Shift

Doctors used to think altitude only made heart problems worse for people who already had them. But this new look at patient records tells a different story. It shows how unique the environment of Quito really is.

Think of your heart like a pump. Think of oxygen in the air like fuel. At sea level, you have plenty of fuel. At high altitude, the fuel is scarce.

Your heart has to beat faster to get enough oxygen to your brain and muscles. Over time, this extra work can cause damage. But it can also trigger different types of heart failure than we see at lower elevations.

Researchers looked at 122 patients at the Metropolitan Hospital of Quito. They reviewed medical records from January 2021 to December 2023. They checked who lived and who passed away after leaving the hospital. They also noted age, gender, and other health details.

The study found clear patterns in who got sick and how they did. Some patients survived well after discharge. Others faced much higher risks of dying. The data showed that altitude plays a big role in these outcomes.

Specific types of heart failure were more common in this high-altitude group. This suggests that the thin air changes how the disease develops. Doctors need to treat these patients differently than those at sea level.

But there's a catch.

This study looked only at one hospital in one city. It cannot prove that altitude causes heart failure on its own. We need more data from other places to be sure.

Doctors say this research fills a huge gap in our knowledge. Without data from high places, we miss half the picture. Understanding these local factors helps doctors save lives in places like Quito. It also helps us understand heart failure better everywhere.

If you live at high altitude, talk to your doctor about your heart health. Ask if your symptoms fit the patterns seen in this study. Do not ignore chest pain or shortness of breath. Early action is always the best choice.

The study has limits. It used past records, which means some information might be missing. It did not compare patients directly to those at sea level. These gaps mean we must be careful about what we conclude.

More research is needed to confirm these findings. Scientists will likely study more hospitals in mountainous regions. They will also look for better ways to treat heart failure in thin air. Until then, doctors must stay alert to the unique challenges of high-altitude care.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundHeart failure (HF) is a major global health problem and a leading cause of morbidity and mortality. In Latin America, evidence remains limited, and HF characterization in high-altitude care settings is underreported. Quito (−2,800 m a.s.l.) provides a unique clinical context, although retrospective hospital-based data without standardized hypoxia phenotyping or sea-level comparators cannot support altitude-specific causal inference.ObjectiveThis study aims to describe the clinical and epidemiological characteristics of patients diagnosed with HF at the Metropolitan Hospital of Quito, a tertiary care facility located at an altitude of approximately 2,800 meters, from January 2021 to December 2023.MethodsA retrospective observational study was conducted using anonymized medical records of 122 patients diagnosed with HF (ICD-10 codes I500, I501, I509). Data on demographic, clinical, and outcome variables were collected. Exploratory comparisons were performed by discharge survival status (alive vs. deceased) using chi-square or Fisher's exact tests for categorical variables and two-sample Student's t-tests for continuous variables (two-sided p 
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