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High altitude residents
Published in Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson, Ward, Milledge and West's High Altitude Medicine and Physiology, 2021
Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson
Without direct, well-controlled comparisons between high altitude populations, it is difficult to sort out why variations exist in the prevalence of hypertension across groups, but several factors warrant consideration. One potential explanation for the differences in the prevalence of hypertension between high altitude populations may be differences in diet. A key difference between Tibetans and Andeans, for example, is the consumption of Tibetan tea, which is made with salt and yak butter and, as a result, is associated with a high sodium intake. Older reports, for example, have noted that some Tibetans and Sherpa drank 20–30 cups of this tea per day (Sehgal et al. 1968) and consume 4–7 g of sodium on a daily basis (Goldstein and Beall 1990; Smith 1999), far higher than the recommended intake in published guidelines (Government of Canada). Sherpa with SBP ≥140 mmHg consumed a greater amount of Tibetan tea compared to those with SBP <140 mmHg. In a patient-blinded randomized controlled trial, a low-sodium, high-potassium, salt-substitute intervention was effective in lowering SBP and DBP by 8.2 mmHg and 3.4 mmHg, respectively, in Tibetans living at 4300 m (Zhao et al. 2014).
Avoiding Stereotypes
Published in Issues in Mental Health Nursing, 2019
Both the Potala Palace and the Jokhang Temple in Lhasa, Tibet are UNESCO World Heritage Sites. At the Potala Palace, formerly the winter palace of the Dalai Lama and now a small monastery and museum, we went through security similar to an airport. Besides that, the only limit on us at 11,850 feet was shortness of breath as we tried to climb the serpentine steps to the top. We were told when we visited Barkhor Square in Lhasa that it is under surveillance by Chinese police because of violent protests in the past. The exile of the Dalai Lama in 1959 after a failed Tibetan uprising against the Chinese occupation was discussed by our Tibetan guide as a matter of history. Tibetans remain loyal to him as their spiritual leader but he is no longer the political authority. Barkhor Square is home to Jokhang Temple (642 C.E.) one of the holiest places of Buddhist worship in Tibet. The area was crowded with pilgrims prostrating themselves, waving prayer wheels, drinking yak butter tea, and burning incense and yak butter. The area is also a focal point of commercial activity in the city, with a maze of streets radiating from it. In addition to pilgrims, tourists crowded into the square. Lining the area were hundreds of shops selling Tibetan souvenirs to the many tourists, and religious goods to the pilgrims. We were too involved with dodging other tourists and pilgrims, negotiating low doorways and uneven footing, and avoiding slipping on stones slick with yak butter to pay much attention to the police presence. Much as we get used to security personnel guarding government sites, the border, and historic monuments in the U.S., people there also went about their business.