High-Altitude Environment and Chronic Obstructive Pulmonary Disease: Epidemiology, Pathological Mechanisms, and...

Wei, Shuna, and Xiaoju Liu. High-altitude environment and chronic obstructive pulmonary disease: epidemiology, pathological mechanisms and clinical management. High Alt Med Biol. 27:189-202, 2026Background:Chronic obstructive pulmonary disease (COPD) is a significant global health concern. Environmental factors such as low oxygen and temperature, along with poor living habits in high-altitude areas, contribute to regional variations in the occurrence and progression of COPD. There is currently a lack of systematic reviews on the relationship between high-altitude environments and COPD, which hinders effective prevention and treatment.

This narrative review comprehensively sorts out and analyzes the research on COPD in high-altitude areas from three aspects: epidemiological characteristics, pathophysiological mechanisms, and clinical management.

Epidemiologically, COPD mortality increases with altitude; however, prevalence rates remain debated. Pathophysiologically, factors include hypoxia-inducible factor regulation, hemodynamic changes, air pollution particles promoting inflammation and oxidative stress, as well as gene mutations like PPARA and SERPINA1. Clinically managing COPD in high-altitude regions requires individualized approaches that consider environmental conditions.

High-altitude environments exacerbate COPD through hypoxic stress, pollutant exposure, and genetic variations. Future efforts should focus on developing a risk prediction model for COPD that incorporates altitude parameters to enhance targeted prevention and treatment strategies in these areas.