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A systematic review of worldwide literature was undertaken, beginning with the pioneering work done in the Andes several decades ago. Original articles were analyzed in most cases and English abstracts or translations of articles written in Chinese were reviewed. Pulmonary hypertension in healthy highlanders is related to a delayed postnatal remodeling of the distal pulmonary arterial branches. The magnitude of pulmonary hypertension increases with the altitude level and the degree of exercise. There is reversal of pulmonary hypertension after prolonged residence at sea level. Chronic mountain sickness develops when the capacity for altitude adaptation is lost. These patients have moderate to severe pulmonary hypertension with accentuated hypoxemia and exaggerated polycythemia. The clinical picture of chronic mountain sickness differs from subacute mountain sickness and resembles other chronic altitude diseases described in China and Kyrgyzstan. The heart and pulmonary circulation in healthy highlanders have distinct features in comparison with residents at sea level. Chronic mountain sickness is a public health problem in the Andean mountains and other mountainous regions around the world. Therefore, dissemination of preventive and therapeutic measures is essential.<\/jats:p>","DOI":"10.1161\/circulationaha.106.624544","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T16:58:01Z","timestamp":1173113881000},"page":"1132-1146","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":578,"title":["The Heart and Pulmonary Circulation at High Altitudes"],"prefix":"10.1161","volume":"115","author":[{"given":"Dante","family":"Penaloza","sequence":"first","affiliation":[{"name":"From the Department of Medicine (D.P.) and Department of Pathology (J.A.-S.), Faculty of Medicine; and the High Altitude Research Institute (D.P., J.A.-S.), Faculty of Sciences, University Cayetano Heredia, Lima, Peru."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Arias-Stella","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (D.P.) and Department of Pathology (J.A.-S.), Faculty of Medicine; and the High Altitude Research Institute (D.P., J.A.-S.), Faculty of Sciences, University Cayetano Heredia, Lima, Peru."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00677.2004"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(60)90390-2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(61)90522-1"},{"key":"e_1_3_2_4_2","first-page":"54","volume":"41","year":"1962","unstructured":"Arias-Stella J, Recavarren S. 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