{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:17:45Z","timestamp":1793038665003,"version":"4.5.0"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T00:00:00Z","timestamp":1617580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Key R&amp;D Program of China","award":["2017YFC1307903"],"award-info":[{"award-number":["2017YFC1307903"]}]},{"name":"&quot;Sail Plan&quot; Key Medical Specialty","award":["ZYLX202139"],"award-info":[{"award-number":["ZYLX202139"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>The detailed characteristics of strokes at high altitudes in diverse nations have not been extensively studied. We retrospectively enrolled 892 cases of first-ever acute ischemic strokes at altitudes of 20, 2550, and 4200 m in China (697 cases from Penglai, 122 cases from Huzhu, and 73 cases from Yushu). Clinical data and brain images were analyzed. Ischemic strokes at high altitudes were characterized by younger ages (69.14 \u00b1 11.10 vs. 64.44 \u00b1 11.50 vs. 64.45 \u00b1 14.03, p &lt; 0.001) and larger infract volumes (8436.37 \u00b1 29,615.07 mm3 vs. 17,213.16 \u00b1 47,044.74 mm3 vs. 42,459 \u00b1 84,529.83 mm3, p &lt; 0.001). The atherosclerotic factors at high altitude, including diabetes mellitus (28.8% vs. 17.2% vs. 9.6%, p &lt; 0.001), coronary heart disease (14.3% vs. 1.6% vs. 4.1%, p &lt; 0.001), and hyperlipidemia (20.2% vs. 17.2% vs. 8.2%, p = 0.031), were significantly fewer than those in plain areas. Polycythemia and hemoglobin levels (138.22 \u00b1 18.04 g\/L vs. 172.87 \u00b1 31.57 g\/L vs. 171.81 \u00b1 29.55 g\/L, p &lt; 0.001), diastolic pressure (89.98 \u00b1 12.99 mmHg vs. 93.07 \u00b1 17.79 mmHg vs. 95.44 \u00b1 17.86 mmHg, p = 0.016), the percentage of hyperhomocysteinemia (13.6% in Penglai vs. 41.8% in Huzhu, p &lt; 0.001), and the percentage of smoking (33.1% in Penglai vs. 50.0% in Huzhu, p = 0.023) were significantly elevated at high altitudes. We concluded that ischemic stroke occurred earlier and more severely in the Chinese plateau. While the atherosclerotic factors were not prominent, the primary prevention of strokes at high altitudes should emphasize anticoagulation, reducing diastolic pressure, adopting a healthy diet, and smoking cessation.<\/jats:p>","DOI":"10.3390\/cells10040809","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T21:30:29Z","timestamp":1617658229000},"page":"809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Acute Ischemic Stroke at High Altitudes in China: Early Onset and Severe Manifestations"],"prefix":"10.3390","volume":"10","author":[{"given":"Moqi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingzong","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yantai Penglai Traditional Chinese Medicine Hospital, Yantai 622110, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yushu People\u2019s Hospital, Yushu 815000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhankui","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huzhu People\u2019s Hospital, Haidong 810500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Ren","sequence":"additional","affiliation":[{"name":"Laboratory of Hypoxia, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunming","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuhai","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1136\/svn-2020-000457","article-title":"China Stroke Statistics 2019: A Report From the National Center for Healthcare Quality Management in Neurological Diseases, China National Clinical Research Center for Neurological Diseases, the Chinese Stroke Association, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention and Institute for Global Neuroscience and Stroke Collaborations","volume":"5","author":"Wang","year":"2020","journal-title":"Stroke Vasc. 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