Letter by Calderón-Gerstein Regarding Article, “Environmental Determinants of Cardiovascular Disease”
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To the Editor:
I read with great interest the article of Bhatnagar1 on the environmental determinants of cardiovascular disease. Concerning high-altitude influence on disease, some precisions are needed to make. In first place, Andean natives develop right ventricular hypertrophy, not left ventricular hypertrophy. This phenomenon has been observed at all ages,2 and is noticeable since the sixth month of age, when the right ventricle fails to regress and, especially at altitudes higher than 4000 m, the cardiac axis remains shifted to the …