In this predominantly high-altitude Andean cohort, chronic residence at high altitude was not detectably associated with hemorrhagic presentation of cerebral AVMs. Instead, established intrinsic vascular morphological features remained the dominant predictors of rupture at diagnosis. Given the homogeneity of altitude exposure, these findings likely reflect limited power to detect subtle effects rather than definitive absence of an altitude influence. Multicenter studies with broader altitude variability, physiological markers of hypoxia, and longitudinal follow-up are needed to further clarify the role of environmental hypoxia in AVM natural history.
Chamba-Vozmediano et al. (Fri,) studied this question.