People who reside at high altitudes may adapt to chronic hypoxemia by increasing production of erythropoietin with increased red blood cell production. In some persons this can result in polycythemia.
Features of altitude polycythemia:
(1) residence at high altitude with acclimatization
(2) polycythemia with hematocrit > 55%
(3) polycythemia not due to other identifiable cause (congenital heart disease, myeloproliferative disorder, chronic obstructive pulmonary disease, etc.)
(4) elevated plasma erythropoietin
(5) persistent proteinuria (24 hour urine protein >= 150 mg on 2 or more occasions >= 2 months apart) with variable chronic renal dysfunction
(6) potential for increased cardiovascular disease
Plata et al found that treatment with an angiotensin-converting-enzyme (ACE) inhibitor (enalapril used in study) was effective in reducing the severity of the condition and its complications.
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