Are Permanent Residents of High Altitude Fully Adapted to Their Hypoxic Environment?

West, John B. Are permanent residents of high altitude fully adapted to their hypoxic environment? High Alt Med Biol. 18:135-139, 2017.-Millions of people live permanently at high altitude and many have been there for generations. It is sometimes claimed that these people have completely adapted to their environment, and certainly some remarkable genetic adaptations have recently been described. However there is now strong evidence that permanent residents are not completely adapted to the high altitude in the sense that they have fully compensated for the environmental hypoxia. By sea level standards, highlanders have severe chronic arterial hypoxemia. Furthermore, their maximum oxygen uptake increases if they descend, and recent measurements suggest that cognitive function is reduced in this population compared with a matched group at a lower altitude. Reproductive success is reduced at high altitude because neonatal mortality increases with altitude. The topic has recently gained importance because new technology enables the physiological altitude of permanent residents to be reduced by adding oxygen to the air of buildings on a large scale, a procedure known as oxygen conditioning. Its feasibility has been questioned, but in essence it is no different from air conditioning that is universally used to improve the well-being and productivity of millions of people in hot climates. Oxygen conditioning has the potential to do the same for permanent residents of high altitude.