High altitude adaptation in Tibetans

High Altitude Medicine and Biology

Volumn 7, Issue 3, 2006, Pages 193-208

  Wu, Tianyi ^a   Kayser, Bengt ^b  

^a High Altitude Med Res Institute   (China)

^b UNIVERSITY OF GENEVA MEDICAL SCHOOL   (Switzerland)

Author keywords

Adaptation; Altitude; Andes; Han; Himalaya; Natural selection; Tibel

Indexed keywords

ENDOTHELIAL NITRIC OXIDE SYNTHASE; ERYTHROPOIETIN; HEMOGLOBIN; NITRIC OXIDE;

AEROBIC METABOLISM; ALTITUDE ACCLIMATIZATION; ALTITUDE DISEASE; ARTERIAL OXYGEN SATURATION; ARTICLE; CHINA; CONTROLLED STUDY; ERYTHROPOIESIS; EVOLUTIONARY ADAPTATION; EXERCISE; GENETIC POLYMORPHISM; HEMOGLOBIN DETERMINATION; HUMAN; HYPERCAPNIA; HYPOXIA; LUNG DIFFUSION; LUNG EDEMA; LUNG FUNCTION; LUNG VENTILATION; LUNG VOLUME; NATURAL SELECTION; OXYGEN CONSUMPTION; PHYSICAL PERFORMANCE; POLYCYTHEMIA; POPULATION GENETICS; PRIORITY JOURNAL; PULMONARY HYPERTENSION; REST; SLEEP PARAMETERS;

ACCLIMATIZATION; ALTITUDE; ALTITUDE SICKNESS; ASIAN CONTINENTAL ANCESTRY GROUP; ETHNIC GROUPS; FEMALE; GENETIC PREDISPOSITION TO DISEASE; HUMANS; MALE; TIBET;

EID: 33846507301     PISSN: 15270297     EISSN: None     Source Type: Journal    
DOI: 10.1089/ham.2006.7.193     Document Type: Article

References (104)

1. Adams W.H., and Shrestha S.M. (1974). Hemoglobin levels, vitamin B 12, and folate status in a Himalayan village. Am. J. Clin. Nutr. 277:217-219.
2. Adams W.H., and Strang L.J. (1975). Hemoglobin levels in persons of Tibetan ancestry living at high altitude. Proc. Soc. Exp. Biol. Med. 149:1036-1039.
3. Ahsan A., Norboo T., Baig M.A., and Qadar Pasha M.A. (2005). Simultaneous selection of the wild-type genotypes of the G894T and 4B/4A polymorphisms of NOS3 associated with high altitude adaptation. Am. Hum. Genet. 69:260-267.
4. Apte C.V., and Rao K.S. (2005). The maximum expiratory flow-volume loop in natives of Ladakh and acclimatized lowlanders. High Alt. Med. Biol. 6:209-214.
5. Arai Y., Tatsumi K., Sherpa N.K., Masuyama S., Hasako K., Tanabe N., Takiguchi Y., and Kuriyama T. (2002). Impaired oxygenation during sleep at high altitude in Sherpa. Respir. Physiol. Neurobiol. 133:131-138.
6. Arias-Stella J., and Saldana M., (1963). The terminal portion of the pulmonary arterial tree in people native to high altitudes. Circulation. 28:915-925.
7. Arias-Stella J., and Recavarren S. (1962). Right ventricular hypertrophy in native children living at high altitude. Am. J. Pathol. 41:55-64.
8. Arias-Stella J., and Valcarcel J. (1976). Chief cell hyperplasia in the human carotid body at high altitude. Physiologic and pathologic significance. Hum. Pathol. 7:361-373.
9. Beall C.M. (2000a). Oxygen saturation increases during childhood and decreases during adulthood among high altitude native Tibetans residing at 3800-4200 m. High Alt. Med. Biol. 1:25-32.
10. Beall C.M. (2000b). Tibetan and Andean patterns of adaptation to high altitude hypoxia. Hum. Biol. 72:201-228.
11. Beall C.M., Goldstein M.C., and the Tibetan Academy of Social Sciences. (1987). Hemoglobin concentrations of pastoral nomads permanently residing at 4,850-5,450 m in Tibet. Am. J. Phys. Anthropol. 73:433-438.
12. Beall C.M., Brittenham G.M., Macuaga F., and Barragan M. (1990). Variation in hemoglobin concentration among samples of high altitude natives in the Andes and the Himalayas. Am. J. Hum. Biol. 2:639-651.
13. Beall C.M., Blangero J., Williams-Blangero S., and Goldstein M.C. (1994). A major gene for percent of oxygen saturation of arterial hemoglobin in Tibetan highlanders. Am. J. Phys. Anthropol. 95:271-276.
14. Beall C.M., Strohl K.P., Blangero J., Williams-Blangero S., Almasy L.A., Decker M.J., Worthman C.M., Goldstein M.C., Vargas E., Villena M., Soria R., Alarcon A.M., and Goldstein M.C. (1997a) Ventilation and hypoxic ventilatory response of Tibetan and Aymara high altitude natives. Am. J. Phys. Anthropol. 104:427-447.
15. Beall C.M., Strohl K.P., Blangero J., Williams-Blangero J., Brittenham G.M., and Goldstein M.C. (1997b). Quantitative genetic analysis of arterial oxygen saturation in Tibetan highlanders. Hum. Biol. 69:597-604.
16. Beall C.M., Brittenham G.M., Strohl K.P., Blangero J., Williams-Blangero S., Goldstein M.C., Decker M.J., Vargas E., Villena M., Soria R., Alareon A.M, and Gonzales C. (1998). Hemoglobin concentration of high altitude Tibetans and Bolivian Aymara. Am. J. Phys. Anthropol. 106:385-400.
17. Beall C.M., Almasy L.A., Blangero T., Williams-Blangero S., Brittenham G.M., Strohl K.P., Decker M., Vargas E., Villena M., Soria R., Alarcon A., and Gonzales C. (1999). Percent of oxygen saturation of arterial hemoglobin of Bolivian Aymara at 3900-4000 m. Am. J. Phys. Anthropol. 108:41-51.
18. Beall C.M., Laskowski D., Strohl K.P., Soria R., Villena M., Vargas E., Alarcon A.M., Gonzales C., and Erzurum S.P. (2001). Pulmonary nitric oxide in mountain dwellers. Nature. 414:411-412.
19. Beall C.M., Song K., Elston R.C., and Goldstein M.C. (2004). Higher offspring survival among Tibetan women with high oxygen saturation genotypes residing at 4,000 m. Proc. Natl. Acad. Sci. U.S.A. 2004 101:14300-14304.
20. Brody J.S., Lahiri S., Simpser M., Motoyama E.K., and Velasquez T. (1977). Lung elasticity and airway dynamics in Peruvian natives to high altitude. J. Appl. Physiol. 42:245-251.
21. Brutsaert T.D., Haas J.D., and Spielvogel H. (2004). Absence of work efficiency differences during cycle ergometry exercise in Bolivian Aymara. High Alt. Med. Biol. 5:41-59.
22. Brutsaert T.D., Parra E.J., Shriver M.D., Gamboa A., Rivera Ch.M., and Leon-Velarde F. (2005). Ancestry explains the blunted ventilatory response to sustained hypoxia and lower exercise ventilation of Quechua altitude natives. Am. J. Physiol. 289:R225-R234.
23. Cheng Q.H., Ge R.L., Wang X.Z., Wu T.Y., Kobayashi T., and Yoshimura K. (1997). Exercise performance of Tibetan and Han adolescents at altitude of 4,417 and 4,300 m. J. Appl. Physiol. 83:6631-6637.
24. Curran L.S., Zhuang J.G., Droma T., Land L., and Moore L.G. (1995). Hypoxic ventilatory responses in Tibetan residents of 4,400 m compared with 3,658 m. Respir. Physiol. 100:223-230.
25. Curran L.S., Zhuang J., Sun S.F, and Moore L.G. (1997). Ventilation and hypoxic ventilatory responsiveness in Chinese-Tibetan residents at 3,658 m. J. Appl. Physiol. 83:2098-2104.
26. Curran L.S., Zhuang J., Droma T., and Moore L.G. (1998). Super exercise performance in lifelong Tibetan residents of 4,400 m compared with Tibetan residents of 3,658 m. Am. J. Phys. Anthropol. 105:21-31.
27. Droma T., McCullough R.G., McCullough R.E., Zhuang J.G., Cymerman A., Sun S.F., Sutton J.R., and Moore L.G. (1991). Increased vital and total lung capacities in Tibetans compared to Han residents of Lhasa (3,658 m). Am. J. Phys. Anthropol. 86:341-351.
28. Fagan K.A., and Weil J.V. (2001). Potential genetic contributions to control of the pulmonary circulation and ventilation at high altitude. High Alt. Med. Biol. 2:165-171.
29. Fried W. (1995). Erythropoietin. Ann. Rev. Nutr. 15:353-377.
30. Garrido E., Rodas G., Javierre C., Segura R., Estruch A., and Ventura J.L. (1997). Cardiorespiratory response to exercise in elite Sherpa climbers transferred to sea level. Med. Sci. Sports Exerc. 29:937-942.
31. 2max in Tibetans than Han residents at 4,700 m. J. Appl. Physiol. 77:684-691.
32. Gelfi C., De P.S., Ripamenti M., Wait R., Eberins I., Bajracharya A., Marconi C., Schneider A., Hoppeler H., and Cerretelli P. (2004). New aspects of altitude adaptation in Tibetans: a new proteomic approach. FASEB J. 18:612-614.
33. Groves B.M., Droma T., Sutton J.R., McCullough R.G., McCullough R.E., Zhuang J.G., Rapmund G., Sun S., Janes C., and Moore L.G. (1993). Minimal hypoxic pulmonary hypertension in normal Tibetans at 3,658 m. J. Appl. Physiol. 74:312-318.
34. Gupta M.L., Rao K.S., Anand I.S., Banerjee A.K., and Boparai M.S. (1992). Lack of smooth muscle in the small pulmonary arteries of the native Lhadakhi. Is the Himalayan highlander adapted? Am. Rev. Respir. Dis. 145:1201-1204.
35. Hackett P.H., Reeves J.T., Reeves C.D., Grover R.F., and Rennie D. (1980). Control of breathing in Sherpas at low and high altitude. J. Appl. Physiol. 49:374-379.
36. Hackett P.H., Reeves J.T., Grover R.F., and Weil J.V. (1984). Ventilation in human populations native to high altitude. In: High Altitude and Man. J.B. West and S. Lahiri, eds. American Physiological Society Press, Bethesda, MD; pp. 179-191.
37. Heath D., Smith P., Rios D.J., Williams D., and Harris P. (1981). Small pulmonary arteries in some natives of La Paz, Bolivia. Thorax. 36:599-604.
38. Hochachka P.W. (1992). Muscle enzymatic composition and metabolic regulation in high altitude adapted natives. Int. J. Sports Med. 13:S89-S91.
39. Hochachka P.W., Clark C.M., Stanley C., Uqurbil K., and Menon R.S. (1996). 31P Magnetic resonance spectroscope of the Sherpa heart: a phosphocreatine adenosine defence against hypebaric hypoxia. Proc. Natl. Acad. Sci. USA 93:1215-1220.
40. Hochachka P.W., Stanley C., Matheson G.O., McKenzie D.C., Allen P.S., and Parkhouse W.S. (1991). Metabolic and work efficiencies during exercise in Andean natives. J. Appl. Physiol. 70:1720-1730.
41. Huang S.Y., Ning X.H., Zhoiu Z.N., Gu Z.Z., and Hu S.T. (1984). Ventilatory function in adaptation to high altitude: studies in Tibet. In: High Altitude and Man. J.B. West and S. Lahiri, eds. American Physiological Society Press, Bethesda, MD; pp. 173-177.
42. Jia N.Y., He W.L., and Guo J. (1998). The variation of serum erythropoietin in high-altitude polycythemia. Abstracts of the 3rd World Congress on Mountain Medicine. Matsumoto, Japan; pp. 83.
43. Kayser B., Hoppeler H., Claassen H., and Cerretelli P. (1991). Muscle structure and performance capacity of Himalayan Sherpas. J. Appl. Physiol. 70:1938-1942.
44. Kayser B., Marconi C., Amatya T., Basnyat B., Colombini A., Broers B., and Cerretelli P. (1994). The metabolic and ventilatory response to exercise in Tibetans born at low altitude. Respir. Physiol. 98:15-26.
45. Kayser B., Hoppeler H., Desplanches D., Marconi C., Broers B., and Cerretelli P. (1996). Muscle ultrastructure and biochemistry of lowland Tibetans. J. Appl. Physiol. 81:419-425.
46. Khan Q., Heath D., Smith O., and Norboo T. (1988). The histology of the carotid bodies in highlanders from Ladakh. Int. J. Biometeorol. 32:254-260.
47. Kobayashi T., Masuyama S., Masuda A., Sakakibara Y., Hayano M., Kojima A., Hasako K., Kuriyama T., and Honda Y. (1992). Control of breathing and metabolism in Tibetans. In: High Altitude Medicine. G. Ueda, J.T. Reeves, and M. Sekiguchi, eds. Shinshu University Press, Matsumoto, Japan, pp. 226-230.
48. Kryger M.H., Glas R., Jackson D., McCullough R.E., Scoggin C., Grover R.F., and Weil J.V. (1978). Impaired oxygenation during sleep in excessive polycythemia of high altitude: improvement with respiratory stimulation. Sleep. 1:3-17.
49. Lahiri S., Maret K., and Sherpa M.G. (1983). Dependence of high altitude sleep apnea on ventilatory sensitivity to hypoxia. Respir. Physiol. 52:281-301.
50. Lahiri S., Maret K.W., Sherpa M.G., and Peters R.M. Jr. (1984). Sleep and periodic breathing at high altitude: Sherpa natives versus sojourners. In: High Altitude and Man. J.B. West and S. Lahiri, eds. American Physiological Society Press, Bethesda, MD; pp. 73-90.
51. Lahiri S., and Data P.G. (1992). Chemosensitivity and regulation of ventilation during sleep at high altitude. Int. J. Sports Med. 13:S31-S33.
52. Lahiri S., Rozanov C., and Cherniack N.S. (2000). Altered structure and function of the carotid body at high altitude and associated chemoreflexes. High Alt. Med. Biol. 1:63-74.
53. Leon-Velarde F., Monge C.C., Vidal A., Carcagno M., Criscuolo M., and Bozzini C.E. (1991). Serum immunoreactive erythropoietin in high altitude natives with and without excessive erythrocytosis. Exp. Hematol. 19:257-260.
54. Leon-Velarde F., Gamboa A., Chuquiza J.A., Esteba W.A., Rivera-Chira M., and Monge C.C. (2000). Hematological parameters in high altitude residents living at 4,355, 4,660, and 5,500 m above sea level. High Alt. Med. Biol. 1:97-104.
55. Leon-Velarde F., Rivera-Chira M., Tapia R., Huicho L., and Monge C. (2001). Relationship of ovarian hormones to hypoxemia in women residing at 4,300 m. Am. J. Physiol. Regul. Interg. Comp. Physiol. 280:R488-R493.
56. Marconi C., Marzorati M., Grassi B., Basnyat B., Colombini A., Kayser B., and Cerretelli P. (2004). Second generation Tibetan lowlanders acclimatize to high altitude more quickly than Caucasians J. Physiol. 556:661-671.
57. Marconi C., Marzorati M., Sciuto D., Ferri A., and Cerretelli P. (2005). Economy of locomotion in high-altitude Tibetan migrants exposed to normoxia. J. Physiol. 569:667-675.
58. 2. Japan J. Physiol. 39:523-535.
59. Miao C.Y., Sun S.Y., Tan X.F., Yan C.G., and Xia S.J. (1989). [An analysis of pulmonary artery pressure in 162 cases at high altitude]. Chin. Circ. 4:27-29.
60. Miao C.Y., Yang L.R., and Yang J.Y. (1994). A comparative study of pulmonary hemodynamics in six lowlanders at an altitude of 15,400 ft in China. J. Wilderness Med. 5:1-3.
61. Milledge J., and Lahiri S. (1967). Respiratory control in lowlanders and Sherpa highlanders at high altitude. Respir. Physiol. 2:310-322.
62. Moore L.G., Curran-Everett L., Droma T.Y., Groves B.M., McCullough R.E., McCullough R.G., Sun S.F., Sutton J.R., Zamudio S., and Zhuang J.G. (1992). Are Tibetans better adapted? Int. J. Sports Med. 13:S86-S88.
63. Moore L.G., Zamudio S., Zhuang J., Droma T., and Shohet R.V. (2002). Analysis of the myoglobin gene in Tibetans living at high altitude. High Alt. Med. Biol. 3:39-47.
64. Morpurgo G., Arese P., Bosia A., Pescarmora G.P., Luzzana M., Modiano G., Krishna S., and Ronjit K. (1976). Sherpa living permanently at high altitude: a new pattern of adaptation. Proc. Natl. Acad. Sci. U.S.A. 73:747-751.
65. Niermeyer S. (2003). Cardiopulmonary transition in the high altitude infant. High Alt. Med. Biol. 4:225-239.
66. Niermeyer S., Yang P., Shanmina J., Drolkar T., Zhuang J., and Moore L.G. (1995). Arterial oxygen saturation in Tibetan and Han infants born in Lhasa. N. Engl. J. Med. 333:1248-1252.
67. Niu W., Wu Y., Li B., Chen N., and Song S. (1995). Effects of long-term acclimatization in lowlanders migrating to high altitude: comparison with high altitude residents. Eur. J. Appl. Physiol. 71:543-548.
68. Pei S.X., Gou J.X., and Sui X.L. (1999). [Plasma erythropoietin in altitude healthy men and in patients with high altitude polycythemia]. Natl. Med. J. China 79:753-755.
69. Penaloza D., Sime F., Banchero N., Gamboa R., Cruz J., and Marticorena E. (1963). Pulmonary hypertension in healthy men born and living at high altitude. Am. J. Cardiol. 11:150-158.
70. Plywaczewski R., Wu T.Y., Wang X.Q., Cheng H.W., Sliwinski P., and Zielinski J. (2003). Sleep structure and periodic breathing in Tibetans and Han at 5,000 m. Respir. Physiol. Neurobiol. 136:187-197.
71. Pugh L.G.C.E. (1962). Physiological and medical aspects of the Himalayan Scientific and Mountaineering Expedition, 1960-1961. BMJ. 2:621-633.
72. Roach R., and Kayser B. (2001). Exercise at Altitude. In: High Altitude. T. Hornbein and R. Schoene, eds. In the Series: Lung Biology in Health and Disease, C. Lenfant, ed. Marcel Dekker, New York; pp. 663-706.
73. Salvaggio A., Insalaco G., Marrone O., Romano S., Braghiroli A., Lanfranchi P., Patruno V., Donner C.F., and Bonsignore G. (1998). Effects of high-altitude periodic breathing on sleep and arterial oxyhaemoglobin saturation. Eur. Respir. J. 12:408-413.
74. 2 transport at high altitude. Acta. Physiol. Scand. 159:249-256.
75. Saunders P.U., Telford R.D., Pyne D.B., Cunningham R.B., Gore C.J., Hahn A.G., and Hawley J.A. (2004). Improved running economy in elite runners after 20 days of simulated moderate-altitude exposure. J. Appl. Physiol. 96:931-937.
76. Scherrer U., Vollenweider L., Delabays A., Savcic M., Eichenberger U., Kleger G.R., Firkle A., Ballmer P.E., Nicod P., and Bärtsch P. (1996). Inhaled nitric oxide for high-altitude pulmonary edema. N. Engl. J. Med. 334:624-629.
77. Shi Z.Y., Ning X.H., Huang P.G., Zhu S.C., Zhao D.M., Yang S.Y., Wang Y., and Dong Z.S. (1979). Comparison of physiological responses to hypoxia at high altitude between highlanders and lowlanders. Sci. Sin. 22:455-469.
78. Sime F., Monge C., and Whittembury J. (1975). Age as a cause of chronic mountain sickness (Monge's disease). Int. J. Biometr. 19:93-98.
79. Stevens S.F. (1993). Claiming the High Ground: Sherpas, Subsistence, and Environmental Change in the Highest Himalaya. University of California Press, Berkeley, CA, USA.
80. Sui G.J., Liu Y.H., Cheng X.S., Anand I.S., Harris E., Harris P., and Heath D. (1988). Subacute infantile mountain sickness. J. Pathol. 155:161-170.
81. 2 uptakes and vital capacities in Tibetan than Han residents of Lhasa. Respir. Physiol. 79:151-161.
82. Sun S.F., Oliver-Pickett C., Ping Y., Micco A.J., Droma T., Zamudio S., Zhuang J., Huang S.-Y., McCullough R.G., Cymerman A., and Moore L.G. (1996). Breathing and brain blood flow during sleep in patients with chronic mountain sickness. J. Appl. Physiol. 81:611-618.
83. Tucker A., and Rhodes J. (2001). Role of vascular smooth muscle in the development of high altitude pulmonary hypertension: an interspecies evaluation. High Alt. Med. Biol. 2:173-189.
84. Weil J.V., Kryger M.H., and Scoggin C.H. (1978). Sleep and breathing at high altitude. In: Sleep Apnea Syndrome. C. Guilleminault and W.C. Dement, eds. Liss, New York; pp. 119-136.
85. Winslow R.M. (1984). High-altitude polycythemia. In: High Altitude and Man. J.B. West and S. Lahiri, eds. American Physiological Society Press, Bethesda, MD; pp. 163-172.
86. Winslow R.M., and Monge C.C. (1987). Hypoxia, Polycythemia, and Chronic Mountain Sickness. Johns Hopkins University Press, Baltimore, MD, USA.
87. Winslow R.M., Chapman K.W., Gibson C.C., Samaja M., Monge C.C., Goldwasser E., Sherpa M., Blume F.D., and Satolaya R. (1989). Different hematological responses to hypoxia in Sherpas and Quechua Indians. J. Appl. Physiol. 66:1561-1569.
88. Winslow R.M., Chapman K.W., and Monge C.C. (1990). Ventilation and the control of erythropoiesis in high altitude natives of Chile and Nepal. Am. J. Human Biol. 2:653-662.
89. Wood S., Norboo T., Lilly M., Yoneda K., and Eldridge M. (2003). Cardiopulmonary function in high altitude residents of Ladakh. High Alt. Med. Biol. 4:445-454.
90. Wu T.Y., and Lin C.P. (1978). [High altitude heart disease: An observation in Qinghai-Tibet]. Chin. J. Cardiovasc. Dis. 6:186-196.
91. Wu T.Y., and Miao C.Y. (2002). High altitude heart disease in children in Tibet. High Alt. Med. Biol. 3:323-325.
92. Wu T.Y., and Tu D.T. (1997). The carotid bodies of Tibetan highlanders (Abstr.). In: International Congress of Mountain Medicine Francois-Xavier Bagnoud, Interlaken, Switzerland; p. 62.
93. Wu T.Y., Li W.S., and Zhang L.Z. (1990). [Changes in cardiac function at rest and during exercise in mountaineers at extreme altitude]. Natl. Med. J. China. 70:72-76.
94. Wu T.Y., Zhang Y.B., Bai Z.Q., Zhang H.M., Li D.G., Sun Z.S., Sakai A., Yanagidaira Y., Fujiwara T., and Ueda G. (1992). Expedition to Mt. Anymaqen: 1986 - physiological and medical research at great altitudes. In High Altitude Medicine. G. Ueda, J.T. Reeves, and M. Sekigushi, eds. Shinshu University Press, Matsumoto, Japan; pp. 414-427.
95. Wu T.Y., Li W.S., Wei L.Y., Ge R.L., Wang S.Z., Cheng Q.H., and Jin Y.S. (1998). A preliminary study on the diagnosis of chronic mountain sickness in Tibetan populations. In: Progress in Mountain Medicine and High Altitude Physiology. H. Ohno, T. Kobayashi, S. Masuyama, and M. Nakashima, eds. Press Committee of the 3rd World Congress on Mountain Medicine and High Altitude Physiology, Matsumoto, Japan; pp. 337-342.
96. Wu T.Y., Miao C.Y., Li W.S., Chen Q.H., Xue F.D., Wang X.Z., Wei T.Y., and Zhao G.C. (1999). [Determination of pulmonary arterial pressure in high altitude residents]. Chin. J. High Alt. Med. 9:1-8.
97. Wu T.Y., Miao C.Y., and Wang X.Q. (2002). High altitude heart disease in children in Tibet. In: Health & Height. G. Viscor, A. Ricart, and C. Leal, eds. Publicacions Universitat de Barcelona, Spain; pp. 291-294.
98. Wu T.Y., Wang X.Q., Wei C.Y., Chen H.W., Wang X.Z., Li Y., Ge-Dong., Zhao H.N., Young P., Li G.L., and Wang Z.G. (2005a). Hemoglobin levels in Qinghai-Tibet: different effects of gender for Tibetans vs. Han. J. Appl. Physiol. 98:598-604.
99. Wu T.Y., Li S.P., and Ward M.P. (2005b). Tibetans at extreme altitude. Wilderness Environ. Med. 16:47-54.
100. Yan J.S., He Z.Q., Zai H.Y., Yang Z., Zhang H.M., Su M.Y., and Qing F. (1987). [A study on the changes of pulmonary arterial pressure at rest and during exercise in healthy men at high altitude and at sea level]. Chin. J. Cardiovasc. Dis. 15:39-41.
101. Yang Z., He Z.Q., and Liu X.L. (1985). [High altitude and pulmonary hypertension]. Chin. J. Cardiovasc. Dis. 13:32-34.
102. Zhuang J., Droma T., Sun S., Janes C., McCullough R.E., McCullough R.G., Cymerman A., Huang C.Y., Reeves J.T., and Moore L.G. (1993a). Hypoxic ventilatory responsiveness in Tibetan compared with Han residents of 3,658 m. J. Appl. Physiol. 74:303-311.
103. Zhuang J., Droma T., Sutton J.R., McCullough R.E., McCullough R.G., Groves B.M., Rapmund G., Janes C., Sun S., and Moore L.G. (1993b). Autonomic regulation of heart rate response to exercise in Tibetan and Han residents of Lhasa (3,858 m). J. Appl. Physiol. 75:1969-1973.
104. 2 gradients in Tibetan than Han residents of Lhasa (3,658 m). Respir. Physiol. 103:75-82.