Permanent Residents of High Altitude

Abstract

This Chapter is concerned with permanent residents of high altitude where typically residence has been for many generations. Colloquially the term “highlanders” is often used partly because the term “high-altitude native” has a negative connotation in some quarters. It is sometimes assumed that lowlanders who go to high altitude and acclimatize there have the same characteristics of high-altitude physiology and medicine as highlanders. However, there is considerable evidence against this. For example, some of the Spanish conquerors of Peru lived at the same altitude as the permanent residents for many years and presumably developed a considerable degree of acclimatization. However, as we shall see, patterns of fertility and reproduction were very different between the acclimatized lowlanders and the highlanders. It is likely that permanent residents of high altitude have developed a true genetic adaptation to high altitude over generations with features that, though similar in some respects to acclimatization, are in fact different.