When is adaptation complete on ascent to high altitude ?

1
When is adaptation complete on ascent to high
altitude ?

• Gustavo Zubieta-Calleja (Jr)
• Gustavo Zubieta-Castillo

High Altitude Pathology Institute Clinica IPPA La
Paz Bolivia
www.altitudeclinic.com
2
The definition of adaptation to high altitude

• The organic systems of human beings and all
  other species tend to adapt to any environmental
  change and circumstance, and never tend towards
  regression which would inevitably lead to death.
  
• Gustavo Zubieta-Castillo Sr.

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The High Altitude Adaptation Formula
time
Adaptation to high altitude
altitude
For a fixed altitude, the only significant
variable is time.
How long does it take to achieve full adaptation
to a fixed altitude ?
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The Mechanisms of Adaptation to high altitude

• Macro-systemic
• Respiratory
• Increased Ventilation
• Cardiac
• Increased Heart Rate
• Pulmonary Hypertension

• Micro-systemic
• Blood oxygen transport
• Hematocrit increase
• Increased circulation
• Neoangiogenesis
• Cellular changes
• Increased mitochondrial density
• Sodium and Potassium pump changes
• Hydro-balance
• Neuro-endocrine changes
• pH correction

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The Mechanisms of Adaptation to high
altitudeHypoxia induced gene expression

• Relevant target genes
• Erythropoyetin
• Vascular endothelial growth factor (VEGF)
• Tyrosine hydroxylase
• Endothelin 1
• Genes involved in glucose metabolism
• Nitric Oxide synthase

• Transcription factors
• Hypoxia inducible factor-1
  (HIF-1)
• Activator protein-1 (AP-1)
• Nuclear factor-IL6 (NF-IL6)
• Early growth factor (Egf-1)
• Nuclear factor kappa B (NFkB)

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The adaptation to sustained exercise
Time dependant
Too acute
lesion
7
.
V
RR
VT
RESP. RATE
TIDAL VOL.
Hb
VS
HR
.
STROKE VOL.
HEART RATE
Q
8
Full Adaptation
Acute Adaptation
Intermediate Adaptation
CMS
Subacute Mountain Sickness
AMS
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Adaptation and Diving
time
Adaptation to diving
altitude
depth
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Conclusions
Immediate adaptation to high altitude is possible
but is not optimal nor definitive. The optimal
adaptation is achieved only when the
hematocrit reaches the plateau value. This
value is specific for each altitude and for each
individual. The time lapse depends on the
initial hematocrit upon ascent and on the health
status.