Anecdotal reports suggest that Sherpa highlanders demonstrate extraordinary tolerance to hypoxia at high altitude despite exhibiting a lower arterial oxygen content than acclimatised Lowlanders. This study tested the hypothesis that Sherpas exposed to hypobaric hypoxia on ascent to 5300m, develop increased microcirculatory blood flow as a means of maintaining normal tissue oxygen delivery. Images of the sublingual microcirculation were obtained from 64 Sherpas and 69 Lowlanders using incident dark field imaging. Serial measurements were obtained from participants undertaking an ascent from baseline testing (35m or 1300m) to Everest base camp (5300m), and following subsequent descent in Kathmandu (1300m). Microcirculatory flow index and heterogeneity index were used to provide indices of microcirculatory flow, whilst capillary density was assessed using small vessel density. Sherpas, when compared to Lowlanders, demonstrated significantly greater microcirculatory blood flow at Everest Base Camp, but not at baseline testing or on return in Kathmandu. Additionally, Sherpa blood flow exhibited greater homogeneity at 5300m and 1300m (descent) when compared to Lowlanders. Sublingual small vessel density was not different between the two cohorts at baseline testing or at 1300m, however at 5300m Sherpas capillary density was up to 30% greater. These data suggest that Sherpas have the ability to maintain a significantly greater microcirculatory flow per unit time, and flow per unit volume of tissue at high altitude, when compared to Lowlanders. These findings support the notion that peripheral vascular factors at the microcirculatory level may be important in the process of adaptation to hypoxia.
- Copyright © 2016, Journal of Applied Physiology