The University of Southampton
University of Southampton Institutional Repository

Higher blood flow and circulating NO products offset high-altitude hypoxia among Tibetans

Erzurum, S. C., Ghosh, S., Janocha, A. J., Xu, W., Bauer, S., Bryan, N. S., Tejero, J., Hemann, C., Hille, R., Stuehr, D. J., Feelisch, M and Beall, C. M. (2007) Higher blood flow and circulating NO products offset high-altitude hypoxia among Tibetans Proceedings of the National Academy of Sciences, 104, (45), pp. 17593-175988. (doi:10.1073/pnas.0707462104). (PMID:12614846).

Record type: Article


The low barometric pressure at high altitude causes lower arterial oxygen content among Tibetan highlanders, who maintain normal levels of oxygen use as indicated by basal and maximal oxygen consumption levels that are consistent with sea level predictions. This study tested the hypothesis that Tibetans resident at 4,200 m offset physiological hypoxia and achieve normal oxygen delivery by means of higher blood flow enabled by higher levels of bioactive forms of NO, the main endothelial factor regulating blood flow and vascular resistance. The natural experimental study design compared Tibetans at 4,200 m and U.S. residents at 206 m. Eighty-eight Tibetan and 50 U.S. resident volunteers (18-56 years of age, healthy, nonsmoking, nonhypertensive, not pregnant, with normal pulmonary function) participated. Forearm blood flow, an indicator of systemic blood flow, was measured noninvasively by using plethysmography at rest, after breathing supplemental oxygen, and after exercise. The Tibetans had more than double the forearm blood flow of low-altitude residents, resulting in greater than sea level oxygen delivery to tissues. In comparison to sea level controls, Tibetans had >10-fold-higher circulating concentrations of bioactive NO products, including plasma and red blood cell nitrate and nitroso proteins and plasma nitrite, but lower concentrations of iron nitrosyl complexes (HbFeIINO) in red blood cells. This suggests that NO production is increased and that metabolic pathways controlling formation of NO products are regulated differently among Tibetans. These findings shift attention from the traditional focus on pulmonary and hematological systems to vascular factors contributing to adaptation to high-altitude hypoxia.

Full text not available from this repository.

More information

e-pub ahead of print date: 30 October 2007
Published date: 6 November 2007
Organisations: Clinical & Experimental Sciences


Local EPrints ID: 337825
ISSN: 0027-8424
PURE UUID: d460193a-446f-4afb-939d-fc5d3372c000
ORCID for M Feelisch: ORCID iD

Catalogue record

Date deposited: 04 May 2012 11:57
Last modified: 18 Jul 2017 06:00

Export record



Author: S. C. Erzurum
Author: S. Ghosh
Author: A. J. Janocha
Author: W. Xu
Author: S. Bauer
Author: N. S. Bryan
Author: J. Tejero
Author: C. Hemann
Author: R. Hille
Author: D. J. Stuehr
Author: M Feelisch ORCID iD
Author: C. M. Beall

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.