Yoshimura. Exercise performance of Tibetan and Han adolescents at altitudes of 3,417 and 4,300 m. J. Appl. Physiol. 83(2): 661-667, 1997.-The difference was studied between O 2 transport in lifelong Tibetan adolescents and in newcomer Han adolescents acclimatized to high altitude. We measured minute ventilation, maximal O 2 uptake, maximal cardiac output, and arterial O 2 saturation during maximal exercise, using the incremental exercise technique, at altitudes of 3,417 and 4,300 m. The groups were well matched for age, height, and nutritional status. The Tibetans had been living at the altitudes for a longer period than the Hans (14.5 6 0.2 vs. 7.8 6 0.8 yr at 3,417 m, P , 0.01; and 14.7 6 0.3 vs. 5.3 6 0.7 yr at 4,300 m, P , 0.01, respectively). At rest, Tibetans had significantly greater vital capacity and maximal voluntary ventilation than the Hans at both altitudes. At maximal exercise, Tibetans compared with Hans had higher maximal O 2 uptake (42.2 6 1.7 vs. 36.7 6 1.2 ml · min 21 ·kg 21 at 3,417 m, P , 0.01; and 36.8 6 1.9 vs. 30.0 6 1.4 ml · min 21 ·kg 21 at 4,300 m, P , 0.01, respectively) and greater maximal cardiac output (12.8 6 0.3 vs. 11.4 6 0.2 l/min at 3,417 m, P , 0.01; 11.5 6 0.5 vs. 10.0 6 0.5 l/min at 4,300 m, P , 0.05, respectively). Although the differences in arterial O 2 saturation between Tibetans and Hans were not significant at rest and during mild exercise, the differences became greater with increases in exercise workload at both altitudes. We concluded that exposure to high altitude from birth to adolescence resulted in an efficient O 2 transport and a greater aerobic exercise performance that may reflect a successful adaptation to life at high altitude. cardiac output; maximal oxygen consumption; ventilation; developmental adaptation; genetic adaptation MAXIMAL O 2 UPTAKE (V O 2 max ), an integrated index of the overall functional capacity of the O 2 transport system, invariably decreases with altitude during both acute and chronic exposure to high altitude in lowland adults (31,34). This is due to the reduction of ambient O 2 pressure at high altitude. Although comparative studies of V O 2 max between high altitude natives and lowland residents at high-altitude have been done, the conclusions are controversial (10-13, 30). High-altitude adult natives in either Andean or Himalayan populations have higher exercise performance and maintain better arterial O 2 saturation (Sa O 2 ) during exercise compared with newcomers (17,20,30,38). These characteristics, which are associated with more efficient pulmonary gas exchange (38) and better adaptation to high-altitude stress, are acquired through many generations of lifelong high-altitude exposure. The Tibetans are believed to have lived at high altitude longer than other highaltitude residents. The effects of high-altitude hypoxia on the physiological responses of Tibetan and Han adolescents to exercise have never been reported. Whether the pulmonary adaptations in humans are determined purely by environment or relate to genetic character...