[Altitude adaptation. V. (conclusion). Morbidity and mortality. Literature]

The ability to adapt to extreme conditions is a continously working principle of man's evolution, in a permanent orientation to an optimal equilibrium between man and environment. A paradigm of biological adaptation is the condition of hypoxia at high altitudes, as one of the few environment constellations to which a pure biological and thus genetically based answer could be possible. The majority of adaptations are influenced by technological actions, which partially modify the environment in compensating unfavourable constellations (heating, clothing, housing, etc.). It is discussed, how far the adaptation to high altitudes produces transitory or permanent alterations with reference to constitution, perseverance, cold-sensitivity, diseases, duration of life, fertility, course of pregnancy, adaptations at the organ- and tissue-level, blood-composition, fluid-equilibrium of the body etc., which guarantee the survival of the individual and its successful reproduction with regard to the continuance of a mendel population. The elucidation of the question on genetic determination of features characteristic for high altitude inhabitants is difficult because we know next to nothing about the genetic determination of physiologic parameters. Studies on ethnic marker-genes (Ethiopia, South-America) give no reference to population differences. Remarkable is a striking prevalence of the blood-group O for all populations of high altitudes, but one must consider the effects of isolation in terms of the increase in the homozygote recessive alleles. We can propose, that in the primary settlement at high altitudes a "hard selection" was working, a kind of biological assortation-process from the beginning, which eliminated those individuals, who proved to be (for genetic reasons?) not adaptable. A good example for this are observations of cattle, from which 50% do not develop pulmonary hypertension when exposed to altitude, that means they already have a higher initial fitness. The non-adaptable animals have to be returned to the lowlands. In the F1-generation only 2% of the animals remaining at high altitude, develop "brisket disease". Possibly that means a sort of "out-mendeling" of "pulmonary-hypertension-genes", which may manifest themselves in the condition of hypoxia. Also the good adaptation of llamas is partially due to the fact that the camelids per se possess an outstanding O2 affinity and morphologically different red blood cells, which predispose this species to inhabit high altitudes. Parallel to considerations like these it could be imaginable, that e.g. the indianids of mongoloids in general, are genetically composed as fit to inhabit lowlands as well as highlands, in contrast to caucasoids and negroids. The largest mountain areas of the world (the Andes: 12 X 10(6)), the Himalayas 12 X 10(6)) are inhabited by populations of mongoloid ancestry, for about 10,000 years, a period, which ought to be long enough to make possible genetic specialisation, although it is not yet possible to prove it...