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Updated: Oct 23, 2025

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Exercise Performance in Central Asian Highlanders: A Cross-Sectional Study.

Aglaia Forrer1,2, Philipp M Scheiwiller1,2, Maamed Mademilov2,3

  • 1Department of Respiratory Medicine, University Hospital of Zurich, Zurich, Switzerland.

High Altitude Medicine & Biology
|August 25, 2021
PubMed
Summary

Central Asian highlanders exhibit reduced exercise performance, with peak oxygen uptake and work rate about 25% lower than predicted for lowlanders. Age and sex significantly influence their aerobic capacity and physical exertion levels.

Keywords:
altitudecardiopulmonary exercise testhigh altitude pulmonary hypertensionhypoxia

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Area of Science:

  • Physiology
  • Altitude Medicine
  • Exercise Science

Background:

  • Lifelong exposure to hypobaric hypoxia in highlanders induces physiological adaptations.
  • Limited reference data exists for exercise performance in high-altitude populations.

Purpose of the Study:

  • To assess exercise performance in lifelong residents of the Tien Shan mountain range.
  • To establish reference data for cardiopulmonary exercise testing in this specific high-altitude population.

Main Methods:

  • Cross-sectional study involving 81 healthy highlanders (2,500–3,500m).
  • Cardiopulmonary exercise tests to exhaustion at 3,250m, measuring ECG, gas exchange, and SpO2.
  • Multivariable linear regression analyses were used to identify determinants of exercise capacity.

Main Results:

  • Highlanders showed reduced peak oxygen uptake (V'O2peak) and peak work rate (Wpeak) compared to lowlanders (approximately 76% and 77% predicted, respectively).
  • Resting SpO2 was 88% ± 2%, decreasing to 84% ± 5% at peak exercise.
  • Age and sex were significant predictors of V'O2peak, Wpeak, and metabolic equivalents (METs), while BMI and blood pressure were not.

Conclusions:

  • Exercise performance in Central Asian highlanders is substantially lower than predicted values for lowlanders.
  • The study provides valuable prediction models for V'O2peak, Wpeak, and METs in this population.
  • These findings aid in comparing exercise capacity across different high-altitude communities.