Find us +44 (0)113 2837100

Markers of physiological stress during exercise under conditions of normoxia, normobaric hypoxia, hypobaric hypoxia, and genuine high altitude

Research output: Contribution to journalArticle

  • David Woods
  • John O'Hara
  • Christopher Boos
  • Peter Hodkinson
  • Costas Tsakirides
  • Neil Hill
  • Darren Jose
  • Amanda Hawkins
  • Kelly Phillipson
  • Antonia Hazlerigg
  • Nicola Arjomandkhah
  • Liam Gallagher
  • David Holdsworth
  • Mark Cooke
  • Nicholas Green
  • Adrian Mellor
Original languageEnglish
Pages (from-to)893-900
Number of pages7
JournalEuropean Journal of Applied Physiology
Issue number5
Early online date15 Mar 2017
StatePublished - 1 May 2017
Purpose: To investigate whether there is a differential response at rest and following exercise to conditions of genuine high altitude (GHA), normobaric hypoxia (NH), hypobaric hypoxia (HH), and normobaric normoxia (NN).
Method: Markers of sympathoadrenal and adrenocortical function [plasma normetanephrine (PNORMET), metanephrine (PMET), cortisol], myocardial injury [highly sensitive cardiac troponin T (hscTnT)], and function [N-terminal brain natriuretic peptide (NT-proBNP)] were evaluated at rest and with exercise under NN, at 3375 m in the Alps (GHA) and at equivalent simulated altitude under NH and HH. Participants cycled for 2 h [15-min warm-up, 105 min at 55% Wmax (maximal workload)] with venous blood samples taken prior (T0), immediately following (T120) and 2-h post-exercise (T240).
Results: Exercise in the three hypoxic environments produced a similar pattern of response with the only difference between environments being in relation to PNORMET. Exercise in NN only induced a rise in PNORMET and PMET.
Conclusion: Biochemical markers that reflect sympathoadrenal, adrenocortical, and myocardial responses to physiological stress demonstrate significant differences in the response to exercise under conditions of normoxia versus hypoxia, while NH and HH appear to induce broadly similar responses to GHA and may, therefore, be reasonable surrogates.

    Research areas

  • High Altitude, Hypobaric Hypoxia, Normobaric Hypoxia, NT-proBNP, Adrenal, Cardiac, Exercise


  • art_10.1007_s00421-017-3573-5

    Rights statement: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (

    Final published version, 560 KB, PDF-document

Related faculties, schools or groups

External organisations

  • Royal Centre for Defence Medicine, Birmingham
  • Imperial College London
  • Charing Cross Hospital
  • Pathology, Poole Hospital NHS Foundation Trust, Poole, UK
  • Department of Biochemistry, Freeman Hospital, Newcastle upon Tyne, UK
  • Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University
  • University of Newcastle, Newcastle upon Tyne
  • Northumbria NHS Trust and Newcastle Trust, Newcastle
  • Department of Cardiology, Poole Hospital NHS Foundation Trust, Poole, UK
  • James Cook University Hospital, Middlesborough

View graph of relations