If you shoot like Randy Ulmer you would probably be able to tell a noticeable difference. For a mere mortal like me I haven' t been able to tell any big difference concerning point of impact on any of my adventures out west as far as the altitude goes. My lungs complained a lot though.
It can be tricky shooting at farther distances up or down the side of the mountain though. On a fairly steep hillside for me it is much more tricky than shooting out of a treestand when the distance gets past 40 yards.