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Clin Exp Immunol (2010) 160(3):45760

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Ueng, T.-H., Wang, H.-W., Huang, Y.-P

1.2.3 Increased blood viscosity and hemodynamic changes Due to the increased number of red blood cells and heightened hemoglobin concentrations, blood viscosity significantly rises under high-altitude conditions, presenting as increased resistance to blood flow, exacerbating the hearts workload, and potentially affecting microcirculation and overall circulatory efficiency (Semenza, 1994