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[(developing)-301.6(countries)-306(such)-304.9(as)-296.9(Peru)-304.9(\(WHO,)-305.6(2014,)-295.8(2016\),)-302.7(and)]TJ
T*
[(CMS)-494.7(is)-497.5(a)-497.6(highly)-490.7(prevalent)-503.2(syndrome)-494.8(in)-491.9(Latin)-497.7(American)]TJ
0 -1.1174 TD
[(highlanders,)-386.5(it)-382.6(is)-382.3(crucial)-385.8(that)-386(the)-384.7(cardiometabolic)-386.9(status)-387.8(of)]TJ
0 -1.1116 TD
[(CMS)-356.4(patients)-356.9(is)-353.5(fully)-357.1(understood)-357.7(so)-353.3(that)-351.4(accurate)-360.3(and)-355.8(ef-)]TJ
T*
[(cient)-371(strategies)-365.8(for)-366.1(the)-367.5(prevention)-370.7(and)-367.3(treatment)-372.1(of)-365(cardio-)]TJ
0 -1.1174 TD
[(metabolic)-222.4(disorders)-218.1(and)-217.6(increased)-221.8(CVR)-213.6(can)-218.7(be)-216.5(developed)-220.9(for)]TJ
0 -1.1116 TD
[(this)-194.5(population.)-188.8(The)-195.7(aim)-190.1(of)-192.2(the)-194.7(present)-194.3(study)-189.8(was)-195.2(to)-192.4(assess)-192.5(the)]TJ
T*
[(association)-338.2(between)-334.7(EE)-332.9(and)-332.8(high)-332.8(CVR,)-332.2(as)-337.2(well)-335(as)-331.5(between)]TJ
0 -1.1174 TD
[(EE)-211.9(and)-211.8(individual)-208.5(CVR)-213.6(factors.)-209.2(In)-209.5(addition,)-215.4(we)-211.6(evaluated)-210.7(the)]TJ
0 -1.1116 TD
[(association)-217.2(between)-213.8(EE)-211.9(and)-211.8(24)-169.2(h)-208.4(blood)-213(pressure)-212.3(measured)-214.9(by)]TJ
T*
[(Ambulatory)-285.2(Blood)-277.4(Pressure)-287(Monitoring)-283(\(ABPM\).)]TJ
/F3 1 Tf
8.9663 0 0 8.9663 313.0582 725.7825 Tm
(Methods)Tj
/F10 1 Tf
0 -1.8336 TD
[(Study)-338.6(design)-330.3(and)-335.7(population)]TJ
/F4 1 Tf
9.843 0 0 9.843 323.0361 692.9006 Tm
[(Th)19.6(is)-468.7(an)19.7(al)19.5(yt)14.9(ic)-464.3(cr)14(os)21(s-)21.1(se)19.9(ct)19.5(io)15(na)19.7(l)-473.5(s)0(t)15.1(u)0(d)20.8(y)-479.2(en)19.7(ro)20.9(ll)20.6(ed)-469.9(20)20.8(9)-479.1(h)0(e)19.7(a)0(l)19.5(t)0(h)20.7(y)]TJ
-1.0137 -1.1116 TD
[(hi)14.9(gh)20.8(la)19.6(nd)20.8(er)19.7(s)-260.1(\()0(H)20(H)0(\))-250.7(a)0(n)13.9(d)-254.5(13)15.1(3)-254.5(i)0(n)15(d)0(i)20.7(v)0(i)20.7(d)0(u)20.8(a)0(l)19.5(s)-260.1(wi)19.8(th)-250(EE)18.5(,)-262.6(a)0(l)19.5(l)-260.4(na)19.7(ti)20.6(ve)-251(an)19.7(d)]TJ
0 -1.1174 TD
[(pe)13.9(rm)19.6(an)19.7(en)19.7(t)-283.5(r)0(e)19.7(s)0(i)15.1(d)0(e)19.7(n)0(t)20.7(s)-283.1(of)-278.6(Ce)18.6(rr)20.9(o)-283.3(d)0(e)-279.8(P)0(a)19.8(s)0(c)19.9(o)0(,)-275.2(P)0(e)19.8(r)0(u)20.9(,)-285.6(at)-280(43)20.8(40)-146.2(m.)-276.5(Pe)19.8(r-)]TJ
0 -1.1116 TD
[(ma)18.4(ne)13.9(nt)-255.8(re)19.7(si)20.9(de)19.7(nc)19.7(e)-267.2(a)0(t)-256.9(H)0(A)-257.4(w)0(a)18.8(s)-271.6(de)19.7(n)21(ed)-256.8(as)-256.6(li)20.6(fe)19.7(-l)15(on)20.8(g)-266(p)0(e)19.7(r)0(m)19.6(a)0(n)19.7(e)0(n)19.7(c)0(e)]TJ
T*
[(in)-163.6(th)20.7(e)-169.3(c)0(i)13.8(t)0(y)-157.8(w)0(i)19.8(t)0(h)-163.6(t)0(o)20.7(t)0(a)19.6(l)-168.3(ti)20.6(me)-165.9(sp)21(en)19.7(t)-168.3(a)0(t)-164.8(a)-169.3(lo)20.7(we)18.8(r)-173.9(a)0(l)19.5(t)0(i)20.6(t)0(u)20.7(d)0(e)-164.6(s)0(h)21(o)0(r)20.9(t)0(e)19.5(r)-173.9(th)20.7(an)-158.9(1)]TJ
0 -1.1174 TD
[(ye)13.9(ar)19.7(.)-199.3(A)0(l)19.8(l)-202.8(pa)13.9(rt)20.7(ic)19.6(ip)20.7(an)19.7(ts)-192.2(we)18.8(re)-193.4(ma)18.5(le)19.5(s)-208.2(b)0(e)19.7(t)0(w)19.8(e)0(e)18.5(n)-202.7(18)-192.3(an)19.7(d)-202.7(6)0(6)-192.3(y)0(e)19.7(a)0(r)19.7(s)-202.5(ol)14.9(d.)]TJ
0 -1.1116 TD
[(A)-180.5(n)0(o)20.8(n)0(p)20.8(r)0(o)20.9(b)0(a)19.7(b)0(i)14.9(l)0(i)20.6(s)0(t)20.9(i)0(c)-164.8(c)0(o)13.9(n)0(v)20.8(e)0(n)19.7(i)0(e)19.6(n)0(c)19.7(e)-175.1(sa)14.1(m)15(p)0(l)14.9(i)0(n)20.7(g)-173.9(me)18.4(th)20.7(od)-169.2(wa)18.8(s)-173.7(u)0(s)15.3(e)0(d)-164.6(f)0(o)20.9(r)]TJ
T*
[(re)14(cr)19.7(ui)20.7(tm)19.5(en)19.7(t)-341.1(o)0(f)-330.5(a)0(l)19.5(l)-335.3(pa)19.7(rt)15(ic)19.5(ip)20.7(an)19.7(ts)20.9(.)-343.3(T)15(o)-340.9(t)0(h)20.7(i)0(s)-330.4(e)0(n)19.7(d)0(,)-332.8(a)-336.3(Hc)18.8(t)-341.1(a)0(n)19.7(d)-340.9(bl)20.7(oo)20.8(d)]TJ
T*
[(pr)15.1(es)19.9(su)21(re)-452.6(co)19.7(nt)20.7(ro)20.9(l)-462(c)0(a)18.5(m)0(p)19.6(a)0(i)19.5(g)0(n)-451.5(f)0(o)20.9(r)-461.8(th)20.7(e)-463(g)0(e)19.7(n)0(e)19.7(r)0(a)19.7(l)-462(Ce)18.6(rr)20.9(o)-461.9(d)0(e)-452.6(P)0(a)19.8(s)0(c)19.9(o)]TJ
0 -1.1174 TD
[(po)15.1(pu)20.8(la)19.5(ti)20.6(on)-365.1(wa)18.8(s)-375.3(o)0(f)20.9(f)0(e)19.7(r)0(e)19.7(d)-375.5(an)19.7(d)-375.5(a)0(d)19.7(v)0(e)19.7(r)0(t)20.7(i)0(s)15.1(e)0(d)-360.5(t)0(h)15(r)0(o)20.9(u)0(g)20.8(h)-375.5(ra)19.7(di)20.7(o)-375.5(b)0(r)20.9(o)0(a)19.7(d)0(-)]TJ
0 -1.1116 TD
[(ca)12.8(st)20.9(in)20.7(g)-387(a)0(n)19.7(d)-387(th)20.7(ro)20.9(ug)20.8(h)-387(p)0(r)20.9(i)0(n)20.7(t)-387.1(ad)19.7(ve)19.7(rt)15(is)20.9(in)20.7(g)-387(d)0(i)20.7(s)0(t)20.9(r)0(i)20.7(b)0(u)15.1(t)0(e)19.6(d)-381.2(th)15(ro)20.9(ug)20.8(ho)20.8(ut)]TJ
T*
[(th)15(e)-376.6(c)0(i)19.5(t)0(y)20.7(.)-377.8(Ex)19.6(cl)13.8(us)21(io)20.7(n)-375.5(c)0(r)13.9(i)0(t)20.6(e)0(r)19.7(i)0(a)-366.4(w)0(e)18.8(r)0(e)-371.9(p)0(r)20.9(e)0(v)19.7(i)0(o)20.7(u)0(s)-370.6(h)0(i)20.7(s)0(t)20.9(o)0(r)15.1(y)-375.5(of)-370.8(ca)18.5(rd)20.9(io)20.7(-)]TJ
0 -1.1174 TD
[(va)13.9(sc)19.9(ul)20.7(ar)19.7(,)-360.5(r)0(e)19.7(s)0(p)21(i)0(r)20.7(a)0(t)19.5(o)0(r)20.9(y)-358.2(or)-347.7(re)14(na)19.7(l)-358.3(d)0(i)20.7(s)0(e)19.9(a)0(s)19.9(e)0(s)19.9(,)-360.5(bl)20.7(oo)20.8(d)-358.2(t)0(r)20.7(a)0(n)19.7(s)0(f)15.3(u)0(s)21(i)0(o)20.7(n)0(s)-347.6(o)0(r)]TJ
0 -1.1116 TD
[(ph)15.1(le)19.6(bo)20.8(to)20.7(mi)19.5(es)-273.9(in)-278.8(th)20.7(e)-284.5(p)0(r)15.1(e)0(v)19.7(i)0(o)20.7(u)0(s)-272.7(6)-289.1(mo)19.6(nt)20.7(hs)21(,)-285.7(j)0(o)20.7(u)0(r)20.9(n)0(e)19.7(y)0(s)-278.5(t)0(o)-273(l)0(o)15(w)0(e)18.8(r)-283.3(al)19.5(-)]TJ
T*
[(ti)14.8(tu)20.7(de)-233.7(fo)20.9(r)-237.2(m)0(o)19.6(r)0(e)-233.7(t)0(h)20.7(a)0(n)-233.7(7)-243(da)19.7(ys)-232.4(du)20.8(ri)20.7(ng)-232.6(th)20.7(e)-244.2(p)0(r)20.9(e)0(v)19.7(i)0(o)20.7(u)0(s)-232.4(6)-237.2(mo)19.6(nt)14.9(hs)21(,)-239.6(a)0(n)19.7(d)]TJ
0 -1.1174 TD
[(ab)13.9(no)20.8(rm)19.6(al)-412.4(ca)18.5(rd)20.9(ia)19.6(c)-422.7(o)0(r)-416.9(p)0(u)20.8(l)0(m)19.5(o)0(n)20.8(a)0(r)19.7(y)-421.6(fu)15.1(nc)19.7(ti)20.6(on)-411.1(ev)19.7(al)19.5(ua)19.7(te)19.6(d)-427.3(t)0(h)20.7(r)0(o)20.9(u)0(g)20.8(h)]TJ
0 -1.1116 TD
[(el)13.8(ec)18.5(tr)20.7(oc)19.7(ar)19.7(di)20.7(og)20.8(ra)14(m)-227(a)0(n)13.9(d)-231.5(sp)21(ir)20.7(om)19.6(et)19.5(ry)20.9(,)-233.8(r)0(e)19.7(s)0(p)21(e)0(c)18.5(t)0(i)20.6(v)0(e)13.9(l)0(y)20.7(.)-228.1(Su)15.2(bj)20.7(ec)18.5(ts)-221(wi)19.8(th)]TJ
T*
[(Hc)13(t)]TJ
/F6 1 Tf
1.7106 0 TD
()Tj
/F4 1 Tf
.5414 0 TD
[(63)15.1(%)-278.6(\()0(H)20(b)-283.3(co)19.7(nc)19.7(en)19.7(tr)15(at)19.5(io)20.7(n)]TJ
/F6 1 Tf
9.5438 0 TD
()Tj
/F4 1 Tf
.5414 0 TD
[(21)-146.2(g/)20.7(dL)19.6(\))-283.3(w)0(e)18.8(r)0(e)-274(s)0(e)19.9(l)0(e)19.6(c)0(t)19.5(e)0(d)-274.1(a)0(s)-273.9(p)0(a)19.7(r)0(-)]TJ
-12.3373 -1.1116 TD
[(ti)14.8(ci)19.5(pa)19.7(nt)20.7(s)-300.4(w)0(i)19.8(t)0(h)-296.1(E)0(E)-292.6(\()0(L)19.7(e)0(o)]TJ
8.6511 .0403 TD
()Tj
.4089 -.0403 TD
[(n-)20.9(Ve)18.8(la)19.5(rd)20.9(e)-301.8(e)0(t)-297.2(a)0(l)19.5(.)13.9(,)-302.9(2)0(0)20.8(0)0(5)20.8(\))0(,)-292.5(w)0(h)20(i)0(l)20.6(e)-307.5(su)21(bj)20.7(ec)18.5(ts)]TJ
-9.06 -1.1174 TD
[(wi)14.1(th)-347.9(Hc)18.8(t)]TJ
/F6 1 Tf
3.8993 0 TD
()Tj
/F4 1 Tf
.5414 0 TD
[(58)20.8(.5)18.5(%)-359.3(w)0(e)18.8(r)0(e)-348.9(s)0(e)19.9(l)0(e)19.6(c)0(t)19.5(e)0(d)-348.9(a)0(s)-354.5(h)0(e)19.7(a)0(l)19.6(t)0(h)20.7(y)-358.2(HA)-349.5(na)19.7(ti)20.6(ve)19.7(s.)-349.9(Th)19.6(e)]TJ
-4.4407 -1.1116 TD
[(st)15.1(ud)20.8(y)-289.1(w)0(a)18.8(s)-288.9(ap)19.7(pr)20.9(ov)20.8(ed)-279.8(by)-278.7(th)20.7(e)-290.2(E)0(t)19.5(h)0(i)20.7(c)0(s)-279.6(C)0(o)19.8(m)0(m)18.4(i)0(t)20.6(t)0(e)13.8(e)-284.5(of)-278.6(Un)14.2(iv)20.7(er)19.7(si)20.9(da)19.7(d)]TJ
T*
-.0192 Tc
[(P)-19.2(e)-5.1(r)-19.2(u)1.7(a)-19.2(n).5(a)-326.7(C)-19.2(ay)-19.2(et)-19.2(an)-19.2(o)-315.1(H)-19.2(er)-19.2(ed)-19.2(ia)-19.2(,)-312.9(a)-19.2(nd)-325.6(a)-19.2(l)-5.4(l)-325.7(p)-19.2(ar)-19.2(ti)-19.2(ci)-19.2(pa)-19.2(nt)-19.2(s)-315.1(s)-19.2(ig)-19.2(ne)-19.2(d)-316.3(a)-19.2(n)-316.3(i)-19.2(n-)]TJ
0 -1.1174 TD
0 Tc
[(fo)15.1(rm)19.6(ed)-389.3(co)19.7(ns)21(en)19.7(t.)-390.6(Th)19.6(is)-393.8(st)20.9(ud)20.8(y)-398.5(w)0(a)18.8(s)-398.3(de)13.9(ve)19.7(lo)20.7(pe)19.7(d)-398.5(i)0(n)-388.2(c)0(o)19.7(l)0(l)14.8(a)0(b)19.7(o)0(r)20.9(a)0(t)19.5(i)0(o)20.7(n)]TJ
0 -1.1116 TD
[(wi)14.1(th)-255.7(th)15(e)-267.2(H)0(I)20(G)0(H)19.1(C)0(A)13.2(R)0(E)24.4(-)0(A)14.2(N)0(D)19.1(E)0(S)-256.7(s)0(t)15.1(u)0(d)20.8(y)0(.)]TJ
/F10 1 Tf
8.9663 0 0 8.9663 313.0582 418.5637 Tm
[(Study)-338.6(procedures)]TJ
/F4 1 Tf
9.843 0 0 9.843 323.0361 402.1227 Tm
[(Al)19.8(l)-346.8(p)0(a)13.9(r)0(t)20.7(i)0(c)19.6(i)0(p)20.7(a)0(n)19.7(t)0(s)-342(u)0(n)20.8(d)0(e)19.7(r)0(w)20(e)0(n)19.7(t)-346.8(th)15(or)20.9(ou)20.8(gh)-336.3(cl)19.5(in)15(ic)19.5(al)-337.6(ex)19.7(am)18.5(in)20.7(at)19.5(io)20.7(n.)]TJ
-1.0137 -1.1116 TD
[(Of)14.2(c)19.8(e)-284.5(b)0(l)20.7(o)0(o)15.1(d)-283.3(pr)20.9(es)19.9(su)15.3(re)-274(wa)18.8(s)-288.9(o)0(b)20.8(t)0(a)19.6(i)0(n)20.7(e)0(d)-274.1(u)0(s)15.3(i)0(n)20.7(g)-283.3(a)-284.5(v)0(a)13.9(l)0(i)20.6(d)0(a)19.7(t)0(e)19.5(d)-283.3(os)15.3(ci)19.5(ll)20.6(o-)]TJ
T*
[(me)18.4(tr)15(ic)-176.3(de)19.7(vi)20.7(ce)-177.3(\(U)20(A-)20(76)20.8(7)-185.4(P)0(l)20.9(u)0(s)15.3(;)-185.5(A&)18.7(D)-180.5(M)0(e)18.8(d)0(i)14.9(c)0(a)18.5(l)0(,)-171.7(J)0(a)14.1(p)0(a)19.7(n)0(\))20.9(.)-182(Di)19.8(ag)13.9(no)20.8(si)20.9(s)]TJ
0 -1.1174 TD
[(of)-376.5(hy)15.1(pe)19.7(rt)20.7(en)19.7(si)20.9(on)-376.6(us)21(in)15(g)-381.2(o)0(f)15.1()0(c)19.8(e)-382.4(bl)14.9(oo)20.8(d)-387(p)0(r)20.9(e)0(s)19.9(s)0(u)21(r)0(e)-377.7(u)0(s)21(e)0(d)-377.7(t)0(h)20.7(r)0(e)19.7(s)0(h)15.3(o)0(l)20.7(d)0(s)]TJ
0 -1.1116 TD
[(of)-399.6(SB)20(P)]TJ
/F6 1 Tf
3.3867 0 TD
()Tj
/F4 1 Tf
.5414 0 TD
[(14)20.8(0)-156.6(m)0(m)18.4(H)0(g)-394.7(o)0(r)-393.8(D)0(B)18.9(P)]TJ
/F6 1 Tf
8.3401 0 TD
()Tj
/F4 1 Tf
.5472 0 TD
[(90)-146.2(mm)24.1(Hg)14.2(.)-400.8(A)0(v)20(e)0(r)13.9(a)0(g)19.7(e)-405.4(of)-393.8(th)20.7(re)19.7(e)]TJ
-12.8153 -1.1116 TD
[(me)18.4(as)14.1(ur)20.9(em)18.5(en)19.7(ts)-203.7(pe)19.7(rf)15.1(or)20.9(me)18.4(d)-214.2(i)0(n)-203.9(s)0(e)19.9(a)0(t)19.5(e)0(d)-205(p)0(o)20.8(s)0(i)20.9(t)0(i)14.8(o)0(n)-203.8(a)0(f)19.7(t)0(e)19.5(r)-214.2(5)-214.2(m)0(i)19.5(n)0(u)20.8(t)0(e)-205.1(r)0(e)19.7(s)0(t)]TJ
0 -1.1174 TD
[(wa)13(s)-317.7(c)0(o)19.7(n)0(s)21(i)0(d)20.7(e)0(r)19.7(e)0(d)19.7(.)-320.2(Ox)20(yg)20.8(en)-308.6(sa)19.9(tu)15(ra)19.7(ti)20.6(on)-307.5(\(S)21(pO)]TJ
7.3823 0 0 6.5614 473.9526 334.7149 Tm
(2)Tj
9.843 0 0 9.843 477.581 336.3589 Tm
[(\))-317.9(w)0(a)18.8(s)-317.7(me)18.5(as)19.9(ur)20.9(ed)-308.6(by)]TJ
-16.7147 -1.1116 TD
[(pu)15.1(ls)20.9(e)-290.2(o)0(x)15.1(i)0(m)19.5(e)0(t)19.5(r)0(y)-278.6(\()0(N)20(e)0(l)13.8(l)0(c)19.6(o)0(r)-278.6(N)0(-)14.2(5)0(6)20.8(0)0(,)-281(N)0(e)18.8(l)0(l)20.6(c)0(o)19.7(r)-294.8(Pu)21(ri)20.7(ta)19.5(n)-294.8(B)0(e)18.6(n)0(n)20.8(e)0(t)19.5(t)-295(In)20.9(c.)17.4(,)]TJ
T*
[(US)14.4(A\))20(.)-377.8(L)0(o)19.6(w)-376.3(ar)14(te)19.6(ri)20.7(al)-366.4(ox)15.1(yg)20.8(en)-366.2(sa)19.9(tu)15(ra)19.7(ti)20.6(on)-365.1(wa)13(s)-375.3(d)0(e)19.7()0(n)21(e)0(d)-372(a)0(s)-366(S)0(p)15.2(O)]TJ
7.3823 0 0 6.5614 548.5038 312.8314 Tm
(2)Tj
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T*
[(ob)26.6(ta)19.6(i)16.1(n)0(e)25.4(d)-185.4(fr)26.7(om)-176.2(t)16.1(h)0(e)-176.2(r)0(e)25.5(c)0(o)25.4(r)0(d)26.6(i)0(n)26.5(g)0(s)-174.8(w)0(e)24.6(r)0(e)-176.1(s)16.4(ys)21(t)16.1(o)0(l)26.5(i)0(c)25.3(,)-187.7(di)26.5(as)25.6(to)26.5(li)26.3(c,)-178.5(a)15(n)0(d)-175(m)15(ea)24.3(n)]TJ
0 -1.1174 TD
[(da)25.4(yt)20.7(i)16.1(m)15(e)-290.2(\()0(a)25.5(w)0(a)24.6(k)0(e)25.4(\))0(,)-275.2(n)0(i)26.5(g)0(h)20.8(t)16.1(-t)26.5(im)25.2(e)-290.2(\()0(s)26.8(l)0(e)25.3(e)0(p)25.4(\))0(,)-275.2(a)0(n)25.4(d)-289.1(24)-140.4(h)-289.1(b)16.2(lo)20.7(o)16.2(d)-289.1(p)16.2(r)0(e)19.7(s)16.4(su)26.8(re)25.5(.)]TJ
0 -1.1116 TD
[(AB)24.7(PM)-434.9(th)26.5(re)25.5(sh)21(o)16.2(l)0(d)26.5(s)-450.2(f)16.2(o)0(r)-434.1(h)0(y)26.6(p)0(e)25.4(r)0(t)26.5(e)0(n)25.4(s)0(i)26.7(o)0(n)-434.2(w)0(e)24.6(r)0(e)-435.3(1)0(3)26.6(5)0(/)26.5(8)0(5)-140.4(m)0(m)24.1(H)0(g)-435(f)16.2(or)]TJ
T*
[(da)25.4(yt)20.7(i)16.1(m)15(e,)-305.2(12)26.6(0/)26.5(70)-140.4(mm)24.1(Hg)-302.6(fo)20.9(r)-312.1(n)0(i)26.5(g)0(h)20.8(t)16.1(-t)26.5(im)25.2(e)-319(a)15(nd)-307.5(1)16.2(3)0(0)26.6(/)0(8)26.5(0)-156.6(m)15(m)0(H)24.5(g)-317.9(f)16.2(o)0(r)]TJ
T*
[(24)-140.4(h)-433.1(\()16.2(O)25.8(Br)25.6(ie)25.3(n)-433.1(e)15(t)-427.4(a)0(l)25.3(.)13.9(,)-429.6(2)0(0)26.6(1)0(3)26.6(\))0(.)-419.2(A)15.3(ls)26.7(o,)-419.2(B)15.2(P)-427.2(va)25.4(ri)26.5(ab)25.4(il)20.6(i)16.1(t)0(y)26.5(,)-429.6(e)15(v)0(a)25.4(l)0(u)20.7(a)15(te)25.3(d)]TJ
0 -1.1174 TD
[(th)26.5(ro)20.9(u)16.2(g)0(h)-249.9(s)0(t)26.7(a)0(n)25.4(d)0(a)25.4(r)0(d)-249.8(d)16.2(ev)19.7(i)16.1(a)0(t)25.3(i)0(o)26.5(n)-260.3(\(S)21(D)15.3(\))-260.2(of)-249.8(av)25.4(er)25.5(ag)25.4(e)-261.4(2)0(4)-146.2(h)16.2(,)-262.6(d)16.2(ay)25.4(ti)20.6(m)15(e)-261.4(an)25.4(d)]TJ
0 -1.1116 TD
[(ni)26.5(gh)20.8(t)16.1(-)0(t)26.5(i)0(m)25.2(e)-244.2(A)15.3(B)0(P)25.7(M)-243.9(v)16.2(a)0(l)25.3(u)0(e)25.4(s)0(,)-229(w)0(a)24.6(s)-242.8(a)15(n)0(a)25.4(l)0(y)20.7(z)15(ed)-228(\()-70.2(M)0(a)24.5(n)0(c)25.4(i)0(a)-228.1(e)0(t)-228.1(a)0(l)25.3(.)0(,)-231.5(1)16.2(99)26.6(3\))20.9(.)]TJ
/F10 1 Tf
8.9663 0 0 8.9663 59.7543 248.3716 Tm
[(Statistical)-336.1(analysis)]TJ
/F4 1 Tf
9.843 0 0 9.843 69.7323 231.9306 Tm
-.0159 Tc
[(ST)4.9(A)5.2(T)-.9(A)5.2(1).3(4)-276.2(s).5(o)6(f).3(t)5.9(w)-.6(a)4.9(r).3(e)-277.3(w)5.2(as)-276(us)6.2(ed)-276.2(f)6.1(o).3(r)-276.2(a)-.9(l)5.9(l)-276.3(st)5.9(at)5.9(is)6.2(ti)5.9(ca)4.9(l)-282.1(a)4.9(na)4.9(l)5.9(y).3(si)5.9(s.)-272.8(Pri)5.9(-)]TJ
-1.0137 -1.1174 TD
-.0178 Tc
[(mary)-381.8(en)4.1(d)-387.5(p)4.1(oi)4(nt)-387.6(was)-387.3(t)-1.7(h)4.1(e)-388.7(ass)4.3(o)-1.6(ciat)]TJ
12.9709 0 TD
-.0201 Tc
[(ion)-384.1(b)-3.9(etwe)-5.1(en)-389.8(the)-385.2(p)-3.9(re)-5.1(senc)-5.1(e)-391(o)1.8(f)]TJ
-12.9709 -1.1116 TD
-.0168 Tc
[(EE)-439.5(an)5.1(d)-444.1(h)5.1(ig)5.1(h)-444.1(C)4.1(VR;)-444.2(s)5.3(econ)5.1(dary)-438.4(en)5.1(d)-444.1(p)5.1(oi)5(nt)5(s)-443.9(w)4.3(er)5.2(e)-445.3(t)5(he)-445.3(ass)5.3(o)-.6(cia-)]TJ
T*
-.0216 Tc
[(t)-5.5(i).2(o)-5.4(n)-253.1(be)-6.6(tw)-6.3(ee)-6.6(n)-253.1(E)-.8(E)-254.3(a)-6.6(nd)-253.1(C)-6.4(V)-.5(R)-254.1(f)-5.4(act)-5.5(or)-5.4(s)-252.9(i)-5.5(nd)-5.4(iv)-5.4(id)-5.4(ua)-6.6(ll)-5.5(y)-253.1(c)-.8(o)-5.4(n).3(s)-5.2(i).2(d)-5.4(e)-.8(r)-5.4(e)-.8(d,)-255.4(a)-6.6(n).3(d)]TJ
0 -1.1174 TD
-.0169 Tc
[(di)4.9(ff)5.1(er)5.1(en)5(ces)-628.3(i)4.9(n)-628.5(a)3.9(mbu)5(l)-.8(ato)5(r)-.7(y)-622.8(b)-.7(l)4.9(o)-.7(o)5(d)-622.8(pr)5.1(es)5.2(su)5(re)-623.9(paramet)4.9(e)-1.9(r)5.1(s)-.5(.)-625.1(F)-.6(o)5(r)]TJ
0 -1.1116 TD
-.0191 Tc
[(c)-4.1(o)2.8(m)-4.1(p)2.8(a)-4.1(r)2.9(ison)-377.3(of)-377.3(m)-4.1(eans)-382.9(b)2.8(etwe)-4.1(en)-383.1(groups)-382.9(\(H)-3.8(H)-378.2(v)-2.9(s.)-379.6(EE\),)-379.6(t)-3(he)-378.5(nor-)]TJ
T*
-.0163 Tc
[(mali)5.5(ty)-305.4(di)5.5(st)5.5(ri)5.5(bu)5.6(ti)5.5(on)-305.4(an)5.6(d)-311.1(h)-.1(o)5.6(m)4.4(og)5.6(en)5.6(ei)5.5(ty)-305.4(of)-305.3(vari)5.5(an)5.6(ce)-306.5(of)-311.1(al)5.5(l)-311.3(c)-1.3(o)5.6(n)-.1(t)5.5(i)-.2(n)5.6(-)]TJ
T*
-.0172 Tc
[(uo)4.7(us)-213.9(vari)4.6(ab)4.7(les)-219.7(w)3.9(er)4.8(e)-215.3(a)-2.2(s)4.9(s)-.8(essed)-214.1(t)-1.1(o)-214.1(d)-1(etermin)4.7(e)-215.3(th)4.7(e)-221(u)4.7(se)-215.3(of)-214.1(p)4.7(a)-2.2(r)4.8(a)-2.2(met)4.6(r)-1(i)4.6(c)]TJ
0 -1.1174 TD
-.0166 Tc
[(\(S)5.5(tu)5.3(dent)5.2(s)]TJ
/F5 1 Tf
4.4926 0 TD
0 Tc
(t)Tj
/F4 1 Tf
.2649 0 TD
-.0215 Tc
[(-t)-5.4(es)-5.1(t\))-569.7(o)-5.3(r)-569.7(no)-5.3(np)-5.3(ar)]TJ
6.543 0 TD
-.0197 Tc
[(am)-4.7(etric)-569.1(\()2.3(W)-5.8(i)2.1(lcox)]TJ
6.6121 0 TD
-.0216 Tc
[(on)-575.6(si)-5.5(gn)-5.4(ed)-5.4(-r)-5.4(an)-5.4(k\))]TJ
-17.9127 -1.1116 TD
[(t)-5.6(e)-.9(s)-5.3(t).1(s)-5.3(.)-163.4(T)-6.7(h).2(e)-167.9(a)-6.7(ss)-5.3(oc)-6.7(ia)-6.7(ti)-5.6(on)-166.8(b)-5.5(e)-.9(tw)-6.4(ee)-6.7(n)-166.8(E)-.9(E)-168(a)-.9(n)-5.5(d)-166.8(CV)-6.4(R)-162.1(a)-6.7(nd)-166.8(b)-5.5(e)-.9(t)-5.6(w)-.6(e)-6.7(e)-.9(n)-166.8(E)-.9(E)-168(a)-6.7(nd)]TJ
T*
-.019 Tc
[(c)-4(a)1.8(rdiom)-4(e)1.8(tabolic)-816.1(p)2.9(aram)-4(eters)-809(i)]TJ
12.297 0 TD
-.0214 Tc
[(nd)-5.2(ep)-5.2(en)-5.2(de)-6.4(nt)-5.3(ly)-817.3(wa)-6.4(s)-811.4(e)-6.4(va)-6.4(lu)-5.2(at)-5.3(ed)]TJ
-12.297 -1.1174 TD
-.0174 Tc
[(th)4.5(ro)4.5(ug)4.5(h)-174(m)-2.4(u)4.5(l)-1.3(t)4.4(i)-1.3(v)4.5(a)-2.4(r)4.6(i)-1.3(ate)-169.4(l)-1.3(o)4.5(g)-1.2(i)4.4(s)-1(t)4.4(i)-1.3(c)-175.2(r)4.6(eg)4.5(ress)4.7(io)4.5(ns,)-170.6(w)-2.1(h)4.5(i)-1.3(ch)-174(i)4.4(n)-1.2(clu)4.5(d)-1.2(ed)-174(kn)4.5(own)]TJ
0 -1.1116 TD
-.0156 Tc
[(co)6.3(nf)6.4(ou)6.3(nd)6.3(er)6.4(s)-344.8(\()6.4(ag)6.3(e,)-341.6(B)5.3(M)5.4(I,)-341.6(a)5.2(n).6(d)-339.2(S).7(p)6.3(O)]TJ
7.3823 0 0 6.5614 189.3543 98.759 Tm
0 Tc
(2)Tj
9.843 0 0 9.843 192.8692 100.4031 Tm
-.0216 Tc
[(\).)-347.6(P)-5.3(h).3(y)-5.4(s).5(i)-5.5(c)-.8(a)-6.6(l)-345.4(ac)-6.6(ti)-5.5(vi)-5.5(ty)-351(wa)-6.6(s)-345(n)-5.4(ot)]TJ
-13.5238 -1.1116 TD
-.0165 Tc
[(in)5.4(cl)5.3(ud)5.4(ed)-288.3(as)-288.1(a)-289.5(p)5.4(ot)5.3(en)5.4(ti)5.3(al)-282.7(co)5.4(nf)5.5(ou)5.4(nd)5.4(er)-288.3(s)5.6(i)-.4(n)5.4(c)-1.5(e)-289.5(t)5.3(here)-283.7(was)-288.1(n)-.3(o)-288.3(a)4.3(ss)5.6(ocia-)]TJ
0 -1.1174 TD
.2087 Tc
[(t)224.8(i)230.5(o)224.9(n).3(b)230.6(e)223.7(t)230.5(w)224(e)229.5(e)223.7(nt)230.5(h)224.9(i)230.5(sp)224.9(a)229.5(r)224.9(a)229.5(m)229.4(e)223.7(t)230.5(e)223.7(r).3(a)229.5(n)224.9(de)229.5(i)224.8(t)230.5(h)224.9(e)229.5(ro)224.9(ft)230.5(h)224.9(e)-.9(s)230.8(t)224.8(u)230.6(d)224.9(yv)230.6(a)223.7(r)230.7(i)224.8(a)229.5(b)230.6(l)224.8(e)229.5(s)225.1(.I)230.7(n)]TJ
0 -1.1116 TD
-.0157 Tc
[(ad)6.2(di)6.1(ti)6.1(on)6.2(,)-416.5(b).5(i)6.1(v).5(a)5.1(r)6.3(ia)5.1(te)-415.4(as)6.4(so)6.2(ci)6.1(at)6.1(io)6.2(ns)-414(w)5.4(e)-.7(r)6.3(e)-415.4(ev)6.2(al)6.1(ua)5.1(te)5.1(d)-414.2(u).5(s)6.4(i).4(n)6.2(g)-420(l)6.1(o).5(g)6.2(i).4(s)6.4(t).4(i)6.1(c)]TJ
T*
-.0165 Tc
[(regr)5.5(es)5.6(si)5.3(on)5.4(s.)-273.4(A)]TJ
/F5 1 Tf
5.7655 0 TD
0 Tc
(p)Tj
/F4 1 Tf
.4838 0 TD
-.0194 Tc
[(-value)-275.1(below)-274.8(0)2.5(.05)-273.9(w)1.7(a)-4.4(s)-273.7(co)]TJ
9.9182 0 TD
-.0198 Tc
[(nsidered)-274.3(as)-274.1(the)-275.5(m)-4.8(ini-)]TJ
-16.1675 -1.1174 TD
-.0215 Tc
[(m)-6.5(u).4(m)-340.6(l)-5.4(ev)-5.3(el)-339.5(o)-5.3(f)-339.3(st)-5.4(at)-5.4(is)-5.1(ti)-5.4(ca)-6.5(l)-339.5(s).6(i)-5.4(g).4(n)-5.3(i).3()-5.2(c)-.7(a)-6.5(n).4(c)-6.5(e)-.7(.)-341.7(I).5(n)-339.4(a)-6.5(dd)-5.3(it)-5.4(io)-5.3(n,)-341.7(a)-340.5(s)-5.1(ens)-5.1(i)-5.4(ti)-5.4(vi)-5.4(ty)]TJ
25.5097 69.0416 TD
[(an)-5.4(al)-5.5(ys)-5.2(is)-264.4(wa)-6.6(s)-258.6(c)-6.6(on)-5.4(duc)-6.6(te)-6.6(d)-258.8(u)-5.4(si)-5.5(ng)-264.6(pr)-5.4(op)-5.4(en)-5.4(si)-5.5(ty)-264.6(sc)-6.6(or)-5.4(e)-260(m)-.9(a)-6.6(t).2(c)-6.6(h).3(i)-5.5(n).3(g)-264.6(t).2(o)-264.6(d).3(e-)]TJ
0 -1.1174 TD
-.0219 Tc
[(te)-6.9(rm)-6.9(in)-5.7(e)-398.5(d)-5.7(e)-398.5(e)-1.1(f)-5.7(f).1(e)-6.9(c)-1.1(t)-403.3(o)0(f)-403.1(E)-1.1(E)-404.3(o)0(n)-403.1(C)-1(V)-6.6(R)]TJ
13.351 0 TD
-.0192 Tc
[(.)-397(N)-3.9(earest)-400.6(n)2.7(eighbor)-394.6(w)-3.9(ith)-394.7(r)-3(e-)]TJ
-13.351 -1.1116 TD
-.0201 Tc
[(plac)-5.1(eme)-5.1(n)1.8(t)-234.4(m).6(ethod)-228.5(w)-4.8(as)-234.1(used)-234.3(to)]TJ
11.9975 0 TD
-.0215 Tc
[(m)-6.5(a)-.7(t)-5.4(c)-.7(h)-229.9(s)-5.1(ub)-5.3(je)-6.5(ct)-5.5(s)-229.7(w)-6.2(it)-5.4(h)-230(E)-6.5(E)-231.1(a)-.7(n)-5.3(d)-229.9(HH)]TJ
-11.9975 -1.1116 TD
[(wh)-5.3(os)-5.1(e)-369.3(p)-5.3(ro)-5.3(pe)-6.5(ns)-5.1(it)-5.5(y)-368.2(s)-5.1(co)-5.3(re)-6.5(s)-368(a)-6.5(re)-375.1(clo)-5.3(s)-5.1(er)-5.3(.)-370.5(T)-.7(he)-375.1(me)-6.5(th)-5.3(od)-373.9(was)-373.7(u).4(s)-5.1(e)-.7(d)-373.9(t).3(o)]TJ
T*
-.0173 Tc
[(b)4.6(a)-2.3(l)4.5(a)-2.3(n)4.6(c)-2.3(e)-221.1(t)4.5(he)-221.1(EE)-221.2(an)4.6(d)-225.7(H)3.8(H)-220.9(g)-1.1(r)4.7(o)-1.1(u)4.6(p)-1.1(s)-219.8(s)-.9(o)-220(t)4.5(hat)-220.1(d)-1.1(i)4.5(r)-1.1(ect)-220.1(c)-2.3(o)4.7(m)3.4(pari)4.5(so)4.6(n)-225.7(w)3.8(ou)4.6(l)4.5(d)]TJ
0 -1.1174 TD
-.0157 Tc
[(b)6.2(e)-202.3(po)6.2(ss)6.4(ib)6.2(le)-202.3(fo)6.2(r)-201.1(e)-.7(v)6.2(a)-.7(l)6.1(u).5(a)5.1(t).4(i)6.1(o).5(n)-201.1(o)6.2(f)-201.1(t).3(h)6.2(e)-202.3(av)6.2(er)6.3(ag)6.2(e)-202.3(t).4(r)6.3(e)-.7(a)5.1(t).4(m)5(e)-.7(n)6.2(t)-201.2(ef)6.3(fe)5.1(ct)-201.2(\()6.3(A)-.4(T)5.1(E)5(\))]TJ
0 -1.1116 TD
-.0201 Tc
[(of)-251.6(E)-5.1(E)-247(on)-251.6(CV)-4.8(R.)-253.9(The)-252.7(v)-3.9(aria)-5.1(bles)-251.4(incl)]TJ
13.063 0 TD
-.0215 Tc
[(ud)-5.3(ed)-253(i)-5.5(n)-253(th)-5.3(e)-254.1(cal)-5.4(cu)-5.3(la)-6.5(ti)-5.4(on)-253(o)-5.3(f)-252.9(th)-5.3(e)]TJ
-13.063 -1.1116 TD
[(pr)-5.4(op)-5.4(en)-5.4(si)-5.6(ty)-264.6(sc)-6.6(or)-5.4(es)-264.4(w)-6.3(e)-.8(r)-5.4(e)-260(a)-6.6(g).3(e)-6.6(,)-261.2(BM)-6.3(I,)-261.2(a)-6.6(n).3(d)-264.6(S).5(p)-5.4(O)]TJ
7.3823 0 0 6.5614 474.066 646.8093 Tm
0 Tc
(2)Tj
9.843 0 0 9.843 477.581 648.4534 Tm
(.)Tj
/F3 1 Tf
8.9663 0 0 8.9663 310.8472 623.1116 Tm
(Results)Tj
/F10 1 Tf
0 -1.8336 TD
[(General)-336(characteristics)]TJ
/F4 1 Tf
9.843 0 0 9.843 320.8251 590.2297 Tm
[(As)-290.9(expected,)-299.3(Hct)-299.2(and)-298.2(CMS)-293.1(scores)-296.5(were)-301.3(higher)-295.9(in)-296.1(partici-)]TJ
-1.0137 -1.1174 TD
[(pants)-334.9(with)-339.6(EE)-338.7(compared)-341.8(to)-336.4(HH,)-335.7(while)-341.9(SpO)]TJ
7.3823 0 0 6.5614 487.1054 577.6439 Tm
(2)Tj
9.843 0 0 9.843 494.1353 579.2313 Tm
[(showed)-336.8(lower)]TJ
-18.6211 -1.1116 TD
[(values.)-421.2(Also,)-417.6(subjects)-419.9(with)-420.2(EE)-419.3(showed)-417.4(higher)-422.6(BMI,)-417.6(heart)]TJ
T*
[(rate,)-465.3(and)-465.2(age.)-464.1(Regression)-469.1(analysis)-466(showed)-469.2(no)-463(association)]TJ
T*
[(between)-380.8(EE)-379(and)-378.8(heart)-382.3(rate)-381.2(in)-376.7(a)-376.6(model)-382.4(adjusted)-379.8(for)-377.6(known)]TJ
0 -1.1174 TD
[(confounding)-215(factors)-217.3(\(age,)-217.5(BMI,)-216(and)-217.6(SpO)]TJ
7.3823 0 0 6.5614 470.3243 533.7637 Tm
(2)Tj
9.843 0 0 9.843 474.0093 535.4077 Tm
[(\);)-215.4(while)-215.1(there)-221(was)-218.3(a)]TJ
-16.5764 -1.1116 TD
[(signicant)-295.6(inverse)-297.9(association)-297.8(between)-294.4(heart)-295.9(rate)-294.8(and)-292.5(SpO)]TJ
7.3823 0 0 6.5614 543.7983 522.8219 Tm
(2)Tj
9.843 0 0 9.843 547.4833 524.466 Tm
(.)Tj
-24.041 -1.1116 TD
[(Iron)-205.9(prole)-209.3(parameters)-212.6(showed)-210(normal)-204.9(value)-8(s)-202.5(i)0(n)-209.7(E)0(E)-206.2(subjects,)]TJ
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[(except)-292.5(for)-297(lower)-295.6(serum)-289.9(ferritin.)-295.9(Time)-296.1(spent)-294.6(in)-296.1(sedentary)-295.5(ac-)]TJ
0 -1.1116 TD
[(tivities)-356(or)-353.5(smoking)-354.5(status)-359(was)-356.5(not)-354.8(statistically)-358.1(different)-358(be-)]TJ
T*
[(tween)-279.5(HH)-286.2(and)-280.9(participants)-281.9(with)-282(EE)-281.1(\(Table)-286.7(1\).)]TJ
/F10 1 Tf
8.9663 0 0 8.9663 310.8472 455.3007 Tm
[(Cardiovascular)-335.9(risk)]TJ
/F4 1 Tf
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[(Multivariate)-392.6(logistic)-390.4(regression)-393.2(showed)-394.4(that)-391.7(the)-390.5(odds)-390.1(of)]TJ
-1.0137 -1.1174 TD
(CVR)Tj
/F6 1 Tf
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(>)Tj
/F4 1 Tf
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-2.8165 -1.1116 TD
[(in)-342.1(a)-342.1(model)-347.9(adjusted)-345.3(for)-343.1(overweight)-348.5(and)-344.3(obesity,)-346.4(SpO)]TJ
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(2)Tj
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[(,)-343.3(and)]TJ
-22.2497 -1.1116 TD
[(age)-391.5(\(Table)-390.4(2\).)-385.7(In)-393.8(addition,)-388.2(a)-388.2(bivariate)-393.9(association)-395.7(was)-391(ob-)]TJ
T*
[(served)-337(between)-334.7(CMS)-339.1(score)-335.9(and)-332.8(CVR.)-338(The)-339.7(results)-337(from)-333.9(the)]TJ
0 -1.1174 TD
[(sensitivity)-203.6(analysis)-206.8(show)-200.9(a)-203.8(statistically)-208.4(signicant)-203.4(ATE)-202.4(of)-203.8(EE)]TJ
0 -1.1116 TD
[(and)-367.3(CVR)-374.9(\(Table)-367.3(3\),)-374.2(supporting)-368.2(the)-373.2(results)-371.6(from)-368.4(the)-367.5(multi-)]TJ
T*
[(variate)-282.1(regression.)]TJ
/F10 1 Tf
8.9663 0 0 8.9663 310.8472 336.8125 Tm
[(Metabolic)-332.5(parameters)]TJ
/F4 1 Tf
9.843 0 0 9.843 320.8251 320.3716 Tm
[(Morning)-279.4(fasting)-285.4(serum)-278.4(glucose)-286.4(concentration)-284.3(was)-281.6(signi-)]TJ
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[(cantly)-331.7(higher)-330.4(in)-330.6(the)-332.9(EE)-332.9(group)-328(compared)-336(with)-328.1(HH)-332.2(\(95.3)-330.4(vs.)]TJ
ET
310.847 258.746 239.074 .28345 re
f
310.847 93.827 239.074 .28342 re
f
420.888 239.868 57.373 .28348 re
f
486.028 239.868 63.893 .28348 re
f
310.847 222.179 239.074 .28348 re
f
BT
/F8 1 Tf
9.845 0 0 9.845 325.5873 284.3716 Tm
(Table)Tj
/F4 1 Tf
3.0002 0 TD
(1.)Tj
/F8 1 Tf
1.2496 0 TD
[(General)-331.2(Characteristics)-339.1(of)-331.2(Healthy)]TJ
-.8811 -1.0135 TD
[(Highlanders)-336(and)-332(Subjects)-337(with)]TJ
1.4799 -1.0077 TD
[(Excessive)-332(Erythrocytosis)]TJ
/F5 1 Tf
5.0848 -1.8427 TD
[(HH)-331.9(\()]TJ
/F4 1 Tf
2.1019 0 TD
(n)Tj
/F6 1 Tf
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(=)Tj
/F5 1 Tf
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[(209\))-1737.3(EE)-332.6(\()]TJ
/F4 1 Tf
5.4649 0 TD
(n)Tj
/F6 1 Tf
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(=)Tj
/F5 1 Tf
.7141 0 TD
(133\))Tj
-10.3827 -1.8197 TD
[(Mean)-1192.4(SEM)-1732.7(Mean)-1526.4(SEM)]TJ
/F4 1 Tf
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[(Age,)-330.8(yrs)-8427.6(40.7)-1808.8(0.9)-1594.7(44.6**)-1891.4(1.0)]TJ
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[(BMI,)-330.6(kg/m)]TJ
7.3837 0 0 6.5625 355.4645 204.1511 Tm
(2)Tj
9.845 0 0 9.845 427.918 199.7858 Tm
[(24.9)-1808.8(0.2)-1594.7(26.4***)-1391.3(0.3)]TJ
-11.8914 -1.0135 TD
[(Time)-335.9(in)-330.4(sedentary)]TJ
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[(activities,)-340(hrs)]TJ
11.4019 1.0077 TD
[(4.0)-1807.8(0.4)-2095.7(5.1)-2890.4(0.5)]TJ
-12.3924 -2.0212 TD
[(CMS)-332.8(score)-7844.5(1.8)-1807.8(0.1)-2095.7(7.5***)-1390.4(0.3)]TJ
0 -1.0135 TD
[(Hematocrit,%)-6292.3(53.3)-1808.8(0.2)-1594.7(67.4***)-1391.3(0.4)]TJ
T*
[(Hemoglobin,)-333.5(g/dL)-4404.8(17.8)-1808.8(0.1)-1594.7(22.5***)-1391.3(0.1)]TJ
0 -1.0077 TD
(SpO)Tj
7.3837 0 0 6.5625 328.2519 138.3874 Tm
(2)Tj
9.845 0 0 9.845 331.9936 140.0314 Tm
[(,%)-8660.5(88.2)-1808.8(0.2)-1617.7(84***)-2118.3(0.3)]TJ
-2.1479 -1.0135 TD
[(Heart)-336.5(rate,)-332.3(beats/min)-3335.4(67.5)-1808.8(0.7)-1594.7(72.1**)-1891.4(1.0)]TJ
T*
[(Serum)-335.4(iron,)]TJ
/F11 1 Tf
5.1424 0 TD
(l)Tj
/F4 1 Tf
.5528 0 TD
[(g/dL)-3800.2(111.3)-1809.8(3.5)-1093.7(105.6)-2892.4(5.5)]TJ
-5.6952 -1.0077 TD
[(Serum)-335.4(ferritin,)-335.5(ng/dL)-2672.5(168.1)-1314.5(16.0)-1088.9(125.4**)-1391.4(13.7)]TJ
0 -1.0135 TD
[(Serum)-335.4(transferrin,)-333.5(mg/dL)-1009.4(303.1)-1809.8(5.4)-1093.7(308.6)-2892.4(7.1)]TJ
8.7511 0 0 8.7511 318.7841 81.8078 Tm
(**)Tj
/F5 1 Tf
1.0041 0 TD
(p)Tj
/F6 1 Tf
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(<)Tj
/F4 1 Tf
.7191 0 TD
[(0.01)-336(versus)-332.9(HH.)]TJ
-2.384 -1.0236 TD
(***)Tj
/F5 1 Tf
1.503 0 TD
(p)Tj
/F6 1 Tf
.6673 0 TD
(<)Tj
/F4 1 Tf
.7126 0 TD
[(0.001)-334.9(versus)-332.9(HH.)]TJ
-2.8829 -1.0236 TD
[(BMI,)-444.4(body)-442.3(mass)-437.9(index;)-445.1(CMS,)-439.2(chronic)-438.5(mountain)-440.4(sickness;)-444.5(EE,)]TJ
-.907 -1.0236 TD
[(excessive)-572.8(erythrocytosis;)-569.7(HH,)-568.5(healthy)-574.7(highlanders;)-564.6(SpO)]TJ
6.5633 0 0 5.8334 521.0077 53.4614 Tm
(2)Tj
8.7511 0 0 8.7511 524.2393 54.9354 Tm
[(,)-572.7(pulse)]TJ
-24.3846 -1.0236 TD
[(oxygen)-331.1(saturation.)]TJ
/F3 1 Tf
8.9663 0 0 8.9663 59.7543 749.7069 Tm
[(EXCESSIVE)-339.5(ERYTHROCYTOSIS)-337.9(AND)-337.2(CVR)-332.3(IN)-335.1(ANDEANS)-26218.4(223)]TJ
ET
endstream
endobj
56 0 obj
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/GS1 gs
BT
/F4 1 Tf
9.843 0 0 9.843 62.022 491.0172 Tm
0 0 0 rg
0 Tc
0 Tw
[(89.8)-168(mg/mL,)]TJ
/F5 1 Tf
5.5408 0 TD
(p)Tj
/F6 1 Tf
.6681 0 TD
(=)Tj
/F4 1 Tf
.7142 0 TD
[(0.019\),)-415.5(while)-416.7(serum)-416.6(insulin)-416.8(concentration)]TJ
-6.9232 -1.1116 TD
[(was)-339.2(similar)-338.6(\(9.5)-335(vs.)-339.5(7.5)]TJ
/F11 1 Tf
9.8261 0 TD
(l)Tj
/F4 1 Tf
.5529 0 TD
[(IU/mL\).)-336(Adjusted)-339.2(multivariate)-341.1(re-)]TJ
-10.379 -1.1116 TD
[(gression)-389.8(showed)-388.6(that)-386(the)-390.5(odds)-384.3(of)-388.1(developing)-388(insulin)-388(resis-)]TJ
0 -1.1174 TD
[(tance)-527.5(in)-520.7(participants)-523.9(with)-523.9(EE)-523(were)-525.9(2.64)-525.1(times)-520.6(the)-523(odds)]TJ
0 -1.1116 TD
[(observed)-298.9(in)-301.8(HH)-297.7(\(Table)-298.2(4\).)-299.3(In)-295.9(addition,)-301.8(participants)-299.2(with)-299.3(EE)]TJ
T*
[(showed)-400.1(a)-393.9(greater)-397.2(area)-399.5(under)-392.5(the)-396.2(curve)-399.5(in)-394(the)-396.3(oral)-397.3(glucose)]TJ
T*
[(tolerance)-285.5(test)-282.1(revealing)-284.3(poor)-280.8(glyce)-8(mic)-282.3(management)-283.2(in)-278.8(these)]TJ
0 -1.1174 TD
[(subjects)-316.3(compared)-313(with)-310.8(HH)-315(\()]TJ
/F5 1 Tf
12.153 0 TD
(p)Tj
/F6 1 Tf
.6624 0 TD
(=)Tj
/F4 1 Tf
.72 0 TD
[(0.019\).)-311.8(Finally,)-312(fasting)-314.2(se-)]TJ
-13.5353 -1.1116 TD
[(rum)-206.1(triglycerides)-208.1(were)-203.4(higher)-209.5(in)-203.9(the)-200.4(EE)-206.2(group)-207.1(compared)-203.6(with)]TJ
T*
[(HH)-205.5(\()]TJ
/F5 1 Tf
2.1426 0 TD
(p)Tj
/F6 1 Tf
.6681 0 TD
(=)Tj
/F4 1 Tf
.7142 0 TD
[(0.012\),)-208.2(although)-206.1(no)-203.8(difference)-205.8(between)-208(these)-209.4(groups)]TJ
-3.5249 -1.1174 TD
[(was)-431.4(observed)-437.1(for)-429.5(fasting)-435.1(total)-433.3(serum)-428.1(chole)-8(sterol,)-431.7(HDL)-432.5(or)]TJ
0 -1.1116 TD
(LDL.)Tj
/F10 1 Tf
8.9663 0 0 8.9663 62.022 343.3889 Tm
[(Conventional)-334.3(and)-335.7(ambulatory)-335.7(blood)-330.8(pressure)]TJ
/F4 1 Tf
9.843 0 0 9.843 72 326.9479 Tm
-.0163 Tc
[(Conv)5.6(ent)5.5(i)-.2(on)5.6(al)-236.4(SBP)-236.1(a)-1.3(n)5.6(d)-236.3(DBP)-236.1(v)-.1(al)5.5(ues)-230.3(w)-1(er)5.7(e)-237.4(h)-.1(ig)5.6(her)-230.5(i)-.2(n)-236.3(t)-.3(h)5.6(e)-237.4(gr)5.7(oup)]TJ
-1.0137 -1.1116 TD
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[(wi)6.2(th)-304.7(EE)-305.9(com)5.1(p).6(a)5.2(r).6(ed)-304.7(wi)6.2(th)-304.7(HH.)-307(A)5.5(B)-.4(PM)-305.6(m)5.1(eas)6.5(ure)5.2(men)6.3(ts)-304.5(sho)6.3(w)-311.3(t)6.2(h).6(at)]TJ
T*
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[(aw)5.3(ake)-455.8(S)6.3(BP,)-451.2(D)-.5(B)5.1(P).5(,)-457(a)5(nd)-454.6(m)4.9(e)-.8(a)5(n)-454.6(art)6(e)-.8(ri)6(al)-454.8(pr)6.2(ess)6.3(ure)-455.8(\()-80.2(M)-.5(A)5.3(P).5(\))-454.6(w)5.3(ere)]TJ
0 -1.1174 TD
-.0161 Tc
[(sig)5.8(n).1(i)6(cantl)5.7(y)-305.2(h)5.8(i)0(gh)5.8(er)-299.4(in)-299.4(th)5.8(e)-300.6(E)-1.1(E)-300.6(gro)5.8(up)5.8(.)-301.8(I).1(n)-299.4(c)-1.1(o)5.8(n).1(tr)5.9(ast,)-296(dur)5.9(ing)-299.4(s).3(l)5.7(eep)5.8(,)]TJ
0 -1.1116 TD
-.0165 Tc
[(on)5.4(ly)-455.3(DBP)-449.4(w)-1.2(as)-449.4(sig)5.4(n)-.3(i)5.6(can)5.4(tly)-449.6(hig)5.4(h)-.3(er)-449.5(in)-449.6(hig)5.4(h)-.3(landers)-455.1(with)-449.6(EE.)]TJ
T*
[(Co)5.5(nventi)5.4(onal)-328.7(a)-1.4(nd)-328.5(ABPM)-329.4(v)5.5(a)-1.4(l)5.4(u)-.2(es)-328.3(of)-328.5(s)5.7(ea-)5.6(lev)5.5(e)-1.4(l)-328.7(\()-.2(S)5.7(L)-1.4(\))-328.5(i)-.3(n)5.5(h)-.2(ab)5.5(itants)]TJ
T*
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[(ar)5.3(e)-399.1(s)-.3(h)5.2(o)-.5(wn)-397.9(fo)5.2(r)-397.9(c)4.1(ompar)5.3(i)-.6(so)5.2(n.)-394.5(In)-392.2(ag)5.2(reement)-398.1(w)4.4(ith)-392.2(dayti)5.1(m)-1.7(e)-393.3(m)4(ea-)]TJ
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[(sur)5.7(e)-1.3(ment)5.5(s,)-238.6(2)5.6(4)-167.1(h)-236.3(S)0(BP,)-232.8(D)-1(BP)5.8(,)-238.6(a)4.5(nd)-236.3(MAP)-236.1(w)-1(er)5.7(e)-237.4(s).1(ig)5.6(ni)5.8(can)5.6(tly)-230.5(hig)5.6(h)-.1(er)]TJ
0 -1.1116 TD
[(in)-501.2(EE)-502.4(particip)5.6(ant)5.5(s)-506.8(\(Tabl)5.5(e)-508.1(5)5.6(\))-.1(.)-503.5(M)-1(o)5.6(r)-.1(eo)5.6(ver)5.7(,)-503.5(log)5.6(i)-.2(st)5.5(ic)-508.1(r)5.7(e)-1.3(gr)5.7(ess)5.8(i)-.2(on)]TJ
T*
-.0168 Tc
[(an)5.1(aly)5.1(s)-.4(is)-248.1(sh)5.1(owed)-248.3(that)-248.4(th)5.1(e)-249.4(odd)5.1(s)-248.1(o)-.6(f)-248.3(presen)5.1(tin)5.1(g)-248.3(a)-1.8(wake)-249.4(s)5.3(y)-.6(sto)5.1(lic)-249.4(and)]TJ
0 -1.1174 TD
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[(di)5.4(ast)5.4(o)-.2(li)5.4(c)-323.9(hyp)5.5(ert)5.4(e)-1.4(ns)5.7(ion)-322.8(m)4.3(eas)5.7(ured)-322.8(b)-.2(y)-322.8(A)-1.1(BPM)-323.7(w)4.7(ere)-323.9(s)5.7(ubst)5.4(a)-1.4(n)5.5(t)-.3(ially)]TJ
0 -1.1116 TD
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[(hi)4.9(gher)-392.3(i)-.8(n)-392.4(t)-.8(he)-393.5(EE)-393.6(gr)5.1(oup)-392.4(comp)5(ared)-392.4(to)-392.4(HH,)-394.7(a)3.9(dju)5(s)-.5(ted)-392.4(f)5.1(or)-392.3(ov)5(er-)]TJ
T*
[(weigh)5(t)-306.1(and)-306(o)5(bes)5.2(ity)5(,)-302.6(a)-1.9(ge,)-302.6(a)-1.9(nd)-300.2(SpO)]TJ
7.3823 0 0 6.5614 192.1322 193.833 Tm
0 Tc
(2)Tj
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-.0167 Tc
[(\(Tabl)5.1(e)-306.9(4\))5.3(.)-302.4(A)-1.4(dd)5.2(iti)5.1(onal)-305.9(m)4(ul-)]TJ
-13.8809 -1.1174 TD
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[(ti)6(var)6.2(i).3(at)6(e)-323.3(r)6.2(egr)6.2(e)-.8(ssi)6(on)-316.4(ana)5(l).3(y)6.1(s).6(is)-316.2(of)-316.4(a)-323.3(r)6.2(ela)5(tio)6.1(nsh)6.1(i).3(p)-322.2(b)6.1(et)6(wee)5(n)-322.2(E)5(E)-317.6(and)]TJ
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[(BP)-282.4(variabil)5.3(ity)-282.5(as)-288.1(a)-283.7(p)5.4(red)5.4(i)-.4(ct)5.3(or)-282.5(of)-282.5(CVR)-283.6(c)-1.5(ou)5.4(ld)-282.5(not)-282.7(d)5.4(e)-1.5(tect)-282.7(an)-282.5(as)5.6(so-)]TJ
T*
-.0156 Tc
[(ci)6.2(ati)6.2(o).6(n)-275.9(b).6(e)5.2(t).5(we)5.2(en)-275.9(th)6.3(ese)-277(p).6(a)5.2(r).6(a)5.2(met)6.2(ers)-275.7(i).5(n)-275.9(o)6.3(ur)-275.9(stu)6.3(d).6(y)-275.9(s).8(a)5.2(m)-.6(pl)6.2(e.)-278.2(F)6.5(i).5(na)5.2(lly)6.3(,)]TJ
T*
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[(we)-306.4(s)5.9(how)-306.1(an)-305.3(ad)5.7(dit)5.6(i)-.1(on)5.7(al)-305.4(co)5.7(mp)5.7(ari)5.6(s).2(on)-305.3(of)-305.3(t)5.6(h)0(e)-306.4(s).2(t)5.6(udy)-299.5(gro)5.7(ups)-305.1(with)-305.3(a)]TJ
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[(sampl)5.1(e)-318.5(o)5.2(f)-317.3(SL)-312.7(ind)5.2(i)-.6(vi)5.1(duals.)-313.9(T)4.1(his)-311.3(c)-1.7(omparis)5.4(o)-.5(n)-317.3(a)4.1(llo)5.2(ws)-317.1(f)5.3(o)-.5(r)-317.3(t)5.1(he)-312.7(ob-)]TJ
25.504 35.595 TD
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[(serv)6.3(ati)6.2(o).6(n)-229.8(o)6.3(f)-229.8(a)-231(g)6.3(r).6(ad)6.3(ien)6.3(t)-229.9(of)-224(BP)-229.6(v)6.3(a)-.6(lu)6.3(es,)-226.4(i).4(n)-229.8(w)5.5(hi)6.2(ch)-229.8(h)6.3(i).4(gh)6.3(er)-229.8(va)5.2(lu)6.3(es)-229.6(ar)6.4(e)]TJ
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T*
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[(and)-276.2().4(n)6(a)-.9(ll)5.9(y)-281.9(t)5.9(he)-277.3(low)5.2(e)-.9(st)-276.3(v)6(a)-.9(lu)6(es)-276(are)-277.3(f).3(o)6(und)-276.2(in)-276.2(HH)5.2(.)]TJ
/F3 1 Tf
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0 Tc
(Discussion)Tj
/F10 1 Tf
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[(EE)-337.3(and)-335.7(CVR)]TJ
/F4 1 Tf
9.843 0 0 9.843 323.0361 413.518 Tm
[(This)-305(is)-301.6(the)-304.1(rst)-303.6(study)-299.2(to)-301.8(show)-304.6(an)-302.9(association)-309.4(between)-305.9(the)]TJ
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[(presence)-347.3(of)-336.2(EE)-338.7(and)-338.5(the)-344.4(estimated)-343.1(risk)-338.4(of)-336.2(developing)-341.9(a)-342.1(car-)]TJ
T*
[(diovas)-7.7(cular)-232.6(event)-238.4(in)-238.5(the)-235(next)-236.1(10)-238.3(years.)-235.7(Our)-234.5(results)-239.1(show)-235.5(that,)]TJ
0 -1.1174 TD
[(compared)-226.6(to)-215.4(healthy)-223.4(HA)-217(residents,)-222.9(participants)-224.4(with)-218.6(EE)-223.5(have)]TJ
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[(more)-191.1(than)-190(three)-186.5(times)-186.5(the)-188.9(odds)-188.5(of)-186.5(being)-191.1(at)-187.8(high)-183.1(\()]TJ
/F6 1 Tf
18.8688 0 TD
(>)Tj
/F4 1 Tf
.5529 0 TD
[(20%\))-189.8(risk)-182.9(of)]TJ
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T*
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T*
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T*
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T*
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T*
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T*
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T*
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T*
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T*
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[(et)-281.6(al.,)-278(20)-15.4(1)11.2(4\).)]TJ
1.0137 -1.1116 TD
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[(Rim)-6.7(o).3(ld)-5.5(i)-431.8(e)-6.6(t)-431.8(a)-.9(l)-5.6(.)-434(eva)-6.6(l).2(u)-5.5(a)-.9(te)-6.6(d)-431.7(t)-5.6(he)-432.9(e)-6.6(f).3(f)-5.4(ect)-437.6(of)-437.4(oxy)-5.5(ge)-6.6(nat)-5.6(i).2(o)-5.5(n)-431.7(on)]TJ
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T*
[(la)-6.5(nde)-6.5(rs)-5.2(,)-422.4(b)-5.4(ut)-426(i)-5.5(t)-426(di)-5.5(d)-425.8(n).4(o)-5.4(t)-426(nor)-5.3(ma)-6.5(liz)-6.5(e)-427(t).3(h)-5.4(e)-.8(s)-5.2(e)-427(par)-5.3(ame)-6.5(te)-6.5(rs)-425.6(w)-6.2(h).4(en)]TJ
0 -1.1174 TD
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0 -1.1116 TD
.013 Tc
[(su)-5.4(gg)-5.4(est)-5.5(i).3(n)-5.4(g)-207(th)-5.4(at)-207.1(ot)-5.5(her)-206.9(m)-6.6(ech)-5.4(an)-5.4(is)-5.2(ms)-206.8(in)-207(a)-6.5(ddi)-5.5(ti)-5.5(on)-207(to)-207(h)-5.4(y).4(p)-5.4(oxe)-6.5(mi)-5.5(a)]TJ
T*
.017 Tc
[(mi)4.3(gh)4.4(t)-272.2(b)-1.4(e)-273.2(i)4.3(nv)4.4(ol)4.3(ved)-272.1(i)-1.5(n)-272.1(t)4.3(he)-273.2(o)4.4(b)-1.4(s)4.6(e)3.2(rv)4.4(ed)-272.1(v)4.4(a)-2.5(s)4.6(c)-2.5(u)4.4(l)-1.5(ar)-272.1(damag)4.4(e)-273.2(and)-272.1(i)4.2(n)]TJ
0 -1.1174 TD
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[(ex)-5.4(pla)-6.5(i).3(n)-5.4(i).3(n)-5.4(g)-460.4(it)-5.5(s)-460.2(e)-6.5(ff)-5.3(ect)-5.5(s)-460.2(o)-5.4(n)-460.4(t)-5.5(he)-467.3(car)-5.3(di)-5.5(ov)-5.4(asc)-6.5(u).4(l)-5.5(a)-.8(r)-466.1(s).6(ys)-5.2(te)-6.5(m)-461.6(\()-5.3(Ri-)]TJ
0 -1.1116 TD
.0127 Tc
[(mol)-5.8(d).1(i)-351.4(e)-6.8(t)-351.4(a)-1.1(l)-5.8(.)-2.2(,)-347.8(2)-5.7(012)-5.7(\).)-353.6(In)-351.3(o)-5.7(u).1(r)-351.2(s)-5.5(tu)-5.7(dy)-5.7(,)-347.8(w)-6.5(e)-352.4(f).1(o)-5.7(und)-351.3(t)-5.8(h).1(a)-6.8(t)-351.4(th)-5.7(e)-352.4(a)-1.1(ss)-5.5(o-)]TJ
T*
.0144 Tc
[(ciation)-257.4(b)-4(etwee)-5.1(n)-257.4(EE)-258.6(a)-5.1(n)1.8(d)-257.4(C).8(V)-4.8(R).8(,)-259.7(a).6(nd)-257.4(the)-258.6(a).6(ssoc)-5.1(ia)-5.1(tion)-257.4(be)-5.1(tw)-4.8(een)]TJ
0 -1.1174 TD
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[(EE)-441.8(and)-440.6(C)1.9(V)-3.7(R)-435.9(fac)-4(t)2.8(ors)-440.4(p)2.9(ersisted)-440.6(after)-440.6(a)1.7(djusting)-434.8(for)-440.6(S)3(pO)]TJ
7.3823 0 0 6.5614 543.6282 76.9323 Tm
0 Tc
(2)Tj
9.843 0 0 9.843 547.4833 78.5197 Tm
(,)Tj
-24.041 -1.1116 TD
.0128 Tc
[(su)-5.6(pp)-5.6(ort)-5.7(in)-5.6(g)-449.1(t)-5.7(he)-456(hyp)-5.6(ot)-5.7(he)-6.7(si)-5.7(s)-448.9(o)-5.6(f)-449(a)-6.7(ddi)-5.7(ti)-5.7(on)-5.6(al)-449.2(m)-6.8(e)-1(c)-6.7(h).2(an)-5.6(is)-5.4(ms)-454.6(be-)]TJ
T*
[(si)-5.7(de)-6.7(s)-351(h).2(y)-5.6(pox)-5.6(emi)-5.7(a)-352.3(c)-1(o)-5.6(n).2(t)-5.7(r).2(i)-5.7(but)-5.7(in)-5.6(g)-351.2(t).1(o)-351.2(t)-5.7(he)-352.3(r)-5.5(e)-1(la)-6.7(ti)-5.7(on)-5.6(sh)-5.6(ip)-351.2(be)-6.7(tw)-6.4(een)]TJ
T*
[(th)-5.6(es)-5.4(e)-283.2(c)-1(on)-5.6(di)-5.7(ti)-5.7(ons)-5.4(.)]TJ
ET
q
312.93 0 0 190.488 148.592 541.757 cm
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Q
BT
/F7 1 Tf
9.845 0 0 9.845 59.7543 524.9762 Tm
0 Tc
[(FIG.)-405.8(1.)]TJ
/F4 1 Tf
4.1865 0 TD
[(Proposed)-400.3(mechanisms)-407.2(for)-400.3(the)-401.7(association)-406.2(between)-403(excessive)-405(erythrocytosis)-402.2(and)-401.5(CVR.)-406.5(EE)-401.7(and)-401.5(chronic)-401(severe)]TJ
-4.1865 -1.0077 TD
[(hypoxemia,)-361.5(characteristics)-362(of)-353.3(CMS,)-353.5(could)-357.6(contribute)-358.3(to)-353.4(increased)-359.1(CVR)-357.1(through)-358.4(their)-352(effects)-361.7(on)-353.3(endothelial)-360.6(and)-355.4(vascular)]TJ
0 -1.0135 TD
[(function,)-421.7(oxidative/nitrosative)-418.3(stress,)-419(inammation,)-416.6(and)-418.8(alteration)-417.2(of)-416.6(autonomic)-421.6(function.)-415.9(These)-417.2(effects)-419.3(are)-419.9(reected)-421.5(in)]TJ
T*
[(increased)-445.5(BP,)-438.1(altered)-442.7(glucose)-441.2(management,)-446.6(and)-436(increased)-445.5(serum)-439(lipid)-437.4(levels.)-443.7(CMS,)-439.9(chronic)-441.3(mountain)-442.5(sickness;)-443(CVR,)]TJ
T*
[(cardiovascular)-342.4(risk;)-333.4(EE,)-335.9(excessive)-335.9(erythrocytosis.)]TJ
/F3 1 Tf
8.9663 0 0 8.9663 59.7543 749.7069 Tm
[(EXCESSIVE)-339.5(ERYTHROCYTOSIS)-337.9(AND)-337.2(CVR)-332.3(IN)-335.1(ANDEANS)-26218.4(227)]TJ
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