Cardiovascular Risk and Obesity in Miner Workers Exposed to Intermittent Hypobaric Hypoxia in the Peruvian Andes

Elizbet.S Montes-Madariaga¹Brando Ortiz-Saavedra¹Julio Samuel Mamani-Castillo¹Anel Ivonne Valencia-Pacheco¹Brenda Massiel Oporto-Arenas¹Jose Luis Manrique-Ccopa¹Jorge Andres Ballon-Echegaray¹Irma Luz Paz¹Ricardo David Davila-Ralaiza¹Arturo Arce-Esquivel²Oscar Jesus Moreno-Loaiza³Ricardo Alfredo Julian Leon-Vasquez^1*

• ¹Universidad Nacional de San Agustin de Arequipa, Arequipa, Peru
• ²The University of Texas at Tyler, Tyler, United States
• ³Universidade Federal do Rio de Janeiro Instituto de Biofisica Carlos Chagas Filho, Rio de Janeiro, Brazil

Background: Occupational activities such as mining and interprovincial transportation expose Peruvian workers to large altitude fluctuations, generating repeated cycles of chronic intermittent hypobaric hypoxia (CIHH). This study aimed to evaluate the effect of CIHH exposure on cardiovascular risk, obesity, sleep quality, and physical activity among male workers performing rotational shifts at high altitude. Methods: A cross-sectional study was conducted with 96 male participants aged 20–60 years, divided into two groups: those exposed to CIHH (n = 53; ≥3,000 m, alternating with <2,500 m) and controls working permanently at low altitude (<2,500 m; n = 43). Anthropometric and body composition parameters were assessed by bioelectrical impedance, and cardiovascular risk was estimated using the Reynolds and Framingham Risk Scores. Sleep apnea risk and physical activity were evaluated using the STOP-Bang and IPAQ-SF questionnaires, respectively. Biochemical and hematological profiles were also analyzed. Results: Obesity prevalence was significantly higher in the CIHH group (80%) compared with controls (20%) (p = 0.036; PR = 1.58, 95% CI: 1.12–2.24). Despite this, body fat (56.8% vs. 43.2%, p = 0.5), skeletal muscle (55.2% vs. 44.8%, p = 0.9), and visceral fat (57.8% vs. 51.0%, p = 0.5) did not differ significantly. Hematocrit levels were higher in CIHH workers (median 52.3%) than controls (50.7%) (p = 0.03), indicating mild erythropoietic adaptation. No significant between-group differences were This is a provisional file, not the final typeset article found in lipid profile, glucose, insulin, hs-CRP, IL-6, physical activity, or OSA risk (all p > 0.05). Estimated cardiovascular risk remained low and comparable between groups. Conclusions: CIHH exposure was associated with higher hematocrit and a significantly greater prevalence of obesity but no adverse alterations in cardiovascular or metabolic biomarkers. These findings suggest a dual physiological response to intermittent hypoxia—erythropoietic adaptation coexisting with metabolic vulnerability—highlighting the need for preventive strategies in high-altitude occupational health.