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5 Hypoxic stress at high altitude can trigger a series of physiological responses across multiple organ systems, especially the brain (increased cerebral blood flow), pulmonary system (increased ventilation and pulmonary vascular remodeling), cardiovascular system (increased heart rate, cardiac output, and systemic blood pressure), renal system (increased bicarbonate excretion and erythropoietin (EPO) secretion), and hematologic system (increased red cell mass, hemoglobin (Hb) concentration, and hematocrit (Hct)), thereby increasing oxygen content and delivery in the body