This cross-sectional study, in long-term CIHH working shifts at high altitude, has the following main findings: (1) a distinctive and unique pattern of physiological responses was determined, wherein a third of subjects showed moderate AMS persistence; (2) high proportions of elevated mPAP (26.1%) and HAPH (9.2%) were found by echocardiography; and (3) specific cardiometabolic variables (high triglycerides, insulin resistance, high ADMA, increased waist perimeter and BMI) appeared to be associated factors, with insulin and ADMA clearly associated with elevated mPAP. Here, INS is linked to Insulin resistance.