In the 90s before the 50% limit for hematocrit was put in place guys would use as much epo as they could. It was referred to as “blood to mud” and there were several Belgian cyclists who died in their sleep of heart attacks since their blood was too thick for their heart to pump. After a crash, Pantani was taken to hospital and his hematocrit was allegedly 64.
To prevent these heart attacks at night, riders would wear a hrm with an alarm. If their pulse got too low they would get out of bed and run in place a bid to get things moving again. The 50 limit was put in place to prevent this, since there was no episode test before 2000.

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