BackgroundThe pathogenesis of vascular disease is complex and as of yet not totally understood. Conventional wisdom suggests that atherosclerotic cardiovascular disease is caused by the accumulation of lipid molecules in the arterial luminal wall. Various therapeutic modalities have been proposed; however, current treatment with cholesterol-lowering drugs has not completely solved this problem. Risk factors aiding in the development of atherosclerotic disease have been long promoted, such as genetics, dyslipidemia, hypertension, smoking, lack of adequate exercise, metabolic syndrome, and obesity. However, 50% of myocardial infarctions occur in subjects without overt hyperlipidemia, and 20% of myocardial infarctions occur in the absence of any classic risk factors [Ridker and Libby, 2011].The reason why the pathogenesis of chronic vascular diseases, including atherosclerosis, hypertension, and the metabolic syndrome, is not fully understood by the mainstream is because the role of blood viscosity has been ignored. Most physicians are aware of acute hyperviscosity syndromes as can be seen in Waldenstrom's macroglobulinemia, polycythemia vera, and leukemia, which require immediate intervention. In these conditions, blood viscosity is in the range of 60 millipoise or greater at a shear rate of 94.5/s. However, chronic lesser elevations of viscosity do occur (roughly, 50-56 millipoise at 94.5/s, normal being 37-49 millipoise at the same shear rate) [Antonova and Velcheva, 1999;Velcheva et al. 2008]. Rosenson and colleagues reported a normal value of 32.6 millipoise at a shear rate of 100/s [Rosenson et al.1996].States of chronic, lower elevations of viscosity are clinically less obvious, and left unappreciated, can ultimately shorten one's lifespan by contributing to cardiovascular disease. In the study of Antonova and Velcheva, viscosities in the range referred to here as 'chronic hyperviscosity' were associated with chronic cerebral infarctions, transient ischemic attacks, and risk factors for stroke [Antonova and Velcheva, 1999]. In Velcheva and colleagues' work, chronic hyperviscosity was associated with transient ischemic attacks and unilateral cerebral infarctions [Velcheva et al. 2008].It should be noted that the reference ranges for blood viscosity are tentative, and work remains in standardizing the reporting and measuring of blood viscosity. Hopefully, a collaboration similar to the Reference Values for Arterial Stiffness'The role of chronic hyperviscosity in vascular disease Gregory Sloop, Ralph E. Holsworth Jr, Joseph J. Weidman and John A. St Cyr Abstract: The pathogenesis of several major cardiovascular diseases, including atherosclerosis, hypertension, and the metabolic syndrome, is not widely understood because the role of blood viscosity is overlooked. Low-density lipoprotein accelerates atherosclerosis by increasing blood viscosity in areas of low flow or shear, predisposing to thrombosis. Atherosclerotic plaques are organized mural thrombi, as proposed by Duguid in the midtwentieth century. High-de...

Renewed interest in the age-old concept of "bloodletting", a therapeutic approach practiced until as recently as the 19th century, has been stimulated by the knowledge that blood loss, such as following regular donation, is associated with significant reductions in key hemorheological variables, including whole blood viscosity (WBV), plasma viscosity, hematocrit and fibrinogen. An elevated WBV appears to be both a strong predictor of cardiovascular disease and an important factor in the development of atherosclerosis. Elevated WBV through wall shear stress is the most direct physiological parameter that influences the rupture and erosion of vulnerable plaques. In addition to WBV reduction, phlebotomy may reduce an individual's cardiovascular risk through reductions in excessive iron, oxidative stress and inflammation. Reflecting these findings, blood donation in males has shown significant drops in the incidence of cardiovascular events, as well as in procedures such as percutaneous transluminal coronary angioplasty and coronary artery bypass grafting. Collectively, the available data on the benefits of therapeutic phlebotomy point to the importance of monitoring WBV as part of a cardiovascular risk factor, along with other risk-modifying measures, whenever an increased cardiovascular risk is detected. The development of a scanning capillary tube viscometer allows the measurement of WBV in a clinical setting, which can prove to be valuable in providing an early warning sign of an increased risk of cardiovascular disease.

BackgroundPrevious research has shown fluid replacement beverages ingested after exercise can affect hydration biomarkers. No specific hydration marker is universally accepted as an ideal rehydration parameter following strenuous exercise. Currently, changes in body mass are used as a parameter during post-exercise hydration. Additional parameters are needed to fully appreciate and better understand rehydration following strenuous exercise. This randomized, double-blind, parallel-arm trial assessed the effect of high-pH water on four biomarkers after exercise-induced dehydration.MethodsOne hundred healthy adults (50 M/50 F, 31 ± 6 years of age) were enrolled at a single clinical research center in Camden, NJ and completed this study with no adverse events. All individuals exercised in a warm environment (30 °C, 70% relative humidity) until their weight was reduced by a normally accepted level of 2.0 ± 0.2% due to perspiration, reflecting the effects of exercise in producing mild dehydration. Participants were randomized to rehydrate with an electrolyzed, high-pH (alkaline) water or standard water of equal volume (2% body weight) and assessed for an additional 2-h recovery period following exercise in order to assess any potential variations in measured parameters. The following biomarkers were assessed at baseline and during their recovery period: blood viscosity at high and low shear rates, plasma osmolality, bioimpedance, and body mass, as well as monitoring vital signs. Furthermore, a mixed model analysis was performed for additional validation.ResultsAfter exercise-induced dehydration, consumption of the electrolyzed, high-pH water reduced high-shear viscosity by an average of 6.30% compared to 3.36% with standard purified water (p = 0.03). Other measured biomarkers (plasma osmolality, bioimpedance, and body mass change) revealed no significant difference between the two types of water for rehydration. However, a mixed model analysis validated the effect of high-pH water on high-shear viscosity when compared to standard purified water (p = 0.0213) after controlling for covariates such as age and baseline values.ConclusionsA significant difference in whole blood viscosity was detected in this study when assessing a high-pH, electrolyte water versus an acceptable standard purified water during the recovery phase following strenuous exercise-induced dehydration.