Does sticky blood predict a sticky end? Associations of blood viscosity, haematocrit and fibrinogen with mortality in the West of Scotland

Woodward, Mark; Rumley, Ann; Tunstall‐Pedoe, Hugh; Lowe, G. D. O.

doi:10.1046/j.1365-2141.2003.04475.x

Cited by 45 publications

(40 citation statements)

References 24 publications

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“…Numerous studies have documented increased rates of stroke and MI in individuals with elevated blood viscosity (9 -13). Because multiple traditional cardiovascular risk factors such as age, male sex, obesity, hypertension, diabetes, and smoking are all associated with increased viscosity, the correlation between viscosity and atherothrombotic events decreases after adjustment for these risk factors (9,14). However, there may be an additional, independent increase in risk for such events associated with high blood viscosity itself (12,13,15).…”

Section: Introductionmentioning

confidence: 99%

“…Yet, a relationship seems likely because the products of chronic inflammation are some of the major determinants of WBV. Elevations in interleukin-6, a cytokine characteristic of SLE (23)(24)(25), are associated with higher blood viscosity in the general population and are thought to drive the hepatic production of acute-phase reactants (9,26,27). Several small studies have found that patients with SLE have elevated plasma or blood viscosity compared with healthy controls (28 -30).…”

Section: Introductionmentioning

confidence: 99%

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Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus

Booth¹,

Chohan²,

Curran³

et al. 2007

Arthritis & Rheumatism

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Objective. To determine if whole blood viscosity (WBV), a rheologic variable contributing to risk of myocardial infarction and stroke in the general population, is elevated in patients with systemic lupus erythematosus (SLE), particularly SLE patients with a history of thrombotic or atherothrombotic events. Because the high rates of arterial and venous thrombosis in lupus cannot be explained by traditional risk factors, elevated WBV may be an easily measurable nontraditional risk factor to identify SLE patients at high risk for thrombotic events. Methods. Sixty SLE patients (30 with a history of a thrombotic event) and 20 matched controls were recruited into the study. The thrombosis group was further subdivided into an arterial thrombosis group (n ‫؍‬ 17). WBV values were determined at 9 different shear rates (1, 2, 5, 10, 50, 100, 150, 300, and 1,000 seconds ؊1 ). WBV was then compared between groups by repeated-measures analysis of variance. Results. SLE patients with a history of arterial events had significantly elevated WBV relative to either controls (P ‫؍‬ 0.022) or SLE patients without arterial events (P ‫؍‬ 0.014). WBV in the total SLE group did not differ from controls. Differences in WBV were most prominent at lower shear rates (1, 2, 5, 10, 50, and 100 seconds ؊1 ). Anticoagulation, prednisone dose, and antiphospholipid antibodies did not significantly impact WBV. Conclusion. Our study demonstrated that WBV is selectively elevated in patients with SLE with a history of arterial events. Although this association is striking, longitudinal studies are needed to assess the positive predictive value of WBV for atherothrombotic events in SLE.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus

Booth¹,

Chohan²,

Curran³

et al. 2007

Arthritis & Rheumatism

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“…In epidemiologic studies, higher Ht levels are associated with an increased risk of hypertension, cardiovascular events and stroke than lower Ht values (6, 7). As Ht levels increase from low to normal levels, plasma viscosity and tissue blood fl ow increase along with an increase in tissue oxygen delivery (8)(9)(10)(11). However, as hematocrit levels rise further, plasma viscosity increases disproportionately, and at some level of hematocrit, tissue blood fl ow and oxygen delivery begin to decline (8)(9)(10)(11).…”

Section: Discussionmentioning

confidence: 99%

“…As Ht levels increase from low to normal levels, plasma viscosity and tissue blood fl ow increase along with an increase in tissue oxygen delivery (8)(9)(10)(11). However, as hematocrit levels rise further, plasma viscosity increases disproportionately, and at some level of hematocrit, tissue blood fl ow and oxygen delivery begin to decline (8)(9)(10)(11). The Endocrine Society's expert panel recommends that testosterone administration should be withheld in men, whose hematocrit rises above 54 % during testosterone therapy.…”

Section: Discussionmentioning

confidence: 99%

Testosterone replacement therapy (TRT) and its effect on bone marrow. How serious is it and is there a true polyglobulia?

Levcikova¹,

Breza²,

Luha³

et al. 2017

BLL

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INTRODUCTION: TRT in men with testosterone defi ciency syndrome (TDS) had multiple positive effects and restore a quality of life of affected men. Polyglobulia is the most common dose-limiting adverse effect of TRT, but the mechanisms of TRT-mediated erythropoesis remain unclear. In this study, we evaluated long term haematological side effects of TRT: polyglobulia, elevated hemoglobin (Hb) and haematocrit (Ht). METHODS: In a cross-sectional descriptive study, the authors treated 69 men with TDS and the average age 59 years and the follow-up period 81.32 months. The men were treated with three-month i.m. injections of 1000 mg testosterone undecanoate. The elevated values were: Hb above 176 g/l, Ht above 0.52 and erythrocytes (Ery) above 6.0 mil/mcl. RESULTS: 21 out of 69 patients (30.43 %) had an increased Hb, Ht or Ery during treatment. The interesting fact was that only fi ve men (7.24 %) had increased the number of Ery (true polyglobulia). No men with elevated level of Hb, Ht or Ery had other side effects (like thrombosis). CONCLUSION: It is still not clear, why in some men on TRT the feedback does not work and bone marrow production of red blood cells continues even if the upper limit is reached. Authors expect that only 7% of men had true polyglobulia, other men had elevated Hb or Ht. Based on our own experience we recommend a regular check of men on TRT on order to avoid possible serious side-effects (Tab. 1, Fig. 2

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“…7,[15][16][17][18] However, in some studies, after adjustment for multiple risk factors, Hct failed to significantly predict all-cause or CVD mortality events. 15,17 We show a nonlinear relationship between Hct and mortality in our hypertensive cohort, and this is consistent with several other reports of nonlinear relationships between Hct and mortality outcomes in more general populations. 6,8 Furthermore, we show that men and women also show differences in causes of Hct-related mortality.…”

Section: Discussionmentioning

confidence: 99%

Hematocrit Predicts Long-Term Mortality in a Nonlinear and Sex-Specific Manner in Hypertensive Adults

et al. 2012

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Hematocrit has been inconsistently reported to be a risk marker of cardiovascular morbidity and mortality. The Glasgow Blood Pressure Clinic Study cohort included 10951 hypertensive patients, who had hematocrit measured at their initial clinic visit and followed for ≤35 years. Cox proportional hazards models were used to estimate hazard ratios for all-cause, cardiovascular, ischemic heart disease, stroke, and noncardiovascular mortality. There were 3484 deaths over a follow-up period of 173245 person-years. Hematocrit was higher in men (median, 0.44; interquartile range, 0.42–0.47) than in women (median, 0.41; interquartile range, 0.38–0.43). The lowest risk for all-cause mortality was seen in quartile 2 for men (range, 0.421–0.440) and women (range, 0.381–0.400). Compared with quartile 2, the adjusted hazard ratios for quartiles 1, 3, and 4 were, respectively, 1.11 (range, 0.97–1.28), 1.19 (range, 1.04–1.37), and 1.22 (range, 1.06–1.39) in men and 1.17 (range, 1.01–1.36), 0.97 (range, 0.83–1.13), and 1.19 (range, 1.04–1.37) in women. Men showed a J-shaped pattern for cardiovascular mortality and a linear pattern for noncardiovascular mortality in cause-specific analysis, whereas in women a U-shaped pattern was observed for noncardiovascular mortality only. Higher baseline hematocrit was associated with higher on-treatment blood pressure during follow-up. Baseline hematocrit did not affect the time to reach target blood pressure. The increased risk of death attributed to higher hematocrit was seen in men and women irrespective of their achievement of target blood pressure, indicating that the risk is independent of the effect of hematocrit on blood pressure. Hypertensive patients with hematocrit levels outside of the sex-specific reference ranges identified in this study should be targeted for more aggressive blood pressure and cardiovascular risk reduction treatment.

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Does sticky blood predict a sticky end? Associations of blood viscosity, haematocrit and fibrinogen with mortality in the West of Scotland

Cited by 45 publications

References 24 publications

Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus

Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus

Testosterone replacement therapy (TRT) and its effect on bone marrow. How serious is it and is there a true polyglobulia?

Hematocrit Predicts Long-Term Mortality in a Nonlinear and Sex-Specific Manner in Hypertensive Adults

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