Hematocrit and risk of coronary heart disease: the Puerto Rico Heart Health Program

Sorlie, Paul D.; García-Palmieri, Mario R.; Costas, R; Havlik, Richard J.

doi:10.1016/0002-8703(81)90136-8

Cited by 141 publications

(79 citation statements)

References 15 publications

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“…Specifically, both studies found an increased mortality risk associated with anemia and a reverse J-shaped relationship between hemoglobin and survival. Although U-shaped or J-shaped relationships between hematocrit and mortality have been reported in other community-based studies, including the Framingham Heart Study, 30 the Puerto Rico Health Program, 31 and the Honolulu Heart Study, 32 these studies are limited by the exclusion of females 31,32 and a relative paucity of older adults. [30][31][32] The interrelations described herein with respect to kidney function, anemia, and mortality are also novel.…”

Section: Discussionmentioning

confidence: 97%

“…Although U-shaped or J-shaped relationships between hematocrit and mortality have been reported in other community-based studies, including the Framingham Heart Study, 30 the Puerto Rico Health Program, 31 and the Honolulu Heart Study, 32 these studies are limited by the exclusion of females 31,32 and a relative paucity of older adults. [30][31][32] The interrelations described herein with respect to kidney function, anemia, and mortality are also novel. Consistent with prior reports, 26,33,34 subjects at greatest risk for death had both anemia and advanced CKD.…”

Section: Discussionmentioning

confidence: 97%

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Impact of anemia on hospitalization and mortality in older adults

Culleton

Manns

Zhang

et al. 2006

Blood

388

265

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Although anemia is common in older adults, its prognostic significance is uncertain. A total of 17 030 communitydwelling subjects 66 years and older were identified between July 1 and December 31, 2001, and followed until December 31, 2004. Cox proportional hazards analyses were performed to determine the associations between anemia (defined as hemoglobin < 110 g/L) and hemoglobin and all-cause mortality, all-cause hospitalization, and cardiovascular-specific hospitalization.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Impact of anemia on hospitalization and mortality in older adults

Culleton

Manns

Zhang

et al. 2006

Blood

388

265

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“…This effect is likely to be, in part, attributable to favourable effects on serum lipids and haemostatic factors [3,5,13]. Haematocrit, which is an independent risk factor for vascular disease [14][15][16][17] perhaps by influencing blood viscosity [18] and erythrocyte-mediated platelet adhesion [19], has not been assessed in previous studies of the response of cardiovascular risk factors to tamoxifen. Our data demonstrate that tamoxifen prevents the age-related increase in haematocrit which occurs in postmenopausal women [17], and which was observed in the placebotreated women in the current study.…”

Section: Discussionmentioning

confidence: 99%

The anti‐oestrogen tamoxifen produces haemodilution in normal postmenopausal women

Grey

Evans

Kyle

et al. 1997

Journal of Internal Medicine

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Abstract. Grey AB, Evans MC, Kyle C, Reid, IR (University of Auckland, Auckland, New Zealand). The anti-oestrogen tamoxifen produces haemodilution in normal postmenopausal women. J Intern Med 1997; 242: 383-8. Objectives.To report the effects of the anti-oestrogen tamoxifen on biochemical and haematological parameters. Design. Randomized, double-blind comparison of tamoxifen 20 mg per day and placebo, over two years. Setting. A university hospital. Subjects. Forty-six healthy late-postmenopausal women (mean, SD time since menopause; 11, seven years). Main outcome measures. Blood specimens were drawn in the fasting state at baseline, six months and two years for measurement of haemoglobin, haematocrit, erythrocyte mean cell volume, mean erythrocyte haemoglobin, leucocyte count, platelet count, urea, electrolytes, creatinine and albumin.Results. There was a significant decline in the haemoglobin concentration in the tamoxifen group (Ϫ4.4, 1.2 g/L; mean, SE) and its levels were lower in this group than in those receiving placebo (P ϭ 0.004). Similarly, haematocrit, erythrocyte count and total leucocyte count were lower in those on placebo (P ϭ 0.002, P ϭ 0.01 and P ϭ 0.01, respectively) and platelet count showed a similar trend (P ϭ 0.08). In the tamoxifen group, the level of serum albumin fell significantly (Ϫ2.2, 0.4 g/L) and was lower throughout the study than that in the placebo group (P ϭ 0.006). That of serum urea tended to fall (Ϫ0.4, 0.2 mmol L) but the between-groups comparison was not significant (P ϭ 0.18). Conclusions. These data suggest that tamoxifen exerts a haemodilutory effect in normal postmenopausal women. Since a similar effect has been reported in response to postmenopausal oestrogen therapy, it is likely that the observed changes represent another oestrogenic effect of tamoxifen in postmenopausal women. Haemodilution may contribute to the reduced incidence of cardiovascular disease reported in tamoxifen-treated women, and, therefore, its assessment in the new oestrogen agonists/antagonists being developed for cardiovascular disease prevention may be important.

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“…However, anaemia with a haematocrit of ,30% was not noticed in the present study. Conversely, erythrocytosis is related to cardiovascular disease, especially myocardial infarction, independent of other risk factors such as smoking [31,32]. Thus, it is conceivable, albeit speculative, that adjunctive AT 1 receptor blockade in a small-but-well-defined subgroup of COPD patients reduces cardiovascular morbidity by reducing erythrocytosis.…”

Section: Haematocritmentioning

confidence: 99%

Angiotensin II blockers in obstructive pulmonary disease: a randomised controlled trial

Andreas¹,

Herrmann‐Lingen²,

Raupach³

et al. 2006

Eur Respir J

100

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In chronic obstructive pulmonary disease (COPD), the sympathetic nervous system, as well as the renin-angiotensin system, is activated with possible negative systemic effects on skeletal muscles. Angiotensin II type-1 receptor blockers inhibit the sympathetic and reninangiotensin systems and might improve skeletal and respiratory muscle strength in patients in whom these systems are activated.The effects of the angiotensin receptor blocker irbesartan given over 4 months was evaluated in 60 patients with COPD and a forced expiratory volume in one second of ,50% of the predicted value and without obvious cardiovascular disease that would necessitate the administration of an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker.Irbesartan was well tolerated, but did not exert a significant effect on the primary end-point maximum inspiratory pressure. Spirometric results were not affected, but total lung capacity was reduced. Irbesartan led to a significant decrease in haematocrit (46.4¡3.6 to 43.9¡4.3% versus 47.5¡2.4 to 48.7¡3.0% with placebo).In conclusion, respiratory muscle strength in chronic obstructive pulmonary disease patients was not influenced by angiotensin II receptor blockade. However, the changes in haematocrit and total lung capacity following irbesartan raise the possibility that well-known cardiovascular drugs can produce unanticipated beneficial effects in chronic obstructive pulmonary disease patients.

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Hematocrit and risk of coronary heart disease: the Puerto Rico Heart Health Program

Cited by 141 publications

References 15 publications

Impact of anemia on hospitalization and mortality in older adults

Impact of anemia on hospitalization and mortality in older adults

The anti‐oestrogen tamoxifen produces haemodilution in normal postmenopausal women

Angiotensin II blockers in obstructive pulmonary disease: a randomised controlled trial

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