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Whole blood viscosity at a range of shear rates (230--0.77 s-1) and plasma viscosity have been measured in 39 patients with treated primary polycythaemia (idiopathic erythrocytosis and primary proliferative polycythaemia) and 30 age-matched normal individuals. There was a wider range of plasma viscosity and whole blood viscosity values at the same haematocrit (0.46), particularly at the lower shear rates, in the 'polycythaemic' group than the normal group. Hypochromic microcytic red cell changes present in 14 patients in the 'polycythaemic' group did not have any noticeable influence on whole blood viscosity at a given haematocrit value, since plasma protein factors override any possible effect of these red cell changes. The range of observed whole blood viscosity results in the 'polycythaemic' patients at the same haematocrit (0.46) was equivalent to the effect on whole blood viscosity of a rise in haematocrit from 0.41 to 0.51. Since there is such a range of whole blood viscosity at the same haematocrit, the haematocrit alone does not necessarily give a precise assessment of the viscosity of a whole blood sample. Since there is evidence from other publications that blood flow in vitro may be critically influenced by whole blood viscosity, this lack of precision should be considered when treating patients at risk of vascular occlusive episodes.

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