Hematocrit and the risk of cardiovascular disease—The Framingham Study: A 34-year follow-up

Gagnon, David; Zhang, Tingjie; Brand, Frederick N.; Kannel, William B.

doi:10.1016/0002-8703(94)90679-3

Cited by 315 publications

(254 citation statements)

References 36 publications

Supporting

Mentioning

227

Contrasting

Unclassified

Order By: Relevance

“…Recent reports from the British Regional Heart Study (Wannamethee et al, 1994a, b) and the Framingham Study (Gagnon et al, 1994) support the general epidemiological evidence that haematocrit shows an independent association with IHD and stroke (reviewed in Lowe, 1986Lowe, , 1994.…”

Section: Discussionmentioning

confidence: 88%

Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study

et al. 1997

View full text Add to dashboard Cite

Summary.We examined the relationships of whole blood viscosity and its major determinants to incident cardiovascular events (ischaemic heart disease and stroke) in a prospective study of a random population sample of 1592 men and women aged 55-74 years (the Edinburgh Artery Study). 272 fatal and non-fatal cardiovascular events occurred during 5 years of follow-up (cumulative incidence 17 . 1%). Age and sex adjusted mean levels of blood viscosity (3 . 70 v 3 . 55 mPa.s), haematocrit (46 . 2 v 45 . 7%), haematocrit-corrected blood viscosity (3 . 57 v 3 . 48 mPa.s), plasma viscosity (1 . 35 v 1 . 33 mPa.s) and fibrinogen (2 . 88 v 2 . 67 g/l) were significantly higher in subjects who experienced events than in subjects who did not. The relationships of these rheological variables to cardiovascular events were at least as strong as those of conventional risk factors (smoking habit, diastolic blood pressure, and low-density lipoprotein cholesterol). After adjustment for these conventional risk factors, the associations of blood viscosity and haematocrit remained significant for stroke, but not for total events; whereas the associations of plasma viscosity and fibrinogen remained significant for total events and for stroke.These findings suggest that increased blood viscosity may be one plausible biological mechanism through which increases in haematocrit and fibrinogen may promote ischaemic heart disease and stroke. Randomized controlled trials of viscosity reduction in the prevention of cardiovascular events (e.g. by lowering high levels of haematocrit or plasma fibrinogen) are suggested.

show abstract

Section: Discussionmentioning

confidence: 88%

Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study

et al. 1997

View full text Add to dashboard Cite

show abstract

“…The Framingham study, which had a 34‐year follow‐up period, reported a J‐shaped relationship between hematocrit and AMI and a U‐shaped relationship between hematocrit and all‐cause mortality after multivariable adjustment among women aged 35 to 64 years at baseline 19. Additionally, 1 prospective cohort of 62 763 Norwegian women aged 30 to 85 years with a 12‐year follow‐up period reported that anemic status (Hb<12.0 g/dL) significantly elevated AMI risk 20.…”

Section: Discussionmentioning

confidence: 99%

Association Between Changes in Hemoglobin Concentration and Cardiovascular Risks and All‐Cause Mortality Among Young Women

Lee

Choi

Kim

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundAnemia is considered to increase the risk of mortality in high‐risk populations, but its effect has not been examined among young populations. This study aimed to determine the effect of hemoglobin (Hb) concentration and its changes on the risk of acute myocardial infarction (AMI), stroke, cerebrovascular disease and all‐cause mortality among young women.Methods and ResultsWe analyzed data from the Korean National Health Information Database on 808 143 women aged 20 to 39 years without any cardiocerebrovascular disease. A 1‐time Hb concentration and changes in Hb over a 2‐year period were calculated as exposures. Participants were followed for a median of 10 years to determine the risk of AMI, stroke, cerebrovascular disease, and all‐cause mortality. There were U‐ or J‐shaped associations between Hb concentration or change in Hb and AMI, stroke, cerebrovascular disease, and all‐cause mortality. Increasing the Hb concentration from normal to high increased the risk for AMI (hazard ratio [95% confidence interval]: 1.49 [1.08‐2.04]). With regard to the risk for stroke, increasing the Hb concentration from a normal to a high range increased the risk (hazard ratio [95% confidence interval]: 1.10 [1.02‐1.35]), and decreasing the Hb concentration from a high to a normal range decreased this risk (hazard ratio [95% confidence interval]: 0.80 [0.60‐0.97]). Improving anemia to the normal Hb range decreased all‐cause mortality (hazard ratio [95% confidence interval]: 0.81 [0.69‐0.94]); however, overcorrection of Hb concentration (Hb≥14.0 g/dL) was not significant.ConclusionsThese findings suggest that regular Hb analysis may assist in identifying young women who are at risk of AMI, stroke, cerebrovascular disease, and all‐cause mortality.

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

Hematocrit and the risk of cardiovascular disease—The Framingham Study: A 34-year follow-up

Cited by 315 publications

References 36 publications

Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study

Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study

Association Between Changes in Hemoglobin Concentration and Cardiovascular Risks and All‐Cause Mortality Among Young Women

The anti‐oestrogen tamoxifen produces haemodilution in normal postmenopausal women

Contact Info

Product

Resources

About