Hematocrit as a risk factor of cerebral infarction: long-term prospective population survey in a Japanese rural community.

Abstract

SUMMARY l b elucidate the relation of hematocrit (Hct) to the incidence of cerebral infarction, a prospective follow-up study of 16 years (1965-81) was performed in a general population sample of 1220 Hisayama residents aged 44 and over, of both sexes. Most of the subjects who died during the follow-up period were autopskd, the rate being 89.0%.Hct decreased with advancing age in men, but not in women. The average value for Hct was significantly lower in women than in men. According to the mean value ± 1 SD of Hct, the subjects were grouped into 3, in each sex as follows: low (<35%), normal (35-45%) and high (2=45%) for men, and, low (<30%), normal (30-40%) and high (2:40%) for women.During the follow-up period, cerebral infarction occurred in 117 patients. The cumulative incidence of cerebral infarction In the low Hct group for men was the lowest, even after adjustments for age and blood pressure. Conversely, the incidence in the low Hct group of women was significantly higher than that in the normal Hct group and was consistently increased with tune during 2-5 years of the follow-up. After the 6th year or later, however, the incidence was gradually but significantly increased hi the Ugh Hct group, compared with the normal Hct group. Since Hct levels were related with other variables such as serum total cholesterol, serum total protein, Quetelet index and prevalence of hypertension in both sexes, heavy alcohol consumption in men, and glucose Intolerance in women, such variables were taken into account using Cox's proportional hazards regression model. The low Hct in women remained important as an independent risk factor of cerebral Infarction.The sex difference hi the role of Hct as a cause of cerebral infarction was discussed, taking into consideration the interrelationship between Hct and other risk factors.

Guidelines for the Early Management of Adults With Ischemic Stroke

“…[393][394][395] In addition, elevated fibrinogen levels, which add to plasma viscosity, have been documented. On the basis of these findings, hemodilution, with or without venesection, has been studied.…”

Risk Factors for Incident Stroke among Patients with End-Stage Renal Disease

“…This is in strong contrast to findings from the general population, in which high, not low, hemoglobin was associated with an increased risk (33)(34)(35)(36). However, these studies may have had insufficient power to detect an association between very low hemoglobin levels and stroke given the low prevalence of severe anemia in the non-ESRD population.…”

Hematocrit and clinical outcome in acute cerebral infarction.

“…Another recent report 7 shows that mean hematocrit decreases from cases with transient ischemic attacks (46%) to cases with reversible ischemic neurologic deficit (45%) to cases with completed stroke (44%). As regards this negative role 21 has shown that cerebral infarction incidence is increased in women (but not in men) with low hematocrit. The authors of this study comment that one of the reasons for this relation could be that low hematocrit is related to reduced tissue oxygenation.…”