Increased Blood Viscosity and Fibrinolytic Inhibitor in Type Ii Hyperlipoproteinaemia

Lowe, G. D. O.; Stromberg, P.; Forbes, C.D.; McArdle, B.; Lorimer, A. R.; Prentice, C. R. M.

doi:10.1016/s0140-6736(82)91450-7

Cited by 89 publications

(34 citation statements)

References 26 publications

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“…57 in the Caerphilly and Speedwell Studies (Yarnell et al, 1991), suggesting that 22-33% of inter-individual variance in plasma viscosity in population samples is attributable to variance in fibrinogen. Lipoproteins also affect plasma and blood viscosity (Lowe et al, 1982;Lowe, 1994); however, in the present study LDL cholesterol did not appear a strong determinant of the predictive value of viscosity for cardiovascular events (or vice versa). Seven other studies have shown that plasma fibrinogen is a predictor of cardiovascular events (Wilhelmsen et al, 1984;Stone & Thorp, 1985;Meade et al, 1986;Kannel et al, 1987;Yarnell et al, 1991;Ernst & Resch, 1993;Cremer et al, 1994;Heinrich et al, 1994); the present study suggests that increased blood viscosity may be one mechanism by which hyperfibrinogenaemia (as well as raised haematocrit) may promote cardiovascular events.…”

Section: Discussioncontrasting

confidence: 85%

“…The association of a blood test with incident cardiovascular events is much stronger evidence for a possible causal role than any association with prevalent cardiovascular disease (Meade, 1994). We have previously related blood viscosity and its determinants to age, male sex, smoking, blood pressure, and hyperlipoproteinaemia (Lowe et al, 1982Smith et al, 1992;Fowkes et al, 1993;Lowe, 1994); and its association with cardiovascular events was reduced following adjustment for these. It is therefore likely that part of the association between blood viscosity and incident cardiovascular events reflects influences of conventional risk factors.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 1997

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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.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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

et al. 1997

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“…27 High afterload decreases cardiac output, which may result in diminished perfusion to vital organs. 42,43 In addition, higher blood viscosity is thrombogenic 44 and has been associated with a higher incidence and extent of coronary disease and stroke. 17,45 The effects of low cardiac output and high thrombogenicity are likely to be exacerbated during surgery, 46 which may ultimately trigger acute cardiovascular events.…”

Section: Preoperative Polycythemiamentioning

confidence: 99%

Preoperative Hematocrit Levels and Postoperative Outcomes in Older Patients Undergoing Noncardiac Surgery

Wu¹,

Schifftner²,

Henderson³

et al. 2007

JAMA

514

365

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creased risk of both abnormal hematocrit values and cardiovascular complications of noncardiac surgery. 1,2 Despite nearly universal measurement of hematocrit values prior to major surgery, 3 the prognostic implications of preoperative anemia or polycythemia are incompletely understood for this high-risk population. Although we have previously found that even mild degrees of anemia increase the mortality risk of elderly patients with acute myocardial infarction, 4 surgical studies of mild anemia have not shown it to be a risk factor for death, unless cardiac disease is present or major blood loss occurs. [5][6][7] The limited physiologic reserve and the higher prevalence of unrecognized cardiovascular disease may still render the elderly population vulnerable to milder degrees of anemia when undergoing the stress of surgery. [8][9][10] For editorial comment see p 2525.

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“…Smokers have a higher blood viscosity, packed cell volume and fibrinogen concentra tion than nonsmokers [25], Yano et al [26] also found that total serum cholesterol was positively related to hemato crit, whereas hyperlipoproteinemic (type II) patients have an increased blood viscosity partly due to a raised hematocrit compared to controls [27], The simplest explanation of the association between hematocrit and total se rum cholesterol in men would be that it is the result of a dilution effect, since high hemato crit values imply a lower volume (percentage) of plasma. Furthermore, since the water-hold ing capacity of the kidney is lower for elderly people than for younger adults and the elec trolyte balance may be altered with advancing age, volume homeostasis may be more diffi cult to maintain [28].…”

Section: Discussionmentioning

confidence: 99%

Hematocrit and Cardiovascular Risk Factors among Elderly Men and Women

Löwik¹,

Odink²,

Kok³

et al. 1992

Gerontology

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Changes in whole blood viscosity associated with hematocrit could be one of the pathways along which the cardiovascular disease (CVD) risk factors affect these diseases. Therefore, we studied in a nationwide survey comprising 514 apparently healthy Dutch elderly men and women aged 65–79 the possibility of any association between hematocrit and CVD risk factors (tobacco smoking, serum cholesterol, body mass index and blood pressure). Among men, diastolic blood pressure and total serum cholesterol were positively associated with hematocrit in both bivariate and multivariate regression analysis, whereas positive associations of hematocrit with body mass index and smoking were only significant (p < 0.05) in bivariate analysis. Among women, hematocrit was positively associated with body mass index and smoking. Except for smoking, which was associated with the mean corpuscular volume of the erythrocytes, hematocrit was positively correlated with hemoglobin and the number of erythrocytes. It is concluded that hemorrheological aspects should be considered when studying CVD among elderly people.

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Increased Blood Viscosity and Fibrinolytic Inhibitor in Type Ii Hyperlipoproteinaemia

Cited by 89 publications

References 26 publications

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

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

Preoperative Hematocrit Levels and Postoperative Outcomes in Older Patients Undergoing Noncardiac Surgery

Hematocrit and Cardiovascular Risk Factors among Elderly Men and Women

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