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Vazquez-Agra N, Marques-Afonso AT, Cruces-Sande A, Novo-Veleiro I, Lopez-Paz JE, Pose-Reino A, Hermida-Ameijeiras A. Are Differences in Inflammatory Markers between Patients with and without Hypertension-Mediated Organ Damage Influenced by Circadian Blood Pressure Abnormalities? J Clin Med 2022; 11:jcm11051252. [PMID: 35268342 PMCID: PMC8911066 DOI: 10.3390/jcm11051252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/13/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023] Open
Abstract
We aimed to explore the influence that the circadian blood pressure (BP) profile could exert on the correlation between some inflammatory markers and hypertension-mediated organ damage (HMOD). This was a cross-sectional study that included patients with primary arterial hypertension older than 18 years old. We included some parameters of 24 h ambulatory blood pressure monitoring collection and several inflammatory markers, as follows: platelet count (PTC), erythrocyte sedimentation rate (ESR), ultrasensitive C-reactive-protein, ferritin, fibrinogen, and uric acid. Myocardial hypertrophy, albuminuria, carotid intima-media thicknesses and ankle brachial index were assessed as HMOD presentations. Individuals were divided into two groups: patients with and without HMOD. We included 522 patients (47% women, mean age of 54 years). Multivariate logistic regression analysis showed that male patients older than 50 years old with uric acid levels above 7 mg/dL, ESR higher than 20 mm/h, fibrinogen greater than 320 mg/dL and PTC lower than 275 × 103/µL were associated with HMOD (p < 0.05). The circadian BP profile (dipper versus non-dipper pattern) did reach neither statistical significance nor influence the odds ratio of those inflammatory markers for HMOD. We found that differences in some inflammatory markers between patients with and without HMOD were not explained by a different circadian BP profile.
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Affiliation(s)
- Nestor Vazquez-Agra
- Department of Internal Medicine, University Hospital of Santiago de Compostela, 15706 A Coruña, Spain; (A.-T.M.-A.); (I.N.-V.); (J.-E.L.-P.); (A.P.-R.); (A.H.-A.)
- Correspondence: (N.V.-A.); (A.C.-S.)
| | - Ana-Teresa Marques-Afonso
- Department of Internal Medicine, University Hospital of Santiago de Compostela, 15706 A Coruña, Spain; (A.-T.M.-A.); (I.N.-V.); (J.-E.L.-P.); (A.P.-R.); (A.H.-A.)
| | - Anton Cruces-Sande
- Department of Biochemistry and Molecular Biology, University of Santiago de Compostela, 15782 A Coruña, Spain
- Correspondence: (N.V.-A.); (A.C.-S.)
| | - Ignacio Novo-Veleiro
- Department of Internal Medicine, University Hospital of Santiago de Compostela, 15706 A Coruña, Spain; (A.-T.M.-A.); (I.N.-V.); (J.-E.L.-P.); (A.P.-R.); (A.H.-A.)
| | - Jose-Enrique Lopez-Paz
- Department of Internal Medicine, University Hospital of Santiago de Compostela, 15706 A Coruña, Spain; (A.-T.M.-A.); (I.N.-V.); (J.-E.L.-P.); (A.P.-R.); (A.H.-A.)
| | - Antonio Pose-Reino
- Department of Internal Medicine, University Hospital of Santiago de Compostela, 15706 A Coruña, Spain; (A.-T.M.-A.); (I.N.-V.); (J.-E.L.-P.); (A.P.-R.); (A.H.-A.)
| | - Alvaro Hermida-Ameijeiras
- Department of Internal Medicine, University Hospital of Santiago de Compostela, 15706 A Coruña, Spain; (A.-T.M.-A.); (I.N.-V.); (J.-E.L.-P.); (A.P.-R.); (A.H.-A.)
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Han JW, Sung PS, Jang JW, Choi JY, Yoon SK. Whole blood viscosity is associated with extrahepatic metastases and survival in patients with hepatocellular carcinoma. PLoS One 2021; 16:e0260311. [PMID: 34855786 PMCID: PMC8638904 DOI: 10.1371/journal.pone.0260311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/05/2021] [Indexed: 12/12/2022] Open
Abstract
Whole blood viscosity (WBV) is increased in cancer patients and associated with the advanced stage with systemic metastases. However, relevance of WBV in hepatocellular carcinoma (HCC) remains unclear. This pilot study included a discovery cohort of 148 treatment-naïve HCC patients with preserved liver function, and a validation cohort of 33 treatment-experienced HCC patients with nivolumab. Systolic and diastolic WBV was measured using an automated scanning capillary tube viscometer at diagnosis or before the nivolumab treatment. Extrahepatic metastases were observed in 15 treatment-naïve patients (11.3%) at diagnosis. Portal vein tumor thrombosis (PVTT), tumor size, number of tumors, and systolic/diastolic WBV were factors associated with extrahepatic metastases. Systolic WBV and diastolic WBV were significantly increased in patients with metastases compared with patients without metastases. Multivariate logistic regression showed that high diastolic WBV > 16 cP was an independent factor associated with metastases. Notably, patients who developed extrahepatic metastases during the observation period among patients without metastases at diagnosis had higher diastolic WBV initially. Patients with high diastolic WBV had poor survival, and multivariate Cox regression analyses showed high diastolic WBV was an independent risk factor for poor survival with the Child-Pugh B7 and PVTT. High diastolic WBV also predicted poor survival in patients with low alpha-fetoprotein (AFP) and proteins induced by vitamin K antagonist-II (PIVKA-II) levels. In 33 nivolumab-treated patients, high diastolic WBV before the treatment was also tended to be associated with overall and progression-free survival. Our study is the first in which high WBV is associated with the distant metastases and survival in patients with HCC, but future prospective, large cohort studies are necessary to validate the results.
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Affiliation(s)
- Ji Won Han
- The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Pil Soo Sung
- The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong Won Jang
- The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong Young Choi
- The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Kew Yoon
- The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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Iskander A, Bilgi C, Naftalovich R, Hacihaliloglu I, Berkman T, Naftalovich D, Pahlevan N. The Rheology of the Carotid Sinus: A Path Toward Bioinspired Intervention. Front Bioeng Biotechnol 2021; 9:678048. [PMID: 34178967 PMCID: PMC8222608 DOI: 10.3389/fbioe.2021.678048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/05/2021] [Indexed: 11/30/2022] Open
Abstract
The association between blood viscosity and pathological conditions involving a number of organ systems is well known. However, how the body measures and maintains appropriate blood viscosity is not well-described. The literature endorsing the function of the carotid sinus as a site of baroreception can be traced back to some of the earliest descriptions of digital pressure on the neck producing a drop in blood delivery to the brain. For the last 30 years, improved computational fluid dynamic (CFD) simulations of blood flow within the carotid sinus have demonstrated a more nuanced understanding of the changes in the region as it relates to changes in conventional metrics of cardiovascular function, including blood pressure. We suggest that the unique flow patterns within the carotid sinus may make it an ideal site to transduce flow data that can, in turn, enable real-time measurement of blood viscosity. The recent characterization of the PIEZO receptor family in the sinus vessel wall may provide a biological basis for this characterization. When coupled with other biomarkers of cardiovascular performance and descriptions of the blood rheology unique to the sinus region, this represents a novel venue for bioinspired design that may enable end-users to manipulate and optimize blood flow.
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Affiliation(s)
- Andrew Iskander
- Department of Anesthesiology, Westchester Medical Center, New York Medical College, Valhalla, NY, United States
| | - Coskun Bilgi
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, CA, United States
| | - Rotem Naftalovich
- Department of Anesthesiology, New Jersey Medical School, University Hospital, Rutgers University, Newark, NJ, United States.,Medical Corps of the U.S. Army, U.S. Army Medical Department, Fort Sam Houston, San Antonio, TX, United States
| | - Ilker Hacihaliloglu
- Department of Biomedical Engineering, Rutgers School of Engineering, Rutgers University, Piscataway, NJ, United States
| | - Tolga Berkman
- Department of Anesthesiology, New Jersey Medical School, University Hospital, Rutgers University, Newark, NJ, United States
| | - Daniel Naftalovich
- Department of Computational and Mathematical Sciences, California Institute of Technology, Pasadena, CA, United States.,Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Niema Pahlevan
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, CA, United States.,Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Adashek JJ, Redding D. A Pilot Study on the Effects of Nut Consumption on Cardiovascular Biomarkers. Cureus 2020; 12:e8798. [PMID: 32742827 PMCID: PMC7384736 DOI: 10.7759/cureus.8798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/24/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in the United States and changes in lifestyle can minimize the likelihood of succumbing to heart disease. Anti-inflammatory agents are commonly used to reduce the chronic inflammatory state behind the pathogenesis of CVD. Multiple studies have been published correlating nut consumption with a reduction in both heart attacks and strokes. The goal of this study is to determine to what extent the consumption of almonds, hazelnuts, and walnuts have on the blood markers associated with cardiac disease and inflammation. METHODS This was a six-week study in which subject's baseline values act as controls. Fasting blood draws occurred at week 0, week 2, and after four weeks of intervention (week 6). All participants had undesirable lipid profiles and no medications related to heart disease. RESULTS Total cholesterol (TC): high-density lipoprotein (HDL-C) ratio was lowered a statistically significant amount at the six-week time point (3.89 ± 0.74) compared to both the zero-week (4.93 ± 1.16, p < 0.01) and two-week (4.63 ± 1.20, p < 0.5) timepoints. Low-density lipoprotein (LDL) measurements were lowered a statistically significant amount at the six-week time point (135.6 ± 15.0 mg/dL) compared to the zero-week (159.7 ± 12.3 mg/dL, p < 0.01). Erythrocyte sedimentation rate (ESR) was lowered a statistically significant amount at six-week time point (10.44 ± 5.05 mm/h) compared to the zero-week (14.44 ± 5.12 mm/h, p < 0.01). CONCLUSIONS Blood markers associated with CVD specifically and the general marker for inflammation associated with many chronic diseases can be favorably modified with the consumption of specific nuts as demonstrated by this study.
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Affiliation(s)
| | - David Redding
- Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine/Family Medicine, Western University of Health Sciences, Pomona, USA
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5
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Rajab M, Jumaa M, Horaniah MY, Barakat A, Bakleh S, Zarzour W. Correlations of C-Reactive Protein and Folate with Smoking, Sport, Hematological Inflammation Biomarkers and Anthropometrics in Syrian University Female Students Cross-Sectional Study. Sci Rep 2019; 9:15189. [PMID: 31645641 PMCID: PMC6811634 DOI: 10.1038/s41598-019-51658-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 10/07/2019] [Indexed: 11/09/2022] Open
Abstract
In Syria, high-Sensitive C-Reactive (hsCRP), folate, and, other health risk data in young women are limited. This cross-sectional study evaluates hsCRP and folate levels along with anthropometric characteristics, lifestyle factors and some biomarkers linked to cardiovascular disease (CVD) risk factors in healthy female students (n = 207, 18-25 years old). Among participants, hsCRP level was at average or high risk of CVD in 20.7% and 2.5% respectively and it was significantly higher in participants who had high body mass index (BMI) (Nonparametric statistical tests, p value < 0.05). Unexpectedly, it did not vary significantly between smokers and nonsmokers. And, it correlated positively with anthropometric and erythrocyte sedimentation rate (ESR) measurements. While folate level was low in 3.4% of participants, no association between hsCRP and folate levels was found. Finally, low hemoglobin level and habit of waterpipe smoking are spreading; and, sport practicing is shrinking. After reviewing similar works, this study suggests that the possible correlation between hsCRP and folate could be displayed in patients older than 30 years. Also, the marked decrease in hemoglobin level needs more attention. Finally, young females in Syria are advised to consider a lifestyle free of smoking and packed with physical activity.
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Affiliation(s)
- Mazen Rajab
- Biochemistry Department, Faculty of Pharmacy, Arab International University, Damascus, Syria.
| | - Mohamad Jumaa
- Biochemistry Department, Faculty of Pharmacy, Arab International University, Damascus, Syria
| | - Muhammad Yusr Horaniah
- Biochemistry Department, Faculty of Pharmacy, Arab International University, Damascus, Syria
| | - Ahmad Barakat
- Biochemistry Department, Faculty of Pharmacy, Arab International University, Damascus, Syria
| | - Saied Bakleh
- Biochemistry Department, Faculty of Pharmacy, Arab International University, Damascus, Syria
| | - Wafika Zarzour
- Biochemistry Department, Faculty of Pharmacy, Arab International University, Damascus, Syria
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Naghedi-Baghdar H, Nazari SM, Taghipour A, Nematy M, Shokri S, Mehri MR, Molkara T, Javan R. Effect of diet on blood viscosity in healthy humans: a systematic review. Electron Physician 2018; 10:6563-6570. [PMID: 29765583 PMCID: PMC5942579 DOI: 10.19082/6563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/16/2017] [Indexed: 01/01/2023] Open
Abstract
Background Increased whole blood viscosity is associated with increased risk of morbidity and mortality of several life-threatening diseases, including cardiovascular and cerebrovascular disease. The effect of diet on human health has been indicated in many studies, and a health dietary pattern can reduce the incidence of several chronic diseases. Objective The aim of this systematic review was to assess the effect of diet on blood viscosity and related parameters such as haematocrit (HCT). Methods This systematic review was carried out in 2017. MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception to 2 May 2017. We selected and included randomized clinical trials (RCTs) in the study. The inclusion criteria were articles that describe the effect of any types of local and traditional diet on blood viscosity in apparently healthy individuals. Results Three randomized controlled trials were included in this systematic review. Different diets were used in the included trials. In one study, ingested dried–bonito broth (DBB) for four weeks, significantly reduced the blood passage time in the intervention group from 55.4±3.4 to 47.6±2.0 sec (mean ± SEM, p<0.05) compared with no significant change in the placebo group. Another study has shown significantly increased blood fluidity score in a vegetarian group in contrast to the control group after six weeks. In the last study, plasma viscosity was significantly decreased in a group which used onion–olive-oil capsules compared to the placebo group, with a highly significant difference between the two groups (p=0.0015). Conclusions Our components of food diets may decrease blood viscosity in health status. Better and expanded methodology may improve our results.
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Affiliation(s)
- Hamideh Naghedi-Baghdar
- Student Research Committee, Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed-Mohammad Nazari
- Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Department of Biostatistics and Health Sciences Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sadegh Shokri
- Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad-Reza Mehri
- Student Research Committee, Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tahereh Molkara
- Student Research Committee, Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roghayeh Javan
- Traditional and Complementary Medicine Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Vinpocetine and pyritinol: a new model for blood rheological modulation in cerebrovascular disorders—a randomized controlled clinical study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:324307. [PMID: 25548768 PMCID: PMC4274818 DOI: 10.1155/2014/324307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 08/21/2014] [Accepted: 09/16/2014] [Indexed: 01/29/2023]
Abstract
Blood and plasma viscosity are the major factors affecting blood flow and normal circulation. Whole blood viscosity is mainly affected by plasma viscosity, red blood cell deformability/aggregation and hematocrit, and other physiological factors. Thirty patients (twenty males + ten females) with age range 50-65 years, normotensive with history of cerebrovascular disorders, were selected according to the American Heart Stroke Association. Blood viscosity and other rheological parameters were measured after two-day abstinence from any medications. Dual effects of vinpocetine and pyritinol exhibit significant effects on all hemorheological parameters (P < 0.05), especially on low shear whole blood viscosity (P < 0.01), but they produced insignificant effects on total serum protein and high shear whole blood viscosity (P > 0.05). Therefore, joint effects of vinpocetine and pyritinol improve blood and plasma viscosity in patients with cerebrovascular disorders.
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Pretorius E, Swanepoel AC, Buys AV, Vermeulen N, Duim W, Kell DB. Eryptosis as a marker of Parkinson's disease. Aging (Albany NY) 2014; 6:788-819. [PMID: 25411230 PMCID: PMC4247384 DOI: 10.18632/aging.100695] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 10/24/2014] [Indexed: 12/20/2022]
Abstract
A major trend in recent Parkinson's disease (PD) research is the investigation of biological markers that could help in identifying at-risk individuals or to track disease progression and response to therapies. Central to this is the knowledge that inflammation is a known hallmark of PD and of many other degenerative diseases. In the current work, we focus on inflammatory signalling in PD, using a systems approach that allows us to look at the disease in a more holistic way. We discuss cyclooxygenases, prostaglandins, thromboxanes and also iron in PD. These particular signalling molecules are involved in PD pathophysiology, but are also very important in an aberrant coagulation/hematology system. We present and discuss a hypothesis regarding the possible interaction of these aberrant signalling molecules implicated in PD, and suggest that these molecules may affect the erythrocytes of PD patients. This would be observable as changes in the morphology of the RBCs and of PD patients relative to healthy controls. We then show that the RBCs of PD patients are indeed rather dramatically deranged in their morphology, exhibiting eryptosis (a kind of programmed cell death). This morphological indicator may have useful diagnostic and prognostic significance.
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Affiliation(s)
- Etheresia Pretorius
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia 0007, South Africa
| | - Albe C Swanepoel
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia 0007, South Africa
| | - Antoinette V Buys
- Microscopy and Microanalysis Unit, University of Pretoria, Arcadia 0007, South Africa
| | - Natasha Vermeulen
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia 0007, South Africa
| | - Wiebren Duim
- Department of Neurology Faculty of Health Sciences, University of Pretoria, Arcadia 0007, South Africa
| | - Douglas B Kell
- School of Chemistry and The Manchester Institute of Biotechnology, The University of Manchester, Manchester M1 7DN, Lancs, UK
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Jin YZ, Zheng DH, Duan ZY, Lin YZ, Zhang XY, Wang JR, Han S, Wang GF, Zhang YJ. Relationship Between Hematocrit Level and Cardiovascular Risk Factors in a Community-Based Population. J Clin Lab Anal 2014; 29:289-93. [PMID: 24849556 DOI: 10.1002/jcla.21767] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 03/17/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to determine the relationship between hematocrit (HCT) levels and cardiovascular risk factors in a community-based population of middle-aged adults. METHODS From April 2011 to February 2012, a total of 1,884 middle-aged adults were selected from a community-based population in China. Blood and urine samples were collected for routine blood and urine tests, and measurement of plasma glucose and lipid levels. Baseline information including traditional cardiovascular risk factors was obtained by standard questionnaire to analyze. We evaluated the distribution of the HCT values for middle-aged adults with or without cardiovascular risk factors. There were 548 males and 1,336 females in this study. The mean age of all subjects was 54.7 ± 6.7 years. There were 1,209 subjects with risk factors and 675 without risk factors. RESULTS The HCT levels in subjects with risk factors were higher than those without risk factors (P = 0.005). According to a simplified tool for evaluation of the 10-year risk of ischemic cardiovascular diseases (CVDs) in Chinese populations, all subjects were divided into four groups: the ultralow-risk group (1,367, 72.6%), low-risk group (232, 12.3%), intermediate-risk group (201, 10.7%), and high-risk/ultrahigh-risk group (84, 4.4%). Compared with HCT levels in the ultralow-risk group, significant differences were found in the low-risk, intermediate-risk, and high-risk/ultrahigh-risk groups (all P < 0.05). CONCLUSION Our results indicate that elevated HCT levels may be positively associated with cardiovascular risk factors. Thus, the combination of HCT values and cardiovascular risk factors may enable early diagnosis of CVDs.
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Affiliation(s)
- Yuan-Ze Jin
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Dong-Han Zheng
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Zhi-Ying Duan
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Ying-Zi Lin
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Xue-Ying Zhang
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Jing-Ru Wang
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Shuo Han
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Guo-Feng Wang
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
| | - Yi-Jing Zhang
- Department of Cardiology, Fourth Affiliated Hospital of China Medical University, Shenyang, P.R. China
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Boffetta P, Islami F, Vedanthan R, Pourshams A, Kamangar F, Khademi H, Etemadi A, Salahi R, Semnani S, Emadi A, Abnet CC, Brennan P, Pharoah PD, Dawsey SM, Malekzadeh R. A U-shaped relationship between haematocrit and mortality in a large prospective cohort study. Int J Epidemiol 2013; 42:601-15. [PMID: 23569195 DOI: 10.1093/ije/dyt013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Only a limited number of studies have investigated the correlation between haematocrit (HCT) and mortality in the general population, and few of those studies have had data on a wide range of low and high levels of HCT. We investigated the association between baseline HCT and mortality in a prospective cohort study of 49,983 adult subjects in Iran with a broad spectrum of HCT values. METHODS Data on socio-demographic and life-style factors, past medical history, and levels of HCT were collected at enrollment. During a mean follow-up of 5 years (follow-up success rate ~99%), 2262 deaths were reported. Cox proportional hazards regression models were used to estimate hazard ratios and corresponding 95% confidence intervals. RESULTS There was a U-shaped relationship between categories of HCT and mortality in both sexes: both low and high levels of HCT were associated with increased overall mortality and mortality from cardiovascular disease. The U-shaped relationship persisted after several sensitivity analyses were done, including analyses restricted to non-smokers and non-users of opium; analyses excluding deaths from accidents and other external causes as well as deaths of persons with self-reported ischemic heart disease at the baseline interview for the study; and analyses excluding the first 2 years of follow-up. Self-reported past medical history and lack of data about lipids and other cellular blood components were the major limitations of the study. CONCLUSIONS Low and high levels of HCT are associated with increased mortality in the general population. The findings in the present study can be of particular importance for low- and middle-income countries in which a substantial proportion of the population lives with suboptimal levels of HCT.
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Affiliation(s)
- Paolo Boffetta
- Institute for Transitional Epidemiology and the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Richter V, Savery MD, Gassmann M, Baum O, Damiano ER, Pries AR. Excessive erythrocytosis compromises the blood-endothelium interface in erythropoietin-overexpressing mice. J Physiol 2011; 589:5181-92. [PMID: 21859826 DOI: 10.1113/jphysiol.2011.209262] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Elevated systemic haematocrit (Hct) increases risk of cardiovascular disorders, such as stroke and myocardial infarction. One possible pathophysiological mechanism could be a disturbance of the blood-endothelium interface. It has been shown that blood interacts with the endothelial surface via a thick hydrated macromolecular layer (the 'glycocalyx', or 'endothelial surface layer'--ESL), modulating various biological processes, including inflammation, permeability and atherosclerosis. However, the consequences of elevated Hct on the functional properties of this interface are incompletely understood. Thus, we combined intravital microscopy of an erythropoietin overexpressing transgenic mouse line (tg6) with excessive erythrocytosis (Hct 0.85), microviscometric analysis of haemodynamics, and a flow simulation model to assess the effects of elevated Hct on glycocalyx/ESL thickness and flow resistance. We show that the glycocalyx/ESL is nearly abolished in tg6 mice (thickness: wild-type control: 0.52 μm; tg6: 0.13 μm; P < 0.001). However, the corresponding reduction in network flow resistance contributes <20% to the maintenance of total peripheral resistance observed in tg6 mice. This suggests that the pathological effects of elevated Hct in these mice, and possibly also in polycythaemic humans, may relate to biological corollaries of a reduced ESL thickness and the consequent alteration in the blood-endothelium interface, rather than to an increase of flow resistance.
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Affiliation(s)
- David M Lowe
- Wellcome Centre for Clinical Tropical Medicine, St Mary's Campus, Imperial College London, London, UK.
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