Blood viscosity, fibrinogen, and activation of coagulation and leukocytes in peripheral arterial disease and the normal population in the Edinburgh Artery Study.
BACKGROUND
Increased blood and plasma viscosity, hematocrit, fibrinogen, and activation of coagulation and leukocytes have been reported in patients with claudication; however, their associations with symptomatic and asymptomatic peripheral arterial disease have not been reported in an epidemiological study.


RESULTS
Blood and plasma viscosity, hematocrit, fibrinogen, urinary fibrinopeptide A, plasma leukocyte elastase, and uric acid were measured in a random sample of 1,581 men and women aged 55-74 years in Edinburgh, Scotland, and related to peripheral arterial stenosis (ankle-brachial systolic pressure index, ABPI) and to lower limb ischemia (intermittent claudication and reactive hyperemia test). Each variable (except fibrinopeptide A) was significantly related to prevalent symptomatic and asymptomatic peripheral arterial disease. On multivariate analysis, blood viscosity (p < 0.05) and fibrinogen (p < 0.01) were independently associated with peripheral arterial narrowing (ABPI); a positive interaction was found between fibrinogen and smoking in the association with ABPI. Plasma viscosity was associated with claudication in the presence of a given degree of arterial narrowing (odds ratio of claudication in top quintile compared with bottom quintile of plasma viscosity, 3.35; 95% CI, 1.32, 8.51). Leukocyte elastase and uric acid were each associated with reactive hyperemia independently of arterial narrowing (p < 0.01).


CONCLUSIONS
Blood rheological factors and leukocyte activation as well as arterial narrowing are associated with lower limb ischemia in the general population and may be implicated in its pathogenesis.
University Department of Medicine, Glasgow (Scotland) Royal Infirmary.
G D
GD
Lowe
F G
FG
Fowkes
J
J
Dawes
P T
PT
Donnan
S E
SE
Lennie
E
E
Housley
D000368:Aged; D001161:Arteriosclerosis / Q000097:blood / Q000453:epidemiology; D001777:Blood Coagulation / Q000502:physiology*; D001809:Blood Viscosity / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000453:epidemiology; D019272:Leukocyte Elastase; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood*; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000453:epidemiology; D012606:Scotland / Q000453:epidemiology
D005340:Fibrinogen; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase