title: Prognostic impact of low-shear whole blood viscosity in hypertensive men.
abstract: BACKGROUND
  The role of blood viscosity as a marker for discriminating cardiovascular risk in essential hypertension remains uncertain. The aim of this study was to assess whether whole blood viscosity (WBV) could be useful in assessing cardiovascular risk in men with a first diagnosis of hypertension.
  
  
  METHODS
  A total of 331 middle-aged men with newly diagnosed essential hypertension (age at entry 40-64 years, average blood pressure 151/95 mmHg) underwent low-shear-rate (0.94 s(-1)) and high-shear-rate (94.5 s(-1)) WBV determination and were then followed for a mean of 4.8 +/- 3 years (range 0-12 years).
  
  
  RESULTS
  Cardiovascular event rates in the bottom, middle and top tertiles of the distribution of low-shear WBV were 1.10, 2.13 and 4.43 per 100 patient-years, respectively (log-rank test, P < 0.001). After taking into account several established cardiovascular risk factors in a Cox survival analysis, a raised low-shear WBV conferred an increased risk for cardiovascular events (top vs. bottom tertile hazard ratio = 3.42, 95% confidence interval = 1.4-8.4, P = 0.006; middle vs. bottom tertile hazard ratio = 2.25, 95% confidence interval = 0.9-5.6, P = 0.09). The independent association between high-shear-rate WBV and cardiovascular events bordered statistical significance (P = 0.07). Inclusion in the survival model of low-shear-rate resulted in a significantly greater chi(2) improvement (P < 0.05) than inclusion of high-shear-rate WBV.
  
  
  CONCLUSIONS
  In hypertensive men, an increased WBV at low shear rate is a predictor of cardiovascular events independently from the effect of several traditional risk factors. Low-shear WBV is a better discriminator of cardiovascular risk than high-shear WBV.
authors.affiliation: Unit of Internal Medicine, Angiology and Atherosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, 06156 Perugia, Italy. gciuffe@unipg.it
authors.forename: G
authors.initials: G
authors.lastname: Ciuffetti
authors.forename: G
authors.initials: G
authors.lastname: Schillaci
authors.forename: R
authors.initials: R
authors.lastname: Lombardini
authors.forename: M
authors.initials: M
authors.lastname: Pirro
authors.forename: G
authors.initials: G
authors.lastname: Vaudo
authors.forename: E
authors.initials: E
authors.lastname: Mannarino
mesh_terms: D000328:Adult; D000789:Angina, Unstable / Q000097:blood / Q000209:etiology; D001809:Blood Viscosity / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000209:etiology