title: Interaction between inflammation and blood viscosity predicts cardiovascular mortality.
abstract: OBJECTIVE
  Inflammation and increased blood viscosity are associated with increased risk of cardiovascular mortality. Erythrocyte sedimentation rate (ESR) and hematocrit both influence blood viscosity whereas the first also is a marker of inflammation. We aimed to investigate ESR, hematocrit and the interaction between them as predictors of cardiovascular mortality during 26 years follow-up among healthy middle aged men.
  
  
  METHODS
  Four hundred and eighty eight men aged 40-59 were extensively examined in 1972-1975 and followed over a period of 26 years. Risk estimation was made in Cox proportional hazards and adjusted for age, smoking, systolic blood pressure, total serum cholesterol, and physical fitness.
  
  
  RESULTS
  A 2.44-fold (95% CI 1.37-4.35) adjusted risk of cardiovascular mortality was found in the highest quartile of hematocrit compared to the lowest. Among the 265 men who had an ESR <6 mm/h (median), the adjusted risk of cardiovascular mortality was 3.05-fold (95% CI 1.49-6.23) in the highest quartile of hematocrit compared to the lowest. This association was not observed among the 223 men with ESR <6 mm/h.
  
  
  CONCLUSIONS
  Elevated hematocrit is independently associated with increased long-term risk of cardiovascular mortality in men with high ESR. Our data suggest that the combination of inflammation and blood viscosity may improve the prediction of cardiovascular risk.
authors: Department of Cardiology, Oslo University Hospital, Ullevaal, Oslo, Norway. torger.skretteberg@gmail.com
authors: Per Torger
authors: PT
authors: Skretteberg
authors: Johan
authors: J
authors: Bodegård
authors: Sverre E
authors: SE
authors: Kjeldsen
authors: Gunnar
authors: G
authors: Erikssen
authors: Erik
authors: E
authors: Thaulow
authors: Leif
authors: L
authors: Sandvik
authors: Jan E
authors: JE
authors: Erikssen
mesh_terms: D000328:Adult; D001799:Blood Sedimentation; D001809:Blood Viscosity; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D005500:Follow-Up Studies; D006400:Hematocrit; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000401:mortality*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors