title: The distribution of whole blood viscosity, its determinants and relationship with arterial blood pressure in the community: cross-sectional analysis from the Gutenberg Health Study.
abstract: BACKGROUND
  Blood viscosity has a role in modulating cardiovascular homeostasis; changes in this parameter have been associated with cardiovascular mortality and morbidity. However, it remains unclear whether these changes are (1) involved in the pathophysiology of disease, (2) an epiphenomenon, or (3) the expression of counterregulatory mechanisms. We report data on the normal values of blood viscosity and its association with cardiovascular risk factors, prevalent cardiovascular disease, and blood pressure in a large population-based cohort study.
  
  
  RESULTS
  Viscosity was calculated using validated formulae and its associations were explored in 15,010 participants (mean 55.0, min-max: 35-74 years old; 49.5% women) from the Gutenberg Health Study as well as in a subgroup of 3223 subjects (61.1% women, mean age 49.2, min-max 35-74 years old) without risk factors or self-reported cardiovascular disease. Age- and gender-adjusted mean values for viscosity were defined. Regression models showed a relationship between classical risk factors and blood viscosity measures; the overall R(2) of the multiple linear regression model was however as low as 0.067 and 0.049 for high and low shear stress viscosity, respectively. After correction for cardiovascular risk factors, there was a very mild association between viscosity and prevalent coronary artery disease and heart failure. Systolic, mean and diastolic blood pressure increased with increasing blood viscosity after correction for age and gender.
  
  
  CONCLUSIONS
  We provide reference values for viscosity in a population-based cohort. Blood viscosity decreases in older subjects and shows a very mild association with cardiovascular risk factors and prevalent disease in our cohort. There is a linear positive association between viscosity and blood pressure.
authors.affiliation: Medizinische Klinik und Poliklinik, University Medical Center of the Johannes Gutenberg - University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany Tommaso.gori@unimedizin-mainz.de.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.affiliation: Preventive Cardiology and Preventive Medicine, Department of Medicine 2, Center for Thrombosis and Hemostasis, University Medical Center Mainz, Germany German Center for Cardiovascular Research, partner site RhineMain, Mainz, Germany.
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
authors.affiliation: Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg and German Center for Cardiovascular Research, partner site Hamburg, Lübeck, Kiel, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Schnabel
authors.affiliation: Preventive Cardiology and Preventive Medicine, Department of Medicine 2, Center for Thrombosis and Hemostasis, University Medical Center Mainz, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schulz
authors.affiliation: Department of Ophthalmology, University Medical Center Mainz, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
authors.affiliation: Institute of Medical Biostatistics, Epidemiology & Informatics, University Medical Center Mainz, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Blettner
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Germany.
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.affiliation: Centro Siena Toronto, University of Siena, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Forconi
authors.affiliation: Institute of Biomaterial Science and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Jung
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Lackner
authors.affiliation: Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg and German Center for Cardiovascular Research, partner site Hamburg, Lübeck, Kiel, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.affiliation: Medizinische Klinik und Poliklinik, University Medical Center of the Johannes Gutenberg University Mainz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D001809:Blood Viscosity; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors
keywords: blood viscosity; cross-sectional; haemorheology; population-based study