title: Plasma and blood viscosity in the prediction of cardiovascular disease and mortality in the Scottish Heart Health Extended Cohort Study.
abstract: Background There is increasing evidence that blood viscosity and its major determinants (haematocrit and plasma viscosity) are associated with increased risks of cardiovascular disease (CVD) and premature mortality; however, their predictive value for CVD and mortality is not clear. Methods We prospectively assessed the added predictive value of plasma viscosity and whole blood viscosity and haematocrit in 3386 men and women aged 30-74 years participating in the Scottish Heart Health Extended Cohort study. Results Over a median follow-up of 17 years, 819 CVD events and 778 deaths were recorded. Hazard ratios (95% confidence intervals) for a 1 SD increase in plasma viscosity, adjusted for major CVD risk factors, were 1.12 (1.04-1.20) for CVD and 1.20 (1.12-1.29) for mortality. These remained significant after further adjustment for plasma fibrinogen: 1.09 (1.01-1.18) and 1.13 (1.04-1.22). The corresponding results for blood viscosity were 0.99 (0.90, 1.09) for CVD, and 1.11 (1.01, 1.22) for total mortality after adjustment for major CVD risk factors; and 0.97 (0.88, 1.08) and 1.06 (0.96, 1.18) after further adjustment for fibrinogen. Haematocrit showed similar associations to blood viscosity. When added to classical CVD risk factors, plasma viscosity improved the discrimination of CVD and mortality by 2.4% (0.7-4.4%) and 4.1% (2.0-6.5%). Conclusions Although plasma and blood viscosity may have a role in the pathogenesis of CVD and mortality, much of their association with CVD and mortality is due to the mutual effects of major CVD risk factors. However, plasma viscosity adds to the discrimination of CVD and mortality and might be considered for inclusion in multivariable risk scores.
authors: 1 The George Institute for Global Health, University of Oxford, UK.
authors: Sanne Ae
authors: SA
authors: Peters
authors: 1 The George Institute for Global Health, University of Oxford, UK.|2 Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK.|3 Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, UK.|4 The George Institute for Global Health, University of Sydney, Australia.
authors: Mark
authors: M
authors: Woodward
authors: 2 Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK.
authors: Ann
authors: A
authors: Rumley
authors: 3 Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, UK.
authors: Hugh D
authors: HD
authors: Tunstall-Pedoe
authors: 2 Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK.
authors: Gordon DO
authors: GD
authors: Lowe
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001809:Blood Viscosity; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010949:Plasma; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D005340:Fibrinogen
keywords: Viscosity; cardiovascular disease; fibrinogen; haematocrit; mortality