From the Wolfson Unit for Prevention of Peripheral Vascular Diseases,
Department of Public Health Sciences, Edinburgh University Medical School
(A.J.L., P.I.M., F.G.R.F.); the University Department of Medicine, Royal
Infirmary, Glasgow (G.D.O.L., A.R.); and the Department of Radiology, The
Royal Infirmary of Edinburgh NHS Trust (P.L.A.), UK.
Background—Several
hemostatic and rheological factors have been associated with incident
cardiovascular events. However, there have been no
reports on the relationship of rheological factors with early
atherosclerosis and very few on hemostatic factors. We
therefore studied the relationship between these factors and carotid
intima-media thickness (IMT).
Methods and Results—The Edinburgh Artery Study measured
fibrinogen, tissue plasminogen activator (tPA),
fibrin D-dimer, von Willebrand factor (vWF), blood
and plasma viscosities, and hematocrit as part of its baseline
examination during 1988–1989. At the 5-year follow-up, valid
measurements of IMT had been recorded in 1106 men and women 60 to
80 years old. In men, blood viscosity (P
Conclusions—These findings suggest that in men, blood viscosity
and its major determinants are associated not only with incident
cardiovascular events but also with the early stages of
atherosclerosis. This may be one explanation for the
link between rheological factors and events.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Blood Viscosity and Elevated Carotid Intima-Media Thickness in Men and Women
The Edinburgh Artery Study
.001) and its
major determinants, plasma viscosity, fibrinogen (both
P.01), and hematocrit (P.05), were
all linearly related to IMT. Furthermore, blood viscosity, fibrinogen
(both P.01), and plasma viscosity
(P.05) remained significantly associated on
multivariate analysis. Correcting blood
viscosity to a standard hematocrit of 45% had little effect on its
association. In men, there was a significantly increased risk of having
an IMT above versus below the upper quartile of its distribution
(1.05 mm) for SD increases in blood viscosity
(P.01), fibrinogen, corrected blood viscosity, and
plasma viscosity (all P.05). With the exception of
plasma viscosity, these risks were unaffected by adjustment for other
common cardiovascular risk factors. No significant
associations were found between any of the hemorheological factors and
IMT in women or for tPA, fibrin D-dimer, or vWF in either
sex.
Key Words: carotid arteries • blood flow • atherosclerosis • fibrinogen
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