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- Title
Haemorheological, platelet and endothelial indices in relation to global measures of cardiovascular risk in hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial.
- Authors
Spencer, C. G. C.; Felmeden, D. C.; Blann, A. D.; Lip, G. Y. H.
- Abstract
Introduction and Methods. We tested the hypothesis that there was a significant relationship between haemorheological markers [white blood cell count (WCC), plasma viscosity (PV), haematocrit (HCT) and fibrinogen], as well as plasma von Willebrand factor (vWf, an index of endothelial damage/dysfunction) and soluble P-selectin (sP-sel, an index of platelet activation), to five global measures of cardiovascular risk [i.e. Framingham coronary heart disease (CHD), stroke and cardiovascular death score, the Pocock cardiovascular risk score and the sum of individual risk factors]. Results. Men with a high (≥median, n=156) Framingham 10-year CHD risk score had higher levels of WBC ( P = 0.027), fibrinogen ( P = 0.012) and vWF ( P = 0.002) than 153 men with results < median. Men with a high 10-year stroke risk score had significantly higher levels of fibrinogen ( P = 0.01) and vWF ( P < 0.0001). In stepwise linear regression analysis in men, vWF and fibrinogen were independent predictors of the number of risk factors ( P < 0.0001), whilst WCC, vWF and fibrinogen emerged as independent predictors of Framingham CHD risk ( P < 0.0001), and fibrinogen and vWF predicted Framingham stroke risk ( R2 = 0.089, P < 0.0001). vWF, PV and fibrinogen were predictors of Pocock cardiovascular death risk ( P < 0.0001) but vWF was the only independent predictor of Framingham cardiovascular death risk ( P = 0.001). Conclusions. Abnormal haemorheological factors (particularly high plasma fibrinogen levels) and endothelial damage/dysfunction (high vWF), but not platelet activation (sP-sel), are related to established cardiovascular and death risk scores. This relationship was most evident amongst male ‘high-risk’ hypertensive subjects.
- Subjects
HYPERTENSION risk factors; CARDIOVASCULAR diseases; VON Willebrand factor; BLOOD coagulation factors; FIBRINOGEN; CORONARY disease; REGRESSION analysis
- Publication
Journal of Internal Medicine, 2007, Vol 261, Issue 1, p82
- ISSN
0954-6820
- Publication type
Article
- DOI
10.1111/j.1365-2796.2006.01735.x