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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
Author(s) -
Spencer C. G. C.,
Felmeden D. C.,
Blann A. D.,
Lip G. Y. H.
Publication year - 2007
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2006.01735.x
Subject(s) - medicine , framingham risk score , fibrinogen , von willebrand factor , cardiology , framingham heart study , risk factor , platelet , disease
. 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 ( R 2 = 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.