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White blood cell count and cardiovascular disease. Insights from the Framingham Study
W B Kannel1, K Anderson, P W Wilson
1Department of Medicine, Evans Memorial Research Foundation, Boston University School of Medicine, MA.
Insights
Elevated white blood cell (WBC) counts, even within the normal range, indicate a higher risk of cardiovascular disease (CVD). This increased risk is partly due to cigarette smoking, highlighting WBC count as a potential CVD marker.
Area of Science:
- Cardiology
- Hematology
- Epidemiology
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality worldwide.
- Identifying novel risk factors and biomarkers for CVD is crucial for effective prevention strategies.
- White blood cell (WBC) count is a general indicator of inflammation and has been investigated for its association with various health outcomes.
Purpose of the Study:
- To investigate the relationship between white blood cell (WBC) count and the incidence of cardiovascular disease (CVD).
- To assess whether WBC count predicts CVD development independently of traditional risk factors, hematocrit, and vital capacity.
- To explore potential confounding factors, such as smoking, in the WBC count-CVD association.
Main Methods:
- Prospective cohort study design with a 12-year follow-up period.
- Analysis of data from the Framingham Offspring Study, including 1393 men and 1401 women free of CVD at baseline.
- Time-dependent, multivariable logistic regression models were employed to analyze the association between WBC count and CVD events.
Main Results:
- A significant association was observed between elevated WBC counts and increased CVD risk in men, independent of smoking status.
- Each 1.0 x 10(9)/L increase in WBC count was linked to a 32% higher CVD risk in men.
- In women, a significant association between WBC count and CVD risk was only observed in smokers, with a 17% increase per 1.0 x 10(9)/L increment, which did not remain significant after adjustments.
Conclusions:
- Elevated WBC count within the normal range serves as a significant marker for increased CVD risk, particularly in men.
- Cigarette smoking partially explains the association between WBC count and CVD risk.
- Further research incorporating differential WBC counts is recommended to better understand their specific roles in CVD development.
Objective:
To examine the relation of white blood cell (WBC) count to the development of cardiovascular disease (CVD), including coronary heart disease, stroke, peripheral arterial disease, and cardiac failure. Traditional CVD risk factors, hematocrit, and vital capacity were considered.
Design:
Prospective cohort analysis with one baseline examination of relevant risk factors and 12 years of follow-up for CVD.
Participants And Methods:
A community-based sample (Farmingham Offspring Study) of 1393 men and 1401 women who were free of CVD at the onset of the study and who were between the ages of 30 and 59 years at baseline. Time-dependent multiple variable logistic regression methods were used.
Results:
There were 180 CVD events in men and 80 in women. The WBC count was correlated most strongly with the number of cigarettes smoked per day, hematocrit, and vital capacity. Among nonsmoking men with WBC counts within the normal range, the age-adjusted WBC count was significantly associated with CVD and coronary heart disease incidence. For each 1.0 x 10(9)/L-cell difference in WBC count, the CVD risk increased 32%. In women, each 1.0 x 10(9)/L-cell increment in WBC count was associated with a 17% increase in CVD risk, but only in smokers, and the relationship was not statistically significant after adjustment for relevant risk factors.
Conclusions:
The degree of elevation of WBC count within the normal range is a marker for increased risk of CVD that is partially explained by cigarette smoking. Future studies should include differential WBC determinations to assess their association with CVD.
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