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Relationship between white blood cell count and Framingham Risk Score in asymptomatic men
Sarwar H Orakzai1, Raza H Orakzai, Khurram Nasir
1Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Insights
White blood cell (WBC) count shows a weak correlation with the Framingham Risk Score (FRS) for coronary heart disease (CHD). However, WBC may indicate other cardiovascular risks not included in the FRS, suggesting its value in risk assessment.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biomarkers
Background:
- An independent association exists between white blood cell (WBC) count and coronary heart disease (CHD) risk.
- The relationship between WBC count and the Framingham Risk Score (FRS) for predicting CHD risk is not well-established.
Purpose of the Study:
- To investigate the correlation between white blood cell (WBC) count and the Framingham Risk Score (FRS) in asymptomatic men.
- To determine if WBC count provides additional cardiovascular risk information beyond traditional FRS factors.
Main Methods:
- A cross-sectional study involving 520 asymptomatic men without CHD.
- Participants were categorized into quartiles based on WBC count and tertiles based on 10-year FRS.
- Correlations were analyzed between WBC count and FRS components: age, smoking, systolic blood pressure, and lipid profiles.
Main Results:
- WBC count demonstrated a weak correlation with FRS (r = 0.18, p = 0.001) and minimal correlation with smoking and systolic blood pressure.
- No significant correlation was found between WBC count and age or total cholesterol.
- Higher WBC quartiles were more prevalent in higher FRS tertiles, although not statistically significant (p=0.09).
Conclusions:
- WBC count has a weak correlation with the FRS and its individual components.
- WBC count may reflect underlying cardiovascular risk factors not captured by the FRS.
- Inflammatory biomarkers like WBC could potentially enhance CHD risk stratification when used alongside the FRS.
Background:
There is an independent association between white blood cell (WBC) and coronary heart disease (CHD) risk. However, the relationship between WBC and Framingham Risk Score (FRS) remains unclear.
Methods:
This is a cross-sectional study on a consecutive sample of 520 white asymptomatic men (mean age 46 +/- 7 years) without CHD. The study population was divided into WBC quartiles (x10(9) cells/L): 1(st) quartile: 3.1-5.3 (n = 139), 2(nd) quartile: 5.4-6.1 (n = 129), 3(rd) quartile: 6.2-7.1 (n = 131), 4(th) quartile: >/=7.2 (n = 121), and into tertiles according to the 10-year FRS: 1(st) tertile (low risk <5%, n = 180, 35%), 2(nd) tertile (intermediate risk 5-12%, n = 210, 40%), 3(rd) tertile (high risk: >/=13%, n = 130, 25%).
Results:
WBC correlated only weakly with FRS (r = 0.18, p = 0.001). Among individual components of FRS, WBC correlated minimally with smoking (r = 0.12, p = 0.003), systolic blood pressure (r = 0.07, p = 0.1), and high-density lipoprotein cholesterol (r = -0.06, p = 0.1). However, no correlation was observed with age (p = 0.3) and total cholesterol (p = 0.5). Nearly one third (31%) of men in the low-risk (FRS <5%) had WBC count in the 1(st) quartile compared to 20% of those classified as high risk (FRS >/=13%). The prevalence of WBC in the 4(th) quartile increased across FRS tertiles (18, 22, 32%) (p = 0.09).
Conclusions:
WBC correlates weakly with FRS or its individual components. Since WBC count is strongly related to CHD, WBC may reflect different components of cardiovascular risk, which might not be captured by traditional cardiovascular risk factors used in calculating FRS. Inflammatory biomarkers afford adjunctive value to FRS and may be used to improve CHD risk stratification.
