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Hematocrit and the risk of cardiovascular disease--the Framingham study: a 34-year follow-up
D R Gagnon1, T J Zhang, F N Brand
1Boston University School of Public Health, Department of Epidemiology and Biostatistics, MA 02118.
Insights
High hematocrit (HCT) levels increase the risk of cardiovascular disease (CVD) mortality and morbidity. The relationship between HCT and CVD events may be J- or U-shaped, varying by sex and age.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Epidemiology
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality worldwide.
- Hematocrit (HCT), a measure of red blood cell volume, has been investigated for its potential role in CVD risk.
- Understanding the relationship between HCT and CVD is crucial for risk stratification and prevention strategies.
Purpose of the Study:
- To examine the long-term association between hematocrit levels and the risk of cardiovascular disease (CVD) mortality and morbidity.
- To investigate potential sex- and age-specific differences in the HCT-CVD relationship.
Main Methods:
- Analysis of 34-year follow-up data from 5209 participants in the Framingham cohort.
- Assessment of the relationship between hematocrit (HCT) levels and all-cause death, CVD morbidity, and CVD mortality.
- Stratification of analyses by sex and age groups.
Main Results:
- Higher HCT levels (highest quintile) were associated with an increased risk of all-cause death and CVD morbidity/mortality.
- A J- or U-shaped relationship between HCT and CVD events was observed, with increased risk at both high and low HCT values in women.
- HCT showed significant associations with various CVD events (CHD, MI, stroke) in younger men and women, with specific associations noted in elderly women.
Conclusions:
- Hematocrit (HCT) is a significant risk factor for certain cardiovascular disease (CVD) events.
- The impact of HCT on CVD risk differs between sexes and age groups, suggesting a complex, non-linear association.
- Further research is warranted to elucidate the mechanisms underlying the HCT-CVD relationship.
Abstract:
We examined the relationship between the risk of CVD mortality and morbidity and HCT over a period of 34 years of follow-up in the 5209 men and women in the Framingham cohort. There was an increased risk of all-cause death as well as morbidity and mortality due to CVD in subjects with HCT values in the highest quintile. There was no evidence of a decrease risk of CVD in men with lower than median HCT values, and women actually showed increased risk of CVD events with lower HCT values, indicating a J- or U-shaped relationship between HCT and CVD events. The impact of HCT on CVD events appears to differ for different age groups and by sex. HCT is significantly related to the incidence of CVD, including CHD, MI, angina pectoris, stroke, and IC in younger men. In younger women, HCT is related to the incidence of CVD, CHD, MI and mortality from CVD and CHD. A negative association with CHF incidence and stroke death is noted in elderly women. These results support the hypothesis that HCT is an important risk factor for some CVD events, an association that merits further investigation.