Blood viscosity, fibrinogen, and activation of coagulation and leukocytes in peripheral arterial disease and the normal population in the Edinburgh artery study

• Published in: Circulation (New York, N.Y.) Vol. 87; no. 6; pp. 1915 - 1920
• Main Authors: LOWE, G. D. O, FOWKES, F. G. R, DAWES, J, DONNAN, P. T, LENNIE, S. E, HOUSLEY, E
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.06.1993
• Subjects: Aged; Arteriosclerosis - blood; Arteriosclerosis - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Blood Coagulation - physiology; Blood Viscosity - physiology; Cardiology. Vascular system; Cross-Sectional Studies; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Fibrinogen - analysis; Humans; Intermittent Claudication - blood; Intermittent Claudication - epidemiology; Leukocyte Elastase; Male; Medical sciences; Middle Aged; Pancreatic Elastase - blood; Peripheral Vascular Diseases - blood; Peripheral Vascular Diseases - epidemiology; Scotland - epidemiology; Scotland; Human; Viscosity; Claudication; Leukocyte; Coagulation; Lower limb; Cardiovascular disease; Exploration; Activation; Blood; Blood plasma; Vascular disease; Atherosclerosis; Fibrinogen; Arterial disease of the limb; Arterial occlusive disease
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.87.6.1915

Increased blood and plasma viscosity, hematocrit, fibrinogen, and activation of coagulation and leukocytes have been reported in patients with claudication; however, their associations with symptomatic and asymptomatic peripheral arterial disease have not been reported in an epidemiological study. Blood and plasma viscosity, hematocrit, fibrinogen, urinary fibrinopeptide A, plasma leukocyte elastase, and uric acid were measured in a random sample of 1,581 men and women aged 55-74 years in Edinburgh, Scotland, and related to peripheral arterial stenosis (ankle-brachial systolic pressure index, ABPI) and to lower limb ischemia (intermittent claudication and reactive hyperemia test). Each variable (except fibrinopeptide A) was significantly related to prevalent symptomatic and asymptomatic peripheral arterial disease. On multivariate analysis, blood viscosity (p < 0.05) and fibrinogen (p < 0.01) were independently associated with peripheral arterial narrowing (ABPI); a positive interaction was found between fibrinogen and smoking in the association with ABPI. Plasma viscosity was associated with claudication in the presence of a given degree of arterial narrowing (odds ratio of claudication in top quintile compared with bottom quintile of plasma viscosity, 3.35; 95% CI, 1.32, 8.51). Leukocyte elastase and uric acid were each associated with reactive hyperemia independently of arterial narrowing (p < 0.01). Blood rheological factors and leukocyte activation as well as arterial narrowing are associated with lower limb ischemia in the general population and may be implicated in its pathogenesis.