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Thromb Haemost 2000; 84(04): 553-558
DOI: 10.1055/s-0037-1614066
Review Article
Schattauer GmbH

Blood Rheology, Cardiovascular Risk Factors, and Cardiovascular Disease: The West of Scotland Coronary Prevention Study

Gordon Lowe
1   From the Department of Medicine, University of Glasgow, Glasgow, UK
,
Ann Rumley
1   From the Department of Medicine, University of Glasgow, Glasgow, UK
,
John Norrie
2   The Department of Biostatistics, University of Glasgow, Glasgow, UK
,
Ian Ford
2   The Department of Biostatistics, University of Glasgow, Glasgow, UK
,
James Shepherd
3   The Department of Clinical Biochemistry, University of Glasgow, Glasgow, UK
,
Stuart Cobbe
4   The Department of Medical Cardiology, University of Glasgow, University of Glasgow, Glasgow, UK
,
Peter Macfarlane
4   The Department of Medical Cardiology, University of Glasgow, University of Glasgow, Glasgow, UK
,
Christopher Packard
3   The Department of Clinical Biochemistry, University of Glasgow, Glasgow, UK
,
The West of Scotland Coronary Prevention Study Group › Author AffiliationsWe thank Dr. A J Lee for information from the Scottish Heart Health Study/ Glasgow MONICA study; and Susan Lennie, Pamela McColl and Karen McLaughlin for technical assistance. The study was supported by a research grant from Bristol-Myers Squibb, Princeton, New Jersey.
Further Information

Publication History

Received 22 February 2000

Accepted after resubmission 21 April 2000

Publication Date:
11 December 2017 (online)

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Summary

The West of Scotland Coronary Prevention Study (WOSCOPS) showed that pravastatin reduced the risk of coronary heart disease (CHD) events in 6,595 middle-aged hypercholesterolaemic men aged 45–64 years without prior myocardial infarction followed for an average of 4.9 years. We hypothesised prospectively (a) that baseline levels of haemorheological variables were related to baseline and incident CHD and to mortality; and (b) that reduction in lipoproteins by pravastatin would lower plasma and blood viscosity, a potential contributory mechanism to CHD events. We therefore studied plasma and blood viscosity, fibrinogen, haematocrit, and blood cell counts at baseline and 1 year. At baseline, plasma and blood viscosity were related to risk factors, CHD measures, and claudication. On univariate analysis, baseline levels of all rheological variables (except platelet count) were related to incident CHD; CHD mortality; and total mortality. On multivariate analysis including baseline CHD and risk factors, plasma and blood viscosity, haematocrit and white cell count each remained significantly associated with incident CHD; while fibrinogen remained an independent predictor of mortality (all p < 0.03). After one year, lipoprotein reduction by pravastatin was associated with significant reductions (about one quarter of a standard deviation) in plasma viscosity (mean difference 0.02 mPa.s, p <0.001) and in blood viscosity (mean difference 0.06 mPa.s, p <0.001), but was not associated with significant changes in other rheological variables. We therefore suggest that pravastatin therapy, which reduces elevated lipoproteins in hypercholesterolaemic men, may lower risks of CHD and mortality partly by lowering plasma and blood viscosity. Further studies are required to test this hypothesis.

Key words

Rheology - viscosity - coronary heart disease - lipoproteins - pravastatin

* Members of the West of Scotland Coronary Prevention Study Group: J. Shepherd, S. Cobbe, I. Ford, C. Packard, P. Macfarlane, A. R. Lorimer, J. H. McKillop and C. G. Isles


 

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