BLOOD SCIENCES
Haemorheology and CVD: what clinical viscosity could tell us
With the association between plasma viscosity and cardiovascular disease having been documented extensively and for some time, David Norcliffe and David Manuel revisit some of these studies to explore how haemorheology and measuring clinical viscosity could play a significant role in the monitoring and early detection of CVD.
Cardiovascular disease (CVD) is a broad term describing a group of diseases of the heart and vascular system. It includes coronary heart disease, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, congenital heart disease, valvular disease, endocarditis, aortic aneurysms, peripheral artery disease, claudication, venous thrombosis, and cerebrovascular events (stroke).1 Coronary artery disease, peripheral artery disease and ischaemic strokes are often accompanied by atherosclerosis, which itself may be caused by hypertension, smoking, diabetes,
hypercholesterolaemia, poor diet or excessive alcohol consumption, among others. According to the World Health Organization (WHO), high blood pressure is estimated to account for approximately 13% of CVD deaths, while tobacco accounts for 9%, diabetes 6%, lack of exercise 6%, and obesity 5%.2 More than four out of five CVD deaths are due to infarctions and strokes,3
with
one third of these deaths occurring prematurely in people under 70 years of age. The number of causes of CVD is unclear, but some risk factors are well known, with hypertension, smoking, high
cholesterol, diabetes, obesity, inactivity and family history being among the most common. CVDs are the leading cause of global death (33%), taking an estimated 20.5 million lives each year. The UK also has a significant number (26%) of deaths and disabilities caused by CVD.4
The
NHS identifies the impact associated with CVD and gives high priority to reduce the mortality. Part of the NHS Long Term Plan is to save lives over the next 10 years from conditions associated with CVDs. Applicable not only for the NHS but also its partners in the voluntary and community sectors, as well as other national organisations, the ambition is to prevent more than 150,000 heart attacks and strokes.5
According to the WHO, high blood pressure is estimated to account for approximately 13% of CVD deaths. 24
Haemorheology and CVD Plasma viscosity and whole blood viscosity are important determinants of blood flow rheology and hence may have roles in atherosclerosis, thrombosis and ischaemia. The association between plasma viscosity (PV) and cardiovascular disease has been documented extensively and for some time; a review being published in 1987.6 Késmárky et al. (2008) suggest plasma fibrinogen concentration and plasma viscosity elevated in unstable angina pectoris, and their higher values, are associated with a higher rate of major adverse clinical events. Most importantly, elevation of plasma viscosity correlated to the progression of coronary and peripheral artery diseases.7
MAY 2024
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