Published Online
on February 7, 2005

A more recent version of this article appeared on April 1, 2005

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Submitted on November 14, 2004
Revised on December 9, 2004

Association of Blood Pressure With Blood Viscosity in American Indians. The Strong Heart Study

Giovanni de Simone^*; Richard B. Devereux; Marcello Chinali; Lyle G. Best; Elisa T. Lee; Thomas K. Welty; for the Strong Heart Study Investigators

From Weill Medical College of Cornell University (G.d.S., R.B.D., M.C.), New York, NY; Federico II University Hospital (G.d.S.), Naples, Italy; Missouri Breaks Industries Research, Inc. (L.G.B.), Timber Lake, SD; Center for American Indian Health Research (E.T.L.), University of Oklahoma Health Sciences Center, Oklahoma City; and Aberdeen Area Tribal Chairmen’s Health Board (T.K.W.), Rapid City, SD.

^* To whom correspondence should be addressed. E-mail: simogi{at}unina.it.

Abstract--Abnormalities in whole blood viscosity (WBV) have been implicated in hypertension. This study analyzes relations between WBV and blood pressure in the Strong Heart Study population of American Indians. We examined 676 participants (489 women, age 62±7 years) without prevalent cardiovascular disease or use of antihypertensive medications, digoxin, or aspirin. WBV was calculated from hematocrit and plasma protein concentration, at a shear rate of 208 seconds^-1, by a validated equation. Forty eight percent of participants were obese, 43% had diabetes, 19% had hypertension, and 30% were current smokers. WBV was higher in men, smokers, and participants with central obesity, but it was not associated with hypertension or diabetes, even accounting for confounders. After adjusting for gender, age, center, smoking, obesity, diabetes, and plasma creatinine, WBV was negatively related to pulse pressure (=-0.13; P<0.001) and systolic pressure (=-0.09; P<0.02), mainly because of negative relations with hematocrit (=-0.11 and -0.10). Among hypertensive individuals, pulse pressure was positively related to age, diabetes, and female gender but not to WBV (multiple R=0.63; P<0.0001); in contrast, in normotensive individuals, pulse pressure was related negatively to WBV or hematocrit, independent of body mass index, without relation to diabetes (R=0.42; P<0.0001). Thus, under normal physiological conditions, in vivo WBV is negatively related pulse pressure. In contrast, the presence of arterial hypertension makes this relation less evident.

Key words: blood volume • hematocrit • hypertension • pulse • risk factors

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