Correlates of leukocyte counts in men

doi:10.1016/1047-2797(95)00091-7

Annals of Epidemiology

Volume 6, Issue 1, January 1996, Pages 74-82

https://doi.org/10.1016/1047-2797(95)00091-7 Get rights and content

Abstract

Because of previously reported associations between a high leukocyte count and risk of ischemic heart disease (IHD), we examined the relation of leukocyte counts to various characteristics among 3591 white and 506 black 31- to 45-year-old men. The mean leukocyte count was approximately 1000 cells/μL higher among whites than among blacks, and approximately 1900 cells/μL higher among current smokers than among nonsmokers. The leukocyte count was also higher among men who had recently stopped smoking and among men who reported their general health as poor or fair. Independent of these relations, the leukocyte count was associated positively with the platelet count (r = 0.29), triglyceride level (r = 0.21), heart rate (r = 0.15), and use of corticosteroids and beta-blockers; and inversely with alcohol consumption and prothrombin time (r = −0.10). The examined characteristics could together account for 37% of the variability in leukocyte counts. These relatively strong associations indicate that it may be difficult to disentangle the relation of the leukocyte count to IHD from that of other risk factors.

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Fasting and non-fasting triglycerides and risk of ischemic cardiovascular disease in Japanese men and women: The Circulatory Risk in Communities Study (CIRCS)
2014, Atherosclerosis
Citation Excerpt :
High triglyceride levels in either the postprandial or fasting state are associated with increased small LDL particles [26], which may be more atherogenic than larger LDL particles because of increased susceptibility to oxidation [27]. High triglycerides levels are also associated with increased concentrations of factor VII and plasminogen activator inhibitor [13], as well as with enhanced insulin resistance [28] and blood leukocyte counts [29], all of which may accelerate atherosclerotic and thrombotic processes. Our study's finding that the positive association between triglycerides and risk of ischemic heart disease was similar for fasting and non-fasting men was in agreement with the previous finding by a cohort study of American men enrolled in the Multiple Risk Factor Intervention Trial [9].
Non-fasting triglycerides were reported to have a greater impact on risk of ischemic cardiovascular events than fasting triglycerides. However, evidence from Asia, where the prevalence of dyslipidemia is generally lower, has been limited.
We used 1975–1986 baseline surveys to investigate cohort data of 10,659 (4264 men and 6395 women) residents aged 40–69 years, initially free from ischemic heart disease and stroke, in four Japanese communities. Serum triglyceride concentrations at baseline were obtained for 2424 fasting (≥8 h after meal) and 8235 non-fasting (<8 h after meal) participants.
During the 22-year follow-up, 284 (165 men and 119 women) developed ischemic heart disease and 666 (349 men and 317 women) ischemic stroke. After adjustment for age, sex and known cardiovascular risk factors, multivariable hazard ratios (95%CI) of ischemic cardiovascular disease (ischemic heart disease and ischemic stroke) for the highest versus lowest quartiles of triglycerides were 1.71 (1.14–2.59), P for trend = 0.013, for fasting participants and 1.60 (1.25–2.05), P for trend <0.001, for non-fasting participants. The positive associations did not differ between fasting and non-fasting men, while they were strong for non-fasting women. They were stronger for ischemic heart disease than for ischemic stroke. After further adjustment for HDL-cholesterol, these associations were slightly attenuated, but remained statistically significant.
Non-fasting as well as fasting triglycerides are predictive of risk of ischemic cardiovascular disease for Japanese men, as are non-fasting triglycerides for women.
Prognostic Value of Elevated White Blood Cell Count in Hypertension
2007, American Journal of Hypertension
Chronic low-grade inflammation may contribute to vascular injury and atherogenesis, and has been described in association to high blood pressure (BP). However, as yet the prognostic significance of white blood cell (WBC) count in the setting of uncomplicated hypertension has not been investigated.
In the Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) study, 1617 white patients with essential hypertension (aged 49 ± 12 years, 55% men) without prevalent cardiovascular or renal disease underwent off-treatment baseline clinical evaluation and were then followed up for 11 years (average 4.9 years).
The WBC count had a direct association with smoking status, serum triglycerides, body mass index, and 24-h BP, and an inverse one with age (all P < .05). During follow-up, 146 patients developed a major fatal or nonfatal cardiovascular event (1.9 events per 100 patient-years). Patients who will develop a cardiovascular event had a higher WBC count (7.08 ± 1.6 v 6.68 ± 1.6 × 10⁹ cells/L, P = .004). Event rate increased progressively from the first to the fourth quartile of WBC count distribution (1.2, 1.8, 1.9, and 2.3 events per 100 patient-years; P < .01 by log-rank test). After adjustment (Cox model) for the effect of age, gender, diabetes, serum cholesterol, glomerular filtration rate, smoking, left ventricular hypertrophy, and 24-h systolic BP, cardiovascular event risk increased by 24% (95% confidence interval +4% to +48%; P = .019) for each 2 × 10⁹ cells/L increase in WBC.
After adjustment for average 24-h BP, established risk factors and target organ damage, an elevated WBC count remains an independent predictor of cardiovascular morbidity in hypertensive patients.
Effects of exposure to air pollution on blood coagulation
2007, Journal of Thrombosis and Haemostasis
Background: Consistent evidence has indicated that air pollution increases the risk of cardiovascular diseases. The underlying mechanisms linking air pollutants to increased cardiovascular risk are unclear. Objectives: We investigated the association between the pollution levels and changes in such global coagulation tests as the prothrombin time (PT) and the activated partial thromboplastin time (APTT) in 1218 normal subjects from the Lombardia Region, Italy. Plasma fibrinogen and naturally occurring anticoagulant proteins were also evaluated. Methods: Hourly concentrations of particulate (PM₁₀) and gaseous pollutants (CO, NO₂, SO₂, and O₃) were obtained from 53 monitoring sites covering the study area. Generalized additive models were applied to compute standardized regression coefficients controlled for age, gender, body mass index, smoking, alcohol, hormone use, temperature, day of the year, and long‐term trends. Results: The PT became shorter with higher ambient air concentrations at the time of the study of PM₁₀ (coefficient = −0.06; P < 0.05), CO (coefficient = −0.11; P < 0.001) and NO₂ (coefficient =−0.06; P < 0.05). In the 30 days before blood sampling, the PT was also negatively associated with the average PM₁₀ (coefficient = −0.08; P < 0.05) and NO₂ (coefficient = −0.08; P < 0.05). No association was found between the APTT and air pollutant levels. In addition, no consistent relations with air pollution were found for fibrinogen, antithrombin, protein C and protein S. Conclusions: This investigation shows that air pollution is associated with changes in the global coagulation function, suggesting a tendency towards hypercoagulability after short‐term exposure to air pollution. Whether these changes contribute to trigger cardiovascular events remains to be established.
Associations between white blood cell count and risk for cerebrovascular disease mortality: NHANES II Mortality Study, 1976-1992
2004, Annals of Epidemiology
To examine associations between elevated white blood cell count (WBC) and cerebrovascular disease (CeVD) mortality independent of cigarette smoking and by gender.
We used Cox regression analyses of data from 8459 adults (3982 men; 4477 women) aged 30 to 75 years in the NHANES II Mortality Study (1976–1992) to estimate the relative risk of death from CeVD across quartiles of WBC.
During 17 years of follow-up, there were 192 deaths from CeVD (93 men; 99 women). Compared with those with WBC (cells/mm³)<5700, adults with WBC > 8200 were at increased risk of CeVD mortality (relative risk [RR], 2.1; 95% confidence interval [CI], 1.2–3.7) after adjustment for smoking and other cardiovascular disease risk factors. Similar results were observed among never smokers (RR, 2.0; 95% CI, 1.0–3.8). The adjusted relative risk of CeVD mortality comparing those with WBC > 8200 to those with WBC<5700 was 1.5 (95% CI, 0.7–3.5) among men and 2.7 (95% CI, 1.4–5.0) among women.
Elevated WBC may predict CeVD mortality even after considering the effects of smoking and other cardiovascular disease risk factors.
Young male smokers have altered platelets and endothelium that precedes atherosclerosis
2004, Journal of Surgical Research
Cigarette smoking results in abnormalities of platelets and endothelium with platelet dysfunction implicated in vascular complications. Healthy endothelium plays a pivotal role in regulating hemostasis via the inhibition of platelet activation and aggregation. Thus, we examined if platelet dysfunction correlated with serum vWF levels—a circulating marker of endothelial dysfunction.
We tested this hypothesis in young male smokers. The parameters of platelet function tested included: CD62/CD63; Glycoprotein (GP) IIb/IIIa; Platelet function analzyer (PFA) studies, platelet aggregometry, flow assessment of platelet microparticles, platelet-leukocyte interactions and receptor numbers. Endothelial dysfunction was assessed with serum von Willebrand Factor (vWF).
There was a significant increase in platelet CD62 receptor expression and aggregation with an associated delay in time to aggregation using PFA. Endothelial dysfunction was represented by higher serum levels of von Willebrand Factor. All other platelet parameters tested were within the standardized reference range.
These initial data suggests that anti-platelet therapy may have a role in reduction of platelet activation and aggregation in young smokers and possibly alter vascular endothelial abnormalities.
Inflammatory dispositions: A population-based study of the association between hostility and peripheral leukocyte counts
2003, Personality and Individual Differences
This study tests the hypothesis that high hostility is associated with increased peripheral blood leukocyte count. Hostility and peripheral blood leukocyte count have been independently associated with cardiovascular and all cause mortality but their association has not been reported in a population-based sample. Participants in the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk), aged 40–80 years, were identified through age–sex general practice registers. White blood cell counts and a measure of hostility were available from 11,367 participants and, after a mean interval of 44 months, from 11,857 at a second health check. The measure of hostility was completed between health checks. Age-adjusted associations were found between hostility and lymphocyte counts assessed at both health checks. Sex differences in these associations were not observed. There was an incremental elevation in mean lymphocyte cell counts with increasing hostility such that there was a 4.6% difference between top and bottom quintiles of hostility at the first (P<0.0001) and 5.0% difference at the second health check (P<0.0001). While half of this association was explained in terms of smoking behaviour, these results support an association between hostility and lymphocyte count, independent of age, sex, smoking history, alcohol intake and social class (1.9% difference, P=0.02 and 2.9% difference, P=0.0007 at the first and second health checks, respectively). If these findings can be replicated, study of inflammation as a plausible pathway linking hostility to health endpoints would be warranted.

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^☆: Data for this study were collected under an interagency agreement with the Department of Veterans Affairs.

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Original reportCorrelates of leukocyte counts in men☆

Abstract

J Clin Epidemiol

Am Heart J

Am Heart J

J Clin Epidemiol

Am Heart J

Prev Med

Ann Epidemiol

J Am Coll Cardiol

Lancet

Ann Epidemiol

Prognostic importance of the white blood cell count for coronary, cancer, and all-cause mortality

JAMA

The leukocyte count as a predictor of myocardial infarction

N Engl J Med

Leucocyte count, smoking and myocardial infarction

N Engl J Med

Leukocyte counts and coronary heart disease in a Japanese cohort

Am J Epidemiol

Fibrinogen, viscosity and white blood cell count are major risk factors for ischemic heart disease: The Caerphilly and Speedwell Collaborative Heart Disease studies

Circulation

Leukocyte count and risk of major coronary heart disease events

Am J Epidemiol

White blood cell count and cardiovascular disease. Insights from the Framingham Study

JAMA

Monocyte count: A risk factor for coronary heart disease?

Am J Epidemiol

Leukocytes and the risk of ischemic diseases

JAMA

The value of cellular markers for the assessment of cardiovascular risk

Curr Opin Lipidol

Hematological stress syndrome in atherosclerosis

J Clin Pathol

Smoking habits and the leukocyte count

Arch Environ Health

Physiological markers of smoking and their relation to coronary heart disease. The Lipid Research Clinics Coronary Primary Prevention Trial

Arteriosclerosis

Original report
Correlates of leukocyte counts in men☆