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High leukocyte count is associated with peripheral vascular dysfunction in individuals with low cardiovascular risk


Li, J; Flammer, A J; Reriani, M K; Matsuo, Y; Gulati, R; Friedman, P A; Thomas, R J; Sandhu, N P; Lerman, L O; Lerman, A (2013). High leukocyte count is associated with peripheral vascular dysfunction in individuals with low cardiovascular risk. Circulation Journal, 77(3):780-785.

Abstract

BACKGROUND: Vascular dysfunction is a surrogate marker of early-stage atherosclerosis. Serum leukocyte count is a non-traditional risk factor of cardiovascular (CV) disease and has predictive value for CV outcome. The aim of this study was to investigate the relationship between leukocyte count and peripheral vascular dysfunction. METHODS AND RESULTS: In this cross-sectional study, 357 individuals without known CV disease and with low Framingham risk (10-year hard coronary heart disease risk <10%) were identified. Vascular function was measured by assessing reactive hyperemia-induced vasodilation (reactive hyperemia index, RHI). In 105 individuals with vascular dysfunction (29.4%), the median leukocyte count was significantly higher than in those with normal RHI (6.4 x 10(9)/L vs. 6.0 x 10(9)/L; P=0.04). The neutrophil count was the strongest predictor of impaired vascular function among leukocyte subtypes (odds ratio [OR], 2.70; 95% confidence interval [CI]: 1.58-4.60, P<0.001). In a multivariate logistic regression model, the highest quintile of neutrophil count (OR, 2.36; 95% CI: 1.35-4.12; P=0.003), body mass index (OR, 1.05; 95% CI: 1.01-1.09; P=0.009) and systolic blood pressure (OR, 0.97; 95% CI: 0.97-0.99; P<0.001) were independently predictive for vascular dysfunction. CONCLUSIONS: The highest quintile of leukocyte count is independently associated with vascular dysfunction in individuals with low CV risk. This suggests that subclinical inflammation affects vascular function. Leukocyte count may be useful for personalized risk stratification.

Abstract

BACKGROUND: Vascular dysfunction is a surrogate marker of early-stage atherosclerosis. Serum leukocyte count is a non-traditional risk factor of cardiovascular (CV) disease and has predictive value for CV outcome. The aim of this study was to investigate the relationship between leukocyte count and peripheral vascular dysfunction. METHODS AND RESULTS: In this cross-sectional study, 357 individuals without known CV disease and with low Framingham risk (10-year hard coronary heart disease risk <10%) were identified. Vascular function was measured by assessing reactive hyperemia-induced vasodilation (reactive hyperemia index, RHI). In 105 individuals with vascular dysfunction (29.4%), the median leukocyte count was significantly higher than in those with normal RHI (6.4 x 10(9)/L vs. 6.0 x 10(9)/L; P=0.04). The neutrophil count was the strongest predictor of impaired vascular function among leukocyte subtypes (odds ratio [OR], 2.70; 95% confidence interval [CI]: 1.58-4.60, P<0.001). In a multivariate logistic regression model, the highest quintile of neutrophil count (OR, 2.36; 95% CI: 1.35-4.12; P=0.003), body mass index (OR, 1.05; 95% CI: 1.01-1.09; P=0.009) and systolic blood pressure (OR, 0.97; 95% CI: 0.97-0.99; P<0.001) were independently predictive for vascular dysfunction. CONCLUSIONS: The highest quintile of leukocyte count is independently associated with vascular dysfunction in individuals with low CV risk. This suggests that subclinical inflammation affects vascular function. Leukocyte count may be useful for personalized risk stratification.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Adult Blood Pressure/physiology Body Mass Index Cardiovascular Diseases/*epidemiology/*pathology/physiopathology Cross-Sectional Studies Female Humans Hyperemia/physiopathology Leukocyte Count Leukocytes/*pathology Logistic Models Male Middle Aged Peripheral Vascular Diseases/*epidemiology/*pathology/physiopathology Predictive Value of Tests Prognosis Risk Factors Vasodilation/physiology
Language:English
Date:2013
Deposited On:01 Nov 2013 08:11
Last Modified:03 Aug 2017 16:08
Publisher:The Japanese Circulation Society
ISSN:1346-9843
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1253/circj.CJ-12-1131
PubMed ID:23220800

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