Koenig W, Sund M, Ernst E, Keil U, Rosenthal J, Hombach V
Department of Internal Medicine IV, Ulm University Medical Center, Germany.
Am J Hypertens. 1991 Jun;4(6):529-36. doi: 10.1093/ajh/4.6.529.
The relationship between determinants of blood viscosity and blood pressure (BP) variables was studied in a large sample of a population aged 25 to 64 years. Plasma viscosity, hemoglobin, and total serum protein were examined. Systolic and diastolic BP and the prevalence of hypertension showed a crude positive association with plasma viscosity levels in both sexes. Age, body mass index, and total serum protein appeared to have a confounding effect on this relationship, whereas hemoglobin, smoking behavior, and alcohol consumption did not. A crude positive association was also found between total serum protein levels and the prevalence of hypertension in men and women; however, since total serum protein was treated as a covariable, no further analyses were carried out. In contrast to findings reported in the literature, hemoglobin levels were not correlated with BP variables in either sex. After adjusting for all confounders, a significant main effect of plasma viscosity still was found. However, the magnitude of the effect was not as large as for body mass index, a well-established risk variable for hypertension. These results indicate that BP is positively associated with plasma viscosity. Whether increased plasma viscosity in hypertension constitutes a primary or a secondary phenomenon remains to be answered. Since plasma viscosity is significantly associated with hypertension but any BP variable, increased levels of plasma proteins (particularly fibrinogen as the main determinant of plasma viscosity) may represent the cause for elevated plasma viscosity. This might contribute to persistently increased resistance to blood flow on the microcirculatory level in arterial hypertension.
在一个年龄为25至64岁的大样本群体中,研究了血液粘度的决定因素与血压(BP)变量之间的关系。检测了血浆粘度、血红蛋白和血清总蛋白。收缩压和舒张压以及高血压患病率与两性的血浆粘度水平呈粗略的正相关。年龄、体重指数和血清总蛋白似乎对这种关系有混杂作用,而血红蛋白、吸烟行为和饮酒则没有。在男性和女性中,血清总蛋白水平与高血压患病率之间也发现了粗略的正相关;然而,由于血清总蛋白被视为协变量,未进行进一步分析。与文献报道的结果相反,血红蛋白水平与两性的血压变量均无相关性。在对所有混杂因素进行调整后,仍然发现血浆粘度有显著的主效应。然而,该效应的大小不如体重指数,体重指数是一个公认的高血压风险变量。这些结果表明,血压与血浆粘度呈正相关。高血压中血浆粘度升高是原发性还是继发性现象仍有待回答。由于血浆粘度与高血压显著相关,但与任何血压变量无关,血浆蛋白水平升高(特别是作为血浆粘度主要决定因素的纤维蛋白原)可能是血浆粘度升高的原因。这可能导致动脉高血压患者在微循环水平上对血流的阻力持续增加。