Direct relationship between blood pressure and blood viscosity in normal and hypertensive subjects: Role of fibrinogen and concentration

doi:10.1016/0002-9343(81)90827-5

The American Journal of Medicine

Volume 70, Issue 6, June 1981, Pages 1195-1202

https://doi.org/10.1016/0002-9343(81)90827-5 Get rights and content

Abstract

Blood pressure and components of blood viscosity were measured in 49 normal subjects and in 49 untreated patients with essential hypertension. Blood viscosity values measured at six different shear rates were significantly correlated with blood pressure (r = 0.432 to 0.505, p < 0.001). Blood viscosity was higher in hypertensive patients. This was due to both higher plasma viscosity (1.29 ± 0.08 standard deviation versus 1.24 ± 0.05 centipoise (cPs), p < 0.001) and increased hematocrit values (44.4 ± 4 percent versus 41.5 ± 3 percent, p < 0.005). When blood viscosity was evaluated in subgroups of normal and hypertensive subjects with matched hematocrit values, it remained higher in the hypertensive patients, and the relationship between blood pressure and viscosity was still significant.

Regardless of the hematocrit value, fibrinogen levels were elevated in hypertensive patients (p < 0.006) and, in association with the increased globulin concentration, fibrinogen was largely responsible for the increased plasma viscosity in hypertensive patients. Since the viscosity of defibrinated blood was similar in normal and hypertensive subjects with matched hematocrit values, the elevated fibrinogen level also affected whole blood viscosity. Defibrinated blood viscosity and arterial pressures were not correlated.

These studies demonstrate a direct correlation between blood pressure and blood viscosity among normotensive and hypertensive subjects. This relationship is, in part, due to the rheologic effects of an elevated fibrinogen level and to an increased hematocrit value. The basis for hyperfibrinogenemia in hypertensive patients is unclear.

References (45)

G Tibblin et al.
Hematocrit, plasma protein, plasma volume, and viscosity in early hypertensive disease
Am Heart J
(1966)
AN Nicolaides et al.
Blood viscosity, red cell deformability, hematocrit and plasma fibrinogen in patients with angina
Lancet
(1977)
SG Chrysant et al.
Pathologic significance of “stress” or relative polycythemia
Am J Cardiol
(1976)
BS Neuhausen et al.
The refractometric determination of serum proteins
J Biol Chem
(1923)
AC Guyton
Arterial pressure and hypertension
S Chien
Blood rheology in hypertension and cardiovascular disease
Cardiovasc Med
(1977)
GW Pickering
The peripheral resistance in persistant arterial hypertension
Clin Sci
(1936)
PM Schloz et al.
Correlation of blood rheology with vascular resistance in critically ill patients
J Appl Physiol
(1975)
I Harris et al.
The viscosity of blood in high blood pressure
Q J Med
(1930)
F Gaisböck
Die Bedeutung der blutdruchmessung Für die arztliche praxis
Deutsch Arch Klin Med
(1905)

RP Russell et al.

Benign polycythemia: Gaisböck's syndrome

Arch Intern Med

(1964)

MS Neff et al.

Hemodynamics of uremic anemia

Circulation

(1971)

RL Letcher et al.

Changes in blood viscosity accompanying the response to prazosin in patients with essential hypertension

J Cardiovasc Pharmacol

(1979)

K-M Jan et al.

Observations on blood viscosity changes after acute myocardial infarction

Circulation

(1975)

GE Burch et al.

The hematocrit in patients with myocardial infarction

JAMA

(1962)

JA Dormandy et al.

Clinical, hemodynamic, rheological, and biochemical findings in 126 patients with intermittent claudication

Br Med J

(1973)

JA Dormandy

Influence of blood viscosity on blood flow and the effect of low-molecular weight dextran

Br Med J

(1971)

WS Tinney et al.

Cardiac disease and hypertension in polycythemia vera

AC Emery et al.

“Stress” polycythemia and hypertension

JAMA

(1974)

KM McDonald

Effect of hematocrit and colloid-induced changes in blood viscosity on renal hemodynamics and renin release in the dog

Circ Res

(1974)

TQ Richardson et al.

Effects of polycythemia and anemia on cardiac output and other circulatory factors

Am J Physiol

(1959)

AC Guyton et al.

The effect of hematocrit on venous return

Circ Res

(1961)

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^☆: This study was supported by U.S. Public Health Service Grant HL-18323-SCR and by U.S. Public Health Service Training Award HL-07114.

¹: From the Cardiovascular Center and Department of Medicine, The New York-Cornell Medical Center, and the Laboratory of Hemorheology, Department of Physiology, College of Physicians and Surgeons, New York, New York.

View full text

Clinical studyDirect relationship between blood pressure and blood viscosity in normal and hypertensive subjects: Role of fibrinogen and concentration☆

Abstract

Am Heart J

Lancet

Am J Cardiol

J Biol Chem

Arterial pressure and hypertension

Blood rheology in hypertension and cardiovascular disease

Cardiovasc Med

The peripheral resistance in persistant arterial hypertension

Clin Sci

Correlation of blood rheology with vascular resistance in critically ill patients

J Appl Physiol

The viscosity of blood in high blood pressure

Q J Med

Die Bedeutung der blutdruchmessung Für die arztliche praxis

Deutsch Arch Klin Med

Benign polycythemia: Gaisböck's syndrome

Arch Intern Med

Hemodynamics of uremic anemia

Circulation

Changes in blood viscosity accompanying the response to prazosin in patients with essential hypertension

J Cardiovasc Pharmacol

Observations on blood viscosity changes after acute myocardial infarction

Circulation

The hematocrit in patients with myocardial infarction

JAMA

Clinical, hemodynamic, rheological, and biochemical findings in 126 patients with intermittent claudication

Br Med J

Influence of blood viscosity on blood flow and the effect of low-molecular weight dextran

Br Med J

Cardiac disease and hypertension in polycythemia vera

“Stress” polycythemia and hypertension

JAMA

Effect of hematocrit and colloid-induced changes in blood viscosity on renal hemodynamics and renin release in the dog

Circ Res

Effects of polycythemia and anemia on cardiac output and other circulatory factors

Am J Physiol

The effect of hematocrit on venous return

Circ Res

Clinical study
Direct relationship between blood pressure and blood viscosity in normal and hypertensive subjects: Role of fibrinogen and concentration☆