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IJE Advance Access published online on July 13, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyp245
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Long-term association of routine blood count (Coulter) variables on fatal coronary heart disease: 30-year results from the first prospective Northwick Park Heart Study (NPHS-I)

Costanza Pizzi*, Bianca L De Stavola and Tom W Meade

Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

* Corresponding author. London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail: costanza.pizzi{at}1shtm.ac.uk


  Abstract

Background Since evidence of a long-term association between routine blood count (Coulter) variables and coronary heart disease (CHD) is inconsistent, the authors analysed white blood cell count (WBC), red blood cell count (RBC), haemoglobin (Hgb), packed cell volume (PCV) and platelet count for their long-term associations with CHD mortality in the first Northwick Park Heart Study (NPHS-I). NPHS-I has follow-up information for >30 years on 2167 White men and 941 White women and holds entry and follow-up data on haematological variables and other known CHD risk factors.

Methods Proportional hazards Cox models were fitted to estimate rate ratios (RRs) for the separate and joint effects of entry and follow-up Coulter variables.

Results Entry RBC, PCV and Hgb were significant risk factors for CHD mortality after adjustment for gender but only PCV remained significant after adjustment for potential confounders [RR per 1 standard deviation (SD) increase = 1.17, 95% confidence interval (CI) 1.00–1.37]. This effect was partly reduced when the values of 6 years were analysed (RR per 1 SD increase = 1.10, 95% CI 0.93–1.30). No significant gender, smoking or age/time interactions were identified. PCV was the only significant predictor when all Coulter variables were studied jointly.

Conclusion PCV was found to predict CHD mortality even after controlling for classical risk factors. This may give some insight into possible mechanisms, such as an influence on thrombin production.

Keywords Coronary heart disease, Coulter, packed cell volume, proportional hazards model

Accepted 4 June 2009


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