4/14/2016

Blood Viscosity Determinants of Blood Viscosity

Gregory D. Sloop, M.D
Hematocrit
Erythrocyte Deformability
Plasma Viscosity; fibrinogen,
lipoproteins, immunoglobulins
particularly IgM

Blood Viscosity
Inversely proportional to perfusion
Increases vascular resistance
Predisposes to thrombosis

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Technical Issues

Blood or plasma
EDTA or heparin
Low shear blood viscosity
correlates with Sed rate
Normalize hematocrit?

Acute Hyperviscosity Chronic Hyperviscosity

 Hypercholesterolemia
Leukemia  Diabetes mellitus
 Hypertension
Inflammation  Hyperfibrinogenemia
 Male gender
Dehydration  Aging
 Polycythemia vera

Multiple myeloma  Obesity

 Insulin resistance
 Smoking

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Edinburgh Artery Study Decreased Erythrocyte Deformability

n=1592, age 55-74 Hypertension

 3.57 v. 3.48 mPa s Diabetes mellitus
“At least as strong as conventional Sickle cell disorders
risk factors”
Smoking

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Therapeutic Phlebotomy
Protocols are similar to blood
donations
250 to 500 cc
Can use smaller needle (18 or
19 gauge)
Health benefits of blood
donation
4/14/2016
Systemic Vascular Resistance Response
 Anemia of Chronic Disease
 Sickle Cell Crisis
 Spaceflight anemia
 Hypertension
 Malaria
 Adaptation to exercise: “Sports Anemia”
“Effects of Phlebotomy-Induced
Reduction of Body Iron Stores on
Metabolic Syndrome”
n= 33 treated, 31 controls
B.P. decreased 16.6 mm Hg (95 %
CI: 20.7 to 12.5 mmHg, p<0.001
Glucose decreased 13.3mg/dl (95 %
CI: 18.8 to 8.1mg/dl, p<0.001
Blood viscosity contributes to
total peripheral resistance.
Therefore, chronic
hyperviscosity will contribute to
accelerated fatigue of elastin
and aortic stiffening
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“Longevity is a vascular question…’a man is

only as old as his arteries’…a man of forty
Summary
may present vessels as much degenerated
as they should be at eighty…the arterio- Increased blood viscosity contributes to
sclerosis results from the bad use of good cardiovascular disease: myocardial
vessels.” infarctions, some strokes, peripheral vascular
disease
 Sir William Osler (1849-1919) from The Principles and Practice
of Medicine, Osler and McCrae, 9th Ed., p. 102, 1921.
May cause hypertension
Accelerates aging