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Global REACH 2018: High Blood Viscosity and Hemoglobin Concentration Contribute to Reduced Flow-Mediated Dilation in High-Altitude Excessive Erythrocytosis

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dc.contributor.author Tremblay, Joshua C.
dc.contributor.author Hoiland, Ryan L.
dc.contributor.author Howe, Connor A.
dc.contributor.author Coombs, Geoff B.
dc.contributor.author Vizcardo-Galindo, Gustavo A.
dc.contributor.author Figueroa-Mujica, Romulo J.
dc.contributor.author Bermudez, Daniela
dc.contributor.author Gibbons, Travis D.
dc.contributor.author Stacey, Benjamin S.
dc.contributor.author Bailey, Damian M.
dc.contributor.author Tymko, Michael M.
dc.contributor.author MacLeod, David B.
dc.contributor.author Gasho, Chris
dc.contributor.author Villafuerte, Francisco C.
dc.contributor.author Pyke, Kyra E.
dc.contributor.author Ainslie, Philip N.
dc.date.accessioned 2019-12-06T20:57:40Z
dc.date.available 2019-12-06T20:57:40Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7358
dc.description.abstract Excessive erythrocytosis (EE; hemoglobin concentration [Hb] >/=21 g/dL in adult males) is associated with increased cardiovascular risk in highlander Andeans. We sought to quantify shear stress and assess endothelial function via flow-mediated dilation (FMD) in male Andeans with and without EE. We hypothesized that FMD would be impaired in Andeans with EE after accounting for shear stress and that FMD would improve after isovolemic hemodilution. Brachial artery shear stress and FMD were assessed in 23 male Andeans without EE (age: 40+/-15 years [mean+/-SD]; Hb<21 g/dL) and 19 male Andeans with EE (age: 43+/-14 years; Hb>/=21 g/dL) in Cerro de Pasco, Peru (4330 m). Shear stress was quantified from Duplex ultrasound measures of shear rate and blood viscosity. In a subset of participants (n=8), FMD was performed before and after isovolemic hemodilution with blood volume replaced by an equal volume of human serum albumin. Blood viscosity and Hb were 48% and 23% higher (both P<0.001) and FMD was 28% lower after adjusting for the shear stress stimulus ( P=0.013) in Andeans with EE compared to those without. FMD was inversely correlated with blood viscosity ( r(2)=0.303; P<0.001) and Hb ( r(2)=0.230; P=0.001). Isovolemic hemodilution decreased blood viscosity by 30+/-10% and Hb by 14+/-5% (both P<0.001) and improved shear stress stimulus-adjusted FMD from 2.7+/-1.9% to 4.3+/-1.9% ( P=0.022). Hyperviscosity, high Hb, or both, actively contribute to acutely reversible impairments in FMD in EE, suggesting that this plays a pathogenic role in the increased cardiovascular risk. en_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartofseries Hypertension
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Altitude en_US
dc.subject brachial artery en_US
dc.subject hemodilution en_US
dc.subject hypoxia en_US
dc.subject polycythemia en_US
dc.subject adult en_US
dc.subject Adult en_US
dc.subject altitude en_US
dc.subject Altitude en_US
dc.subject blood en_US
dc.subject blood flow en_US
dc.subject blood viscosity en_US
dc.subject Blood Viscosity en_US
dc.subject Blood Viscosity/physiology en_US
dc.subject brachial artery en_US
dc.subject Brachial Artery en_US
dc.subject Brachial Artery/diagnostic imaging/physiopathology en_US
dc.subject clinical trial en_US
dc.subject diagnostic imaging en_US
dc.subject Doppler ultrasonography en_US
dc.subject Endothelium, Vascular en_US
dc.subject Endothelium, Vascular/physiopathology en_US
dc.subject hemodilution en_US
dc.subject hemoglobin en_US
dc.subject Hemoglobins en_US
dc.subject Hemoglobins/metabolism en_US
dc.subject human en_US
dc.subject Humans en_US
dc.subject hypoxia en_US
dc.subject male en_US
dc.subject Male en_US
dc.subject metabolism en_US
dc.subject multicenter study en_US
dc.subject pathophysiology en_US
dc.subject physiology en_US
dc.subject polycythemia en_US
dc.subject Polycythemia en_US
dc.subject Polycythemia/blood/etiology/physiopathology en_US
dc.subject Regional Blood Flow en_US
dc.subject Regional Blood Flow/physiology en_US
dc.subject risk factor en_US
dc.subject Risk Factors en_US
dc.subject Ultrasonography, Doppler en_US
dc.subject vascular endothelium en_US
dc.subject vasodilatation en_US
dc.subject Vasodilation en_US
dc.subject Vasodilation/physiology en_US
dc.title Global REACH 2018: High Blood Viscosity and Hemoglobin Concentration Contribute to Reduced Flow-Mediated Dilation in High-Altitude Excessive Erythrocytosis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1161/HYPERTENSIONAHA.119.12780
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.relation.issn 1524-4563


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