The association between circulating white blood cell count, triglyceride level and cardiovascular and all-cause mortality: Population-based cohort study

• Published in: Atherosclerosis 2007-05, Vol.192 (1), p.177-183
• Main Authors: Shankar, Anoop, Mitchell, Paul, Rochtchina, Elena, Wang, Jie Jin
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Atherosclerosis (general aspects, experimental research); Australia - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Blood vessels and receptors; Blue Mountains Eye Study; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - mortality; Cardiovascular system; Cohort Studies; Female; Fundamental and applied biological sciences. Psychology; Humans; Leukocyte Count; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Risk; Triglyceride levels; Triglycerides - blood; Vasodilator agents. Cerebral vasodilators; Vertebrates: cardiovascular system; WBC count
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2006.04.029

Abstract Objectives To examine the individual and combined relationship between elevated white blood cell count (WBC), triglyceride level and cardiovascular and all-cause mortality among older Australians. Design Prospective population-based cohort study. Setting Community in Blue Mountains region, Australia. Participants 2904 individuals, aged 49–84 years, free of cardiovascular disease and cancer at the baseline examination. Main outcome measures Cardiovascular ( n = 242) and all-cause mortality ( n = 575). Results Elevated WBC count and triglyceride level were found to be associated with cardiovascular and all-cause mortality, independent of several important confounders. Multivariable relative risk [RR] (95% confidence interval [CI]) comparing fourth (6.8 × 109 cells/L and above) versus first quartile (4.8 × 109 cells/L and below) of WBC count was 2.01 (1.40–2.90) for cardiovascular mortality and 1.68 (1.35–2.09) for all-cause mortality. Multivariable RR (95% CI) comparing fourth (1.98 mmol/L and above) versus first quartile (0.95 mmol/L and below) of triglyceride level was 1.58 (1.08–2.30) for cardiovascular mortality and 1.40 (1.11–1.77) for all-cause mortality. Furthermore, a combined exposure to the fourth quartiles of both WBC count and triglyceride level was found to be related to more than three-fold risk of cardiovascular mortality (RR [95% CI]: 3.15 [2.17–4.57], p -interaction = 0.01), independent of traditional risk factors. Conclusions Elevated WBC count and triglyceride level were associated with cardiovascular and all-cause mortality among older Australians. These data provide new epidemiological evidence regarding cardiovascular risk stratification using simple, inexpensive, and routinely available measures, suggesting that a combined exposure to both high WBC count and triglyceride level is related to more than three-fold risk of cardiovascular mortality, independent of traditional risk factors.