(Stroke. 2001;32:842.)
© 2001 American Heart Association, Inc.
Original Contributions |
Elevated White Blood Cell Count and Carotid Plaque Thickness
The Northern Manhattan Stroke Study
Presented in abstract form at the American Heart Association Stroke Conference, New Orleans, La, February 10, 2000.
From the Department of Neurology (M.S.E., R.L.S.) and Sergievsky Center (M.S.E., B.B.-A., R.L.S.), College of Physicians and Surgeons, Columbia University, New York, NY; Columbia-Presbyterian Medical Center of New York Presbyterian Hospital, New York, NY (M.S.E., R.L.S.); and Divisions of Biostatistics (J.C., M.C.P.), Sociomedical Sciences (B.B.-A.), and Epidemiology (R.L.S.), Joseph P. Mailman School of Public Health, Columbia University, New York, NY.
Correspondence to Mitchell S. Elkind, MD, Neurological Institute, 710 W 168th St, New York, NY 10032. E-mail mse13{at}columbia.edu
Background and Purpose—Elevated leukocyte count has been associated with cardiovascular and cerebrovascular disease in several epidemiological studies. We sought to determine whether white blood cell count (WBC) is associated with carotid plaque thickness in a stroke-free, multiethnic cohort.
Methods—For this
cross-sectional analysis, WBC was measured in stroke-free
community subjects undergoing carotid duplex Doppler ultrasound.
Maximal internal carotid plaque thickness (MICPT) was measured for each
subject. Demographic and potential medical confounding factors were
analyzed with linear and logistic regression to calculate the
effect of quartile of WBC on MICPT. Odds ratios (ORs) and 95%
confidence intervals (CIs) for the effect of quartile of WBC on MICPT
75th percentile were calculated. All analyses were stratified
by race-ethnicity.
Results—The mean age of
the 1422 subjects was 68.6±10.2 years; 40.0% were men; 24.4% were
white, 46.9% Hispanic, and 26.7% black. Among Hispanics, compared
with the lowest quartile of WBC, those in the highest quartile had
significantly increased MICPT (mean difference=0.30 mm,
P=0.0086) after adjustment for
age, sex, and other atherosclerotic risk factors. There was no
significant increase for blacks or whites. The OR for MICPT 75th
percentile (1.9 mm) was significantly increased for Hispanics (OR,
2.8; 95% CI, 1.4 to 5.6), marginally elevated for black non-Hispanics
(OR, 1.6; 95% CI, 0.8 to 3.2), and not increased for white
non-Hispanics (OR, 0.5; 95% CI, 0.2 to
1.1).
Conclusions—Relative elevation in WBC is associated with carotid atherosclerosis, but this relationship differs by race-ethnicity. The association is strongest in Hispanics, intermediate in black non-Hispanics, and not present in white non-Hispanics in this population. Chronic subclinical infection or inflammation may account for this association.
Key Words: atherosclerosis • cerebrovascular disorders • epidemiology • risk factors
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