Angina, ischemic heart disease and blood viscosity.
Greenberg's recent demonstration of the way in which citation bias
can lead to wrong conclusions seem to be exemplified by the material
published in the fields of cardiovascular and cerebrovascular disorders.
By ignoring what has been written about the role of blood viscosity in
these disorders, clinicians focus on vascular changes, rather than changes
in the physical properties of the blood,in the management of such
disorders.
The symptoms of angina are probable manifestations of impaired
capillary blood flow due to reduced red cell deformability and/or
increased blood viscosity. Such changes may be amplified by vigorous
activity or stress, but are relieved by rest. It was noted that both
smoking and age were associated with adverse outcomes, and both are
associated with increased blood viscosity. Unless the blood viscosity
problem is addressed, then it can be predicted that ischemic heart disease
will follow.
But it is irrational to use angioplasty or bypass operations in an
attempt to restore normal cardiac blood flow, without attempting to lower
blood viscosity. Buckley et al noted, "Neither of the invasive cardiac
procedures significantly reduced the risk of all cause mortality," a
conclusion which implies that the major problem was not being addressed.
The authors stated also, "To minimise adverse reactions, optimal
preventive treatments should be used in patients with angina," but made no
specific recommendations. But there are several approaches to lowering
blood viscosity which could be helpful. Cessation of smoking, dietary
modification towards a low meat and fat intake, with an increased intake
of oily fish, and regular, low intensity physical activity (such as
walking) will lower blood viscosity. As an elevated haematocrit raises
blood viscosity, if necessary this should be lowered. Increased levels of
fibrinogen is an important factor in raised blood viscosity, and if
elevated should be lowered to normal levels.
The recognition of increased blood viscosity as a causal factor in
angina means that the patient can be given some responsibility in managing
his/her health problem. In addition, significant savings could be
anticipated from the lack of use of the surgical procedures.
Rapid Response:
Angina, ischemic heart disease and blood viscosity.
Greenberg's recent demonstration of the way in which citation bias
can lead to wrong conclusions seem to be exemplified by the material
published in the fields of cardiovascular and cerebrovascular disorders.
By ignoring what has been written about the role of blood viscosity in
these disorders, clinicians focus on vascular changes, rather than changes
in the physical properties of the blood,in the management of such
disorders.
The symptoms of angina are probable manifestations of impaired
capillary blood flow due to reduced red cell deformability and/or
increased blood viscosity. Such changes may be amplified by vigorous
activity or stress, but are relieved by rest. It was noted that both
smoking and age were associated with adverse outcomes, and both are
associated with increased blood viscosity. Unless the blood viscosity
problem is addressed, then it can be predicted that ischemic heart disease
will follow.
But it is irrational to use angioplasty or bypass operations in an
attempt to restore normal cardiac blood flow, without attempting to lower
blood viscosity. Buckley et al noted, "Neither of the invasive cardiac
procedures significantly reduced the risk of all cause mortality," a
conclusion which implies that the major problem was not being addressed.
The authors stated also, "To minimise adverse reactions, optimal
preventive treatments should be used in patients with angina," but made no
specific recommendations. But there are several approaches to lowering
blood viscosity which could be helpful. Cessation of smoking, dietary
modification towards a low meat and fat intake, with an increased intake
of oily fish, and regular, low intensity physical activity (such as
walking) will lower blood viscosity. As an elevated haematocrit raises
blood viscosity, if necessary this should be lowered. Increased levels of
fibrinogen is an important factor in raised blood viscosity, and if
elevated should be lowered to normal levels.
The recognition of increased blood viscosity as a causal factor in
angina means that the patient can be given some responsibility in managing
his/her health problem. In addition, significant savings could be
anticipated from the lack of use of the surgical procedures.
Competing interests:
None declared
Competing interests: No competing interests