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Hemoglobin and erythrocyte count are independently and positively associated with arterial stiffness in a community-based study

Abstract

The association of blood hemoglobin (Hb) concentration and red blood cell (RBC) count with arterial stiffness is not well-defined. Herein, we examined the associations of brachial–ankle pulse wave velocity (baPWV) and augmentation index (AI) with Hb level and RBC count from a population cohort in and around Beijing, China. A total of 3994 participants (57.1 ± 8.8 years old) were included in our analysis. Blood routine examination, baPWV, and possible covariates were examined. The mean Hb, RBC count, AI corrected for a heart rate of 75 bpm (AIP75), and baPWV were 131.4 ± 17.1 g/l, 4.2 ± 0.5 1012/l, 80.2 ± 12.0%, and 1665.3 ± 377.1 cm/s, respectively, consistent with previously described cohorts. RBC counts and Hb levels were positively associated with baPWV (β for 1012/l RBC: 50.08 cm/s, 95% confidence interval [CI]: 30.54–69.63, p < 0.001; β for 10 g/l Hb: 9.05 cm/s, 95% CI: 3.35–14.76, p = 0.002) and AIP75 (β for 1012/l RBC: 1.33%, 95% CI: 0.55–2.12, p < 0.001; β for 10 g/l Hb: 0.34%, 95% CI: 0.12−0.57, p = 0.003), despite adjustment for covariates. The average levels of baPWV in the third–fourth quartile RBC groups were higher than in the first quartile (Q1) group (p < 0.001 for all). The average levels of baPWV in the fourth quartile Hb groups were higher than in the Q1 Hb group (p = 0.038). Mean AIP75 levels in the third−fourth RBC and Hb groups were higher than in the Q1 groups (p < 0.05 for all). In conclusion, circulating blood Hb levels and RBC counts are positively associated with arterial stiffness in our community-based study.

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Fig. 1: Association of red blood cell (RBC) traits with arterial stiffness measures.
Fig. 2: Subgroup and interaction analysis of the association of Hb with PWV.

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Acknowledgements

We thank Liwen Bianji, Edanz Editing China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This study was supported by the UM-PUHSC Joint Institute for Translational and Clinical Research (Grant Nos: BMU20110177 and BMU20160530). SKG is supported by R01HL122684 and R01HL139672.

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Correspondence to Santhi K. Ganesh or Yan Zhang.

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Sun, P., Jia, J., Fan, F. et al. Hemoglobin and erythrocyte count are independently and positively associated with arterial stiffness in a community-based study. J Hum Hypertens 35, 265–273 (2021). https://doi.org/10.1038/s41371-020-0332-6

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