Elevated white blood cell count and carotid plaque thickness: The Northern Manhattan stroke study

Mitchell S. Elkind, Jianfeng Cheng, Bernadette Boden-Albala, Myunghee C. Paik, Ralph L. Sacco

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)842-849
Number of pages8
JournalStroke
Volume32
Issue number4
StatePublished - 2001

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Leukocyte Count
Stroke
Hispanic Americans
Odds Ratio
Confidence Intervals
Cerebrovascular Disorders
Doppler Ultrasonography
Asymptomatic Infections
Carotid Artery Diseases
Epidemiologic Studies
Linear Models
Cardiovascular Diseases
Cross-Sectional Studies
Logistic Models
Demography
Inflammation
Population

Keywords

  • Atherosclerosis
  • Cerebrovascular disorders
  • Epidemiology
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Elkind, M. S., Cheng, J., Boden-Albala, B., Paik, M. C., & Sacco, R. L. (2001). Elevated white blood cell count and carotid plaque thickness: The Northern Manhattan stroke study. Stroke, 32(4), 842-849.

Elevated white blood cell count and carotid plaque thickness : The Northern Manhattan stroke study. / Elkind, Mitchell S.; Cheng, Jianfeng; Boden-Albala, Bernadette; Paik, Myunghee C.; Sacco, Ralph L.

In: Stroke, Vol. 32, No. 4, 2001, p. 842-849.

Research output: Contribution to journalArticle

Elkind, MS, Cheng, J, Boden-Albala, B, Paik, MC & Sacco, RL 2001, 'Elevated white blood cell count and carotid plaque thickness: The Northern Manhattan stroke study', Stroke, vol. 32, no. 4, pp. 842-849.
Elkind, Mitchell S. ; Cheng, Jianfeng ; Boden-Albala, Bernadette ; Paik, Myunghee C. ; Sacco, Ralph L. / Elevated white blood cell count and carotid plaque thickness : The Northern Manhattan stroke study. In: Stroke. 2001 ; Vol. 32, No. 4. pp. 842-849.
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abstract = "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.",
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T1 - Elevated white blood cell count and carotid plaque thickness

T2 - The Northern Manhattan stroke study

AU - Elkind, Mitchell S.

AU - Cheng, Jianfeng

AU - Boden-Albala, Bernadette

AU - Paik, Myunghee C.

AU - Sacco, Ralph L.

PY - 2001

Y1 - 2001

N2 - 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.

AB - 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.

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