White Blood Cell Count, C-Reactive Protein, and Incident Heart Failure in the Atherosclerosis Risk in Communities (ARIC) Study

Wobo Bekwelem, Pamela L. Lutsey, Laura R. Loehr, Sunil K. Agarwal, Brad C. Astor, Cameron Guild, Christie M. Ballantyne, Aaron R. Folsom

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

Purpose: To test the hypothesis that inflammation measured by white blood cell count (WBC) and C-reactive protein (CRP) is associated positively with incident heart failure (HF). Methods: Using the Atherosclerosis Risk in Communities (ARIC) Study, we conducted separate Cox proportional hazards regression analyses for WBC (measured 1987-1989) and CRP (measured 1996-1998) in relation to subsequent heart failure occurrence. A total of 14,485 and 9,978 individuals were included in the WBC and CRP analyses, respectively. Results: There were 1647 participants that developed HF during follow-up after WBC assessment and 613 developed HF after CRP assessment. After adjustment for demographic variables and traditional HF risk factors, the hazard ratio (95% confidence interval) for incident HF across quintiles of WBC was 1.0, 1.10 (0.9-1.34), 1.27 (1.05-1.53), 1.44 (1.19-1.74), and 1.62 (1.34-1.96), p trend < .001; hazard ratio across quintiles of CRP was 1.0, 1.03 (0.68-1.55), 0.99 (0.66-1.51), 1.40 (0.94-2.09), and 1.70 (1.14-2.53), p trend .002. Granulocytes appeared to drive the relation between WBCs and heart failure (hazard ratios across quintiles: 1.0, 0.93 [0.76-1.15], 1.26 [1.04-1.53], 1.67 [1.39-2.01], and 2.19 [1.83-2.61], p trend <0001), whereas lymphocytes or monocytes were not related. Conclusions: Greater levels of WBC (especially granulocytes) and CRP are associated with increased risk of heart failure in middle-aged adults, independent of traditional risk factors.

Original languageEnglish (US)
Pages (from-to)739-748
Number of pages10
JournalAnnals of epidemiology
Volume21
Issue number10
DOIs
StatePublished - Oct 2011

Keywords

  • C-Reactive Protein
  • Granulocytes
  • Heart Failure
  • Inflammation
  • Leukocytes
  • Prospective Study
  • Risk Factors

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