Symptoms of chronic bronchitis, haemostatic factors, and coronary heart disease risk
Introduction
Experimental and epidemiological studies have suggested a positive association between a variety of infections and coronary heart disease [1], [2], [3], [4], [5]. These include infections in different organs, both of viral and bacterial origin, and both acute and chronic in nature. Most attention has been paid to dental, gastric, and respiratory tract infections.
There is also growing evidence that haemostatic activity plays a role in coronary heart disease risk [6], [7]. The association between plasma fibrinogen level and the risk of coronary heart disease has been demonstrated in several studies. Increased risk of coronary heart disease death has been shown to associate also with factor VII coagulant activity. Further, increased levels of haemostatic factors, particularly high plasma fibrinogen levels, have been shown to be associated with the occurrence of respiratory infections [8]. Therefore, haemostatic factors may form a biologically plausible mechanism to link infections to coronary heart disease risk. Several life style factors, such as smoking, obesity, physical exercise, and socio-economic status have also been shown to affect the levels of haemostatic factors [9], [10].
The aim of this study was to analyze whether chronic bronchitis, defined by the occurrence of symptoms, is associated with the following haemostatic factors, plasma fibrinogen, coagulation factor VII antigen (F VII:Ag), factor VII coagulant activity (F VII:C), and plasminogen.
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Material and method
The participants of the Finrisk haemostasis study are a sub-sample of the FINMONICA (The Finnish part of the WHO MONICA study) risk factor survey carried out in 1992 [11]. A random sample of 3000 people aged 45–64 years living in three geographical areas was drawn from the Finnish population register. The sampling was stratified so that the sample size was 250 men and 250 women per area and 10-year age group. Ten people were excluded from the sample because of death or emigration from the study
Results
Plasma fibrinogen levels were significantly higher among subjects with symptoms of chronic bronchitis, as compared with those without the symptoms (Table 1). In men the mean fibrinogen levels were 3.70 and 3.35 g/l (P<0.001), and in women 3.64 and 3.44 g/l (P<0.001), among subjects with and without the symptoms, respectively. Also plasminogen levels were slightly higher, 115.3 versus 113.1% (P=0.022), among men with symptoms of chronic bronchitis than among men without the symptoms. This
Discussion
Symptoms of chronic bronchitis associated with plasma fibrinogen levels but not with the other measured haemostatic factors. The mean fibrinogen level of men was about 11% higher and of women about 6% higher among subjects with symptoms of chronic bronchitis than among subjects without the symptoms. Part of that difference was due to the difference in smoking prevalence between the groups but a significant difference remained also after adjustment for smoking. It has been estimated that the
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