Elsevier

Atherosclerosis

Volume 142, Issue 2, February 1999, Pages 403-407
Atherosclerosis

Symptoms of chronic bronchitis, haemostatic factors, and coronary heart disease risk

https://doi.org/10.1016/S0021-9150(98)00248-2Get rights and content

Abstract

Positive association has been suggested between a variety of infections and coronary heart disease. Disturbances in blood coagulation system may form a link between infections and coronary heart disease. The aim of this study was to analyze whether chronic bronchitis, defined by the occurrence of symptoms, is associated with selected haemostatic factors in a cross-sectional population study of 2379 Finnish men and women aged between 45 and 64 years. Plasma fibrinogen level was significantly higher, 3.70 versus 3.35 g/l (P<0.001) in men and 3.64 versus 3.44 g/l (P<0.001) in women, among subjects with symptoms of chronic bronchitis than among those without symptoms. The association was independent of age, smoking, body mass index, physical exercise, and alcohol consumption. Also plasminogen was higher among men with symptoms than among those without but the difference disappeared after adjustment for age and smoking. Factor VII coagulant activity and factor VII antigen level did not differ between subjects with and without symptoms. Thus, fibrinogen may be associated with a possible mechanism to link chronic bronchitis to coronary heart disease risk, even though the causality of the association cannot be verified in a cross-sectional study.

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.

Section snippets

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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