Reticulocyte levels have an ambivalent association with hypertension and atherosclerosis in the elderly: a cross-sectional study

Abstract

Yuji Shimizu,1,2 Shin-Ya Kawashiri,1 Hirotomo Yamanashi,3,4 Jun Koyamatsu,3 Shoichi Fukui,1 Hideaki Kondo,1,4 Mami Tamai,1 Seiko Nakamichi,4 Takahiro Maeda1,3–41Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; 2Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan; 3Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; 4Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanPurpose: Age-related reduction in bone marrow activity has been shown to cause anemia, and hypertension and endothelial dysfunction (atherosclerosis) are age-related diseases. However, recent studies have revealed a close association between bone marrow activity and endothelial maintenance. This study aimed to determine the association between elevated reticulocyte levels in conjunction with vigorous bone marrow activity and hypertension and atherosclerosis among the elderly.Study population and Methods: To determine the associations between reticulocyte levels and hypertension and atherosclerosis, we conducted a cross-sectional study of 2,098 elderly Japanese individuals, aged between 60 and 89 years, who had participated in an annual health check-up in 2014.Results: Of the total study population, 1,348 individuals were diagnosed with hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and/or having used antihypertensive medication), and 393 were diagnosed with atherosclerosis (carotid intima-media thickness ≥1.1 mm). Reticulocyte levels were found to be significantly positively associated with hypertension and inversely associated with atherosclerosis. Cardiovascular risk factor-adjusted odds ratios and 95% confidence intervals for hypertension and atherosclerosis, when raised incrementally by 1 standard deviation to determine reticulocyte levels (5.5×104 cells/μL for men and 5.0×104 cells/μL for women), were 1.12 (1.01, 1.25) and 0.83 (0.72, 0.94), respectively.Conclusion: Along with established cardiovascular risk factors, reticulocyte levels in elderly Japanese individuals were found to be positively associated with hypertension and inversely associated with atherosclerosis. This finding may help clarify the background mechanisms concerning the association between bone marrow activity and vascular remodeling.Keywords: atherosclerosis, hypertension, reticulocyte

Keywords

• atherosclerosis
• hypertension
• reticulocyte