| الملخص: | <strong>Background:</strong> There is increasing evidence that blood viscosity and its major determinants (haematocrit and plasma viscosity) are associated with increased risks of cardiovascular disease (CVD) and premature mortality; however, their predictive value for CVD and mortality is not clear. <strong>Methods:</strong> We prospectively assessed the added predictive value of plasma viscosity and whole-blood viscosity and haematocrit in 3386 men and women aged 30-74 years participating in the Scottish Heart Health Extended Cohort study. <strong>Results:</strong> Over a median follow-up of 17 years, 819 CVD events and 778 deaths were recorded. Hazard ratios (95% confidence intervals) for a 1SD increase in plasma viscosity, adjusted for major CVD risk factors were 1.12 (1.04, 1.20) for CVD, and 1.20 (1.12, 1.29) for mortality. These remained significant after further adjustment for plasma fibrinogen: 1.09 (1.01, 1.18) and 1.13 (1.04, 1.22). Corresponding results for blood viscosity were 0.99 (0.90, 1.09) for CVD, and 1.11 (1.01, 1.22) for total mortality; and 0.97 (0.88, 1.08) and 1.06 (0.96, 1.18) after further adjustment for fibrinogen. Haematocrit showed similar associations to blood viscosity. When added to classical CVD risk factors, plasma viscosity improved discrimination of CVD and mortality by 2.4% (0.7, 4.4) and 4.1% (2.0, 6.5). <strong>Conclusion:</strong> While plasma and blood viscosity may play a role in pathogenesis of CVD and mortality, much of their associations with CVD and mortality are due to mutual effects of major CVD risk factors. However, plasma viscosity adds to discrimination of CVD and mortality and might be considered for inclusion in multivariable risk scores.
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