Hemolobin and the Risk of Cerebral Infarction: The Framingham Study

Abstract

Risk of cerebral infarction over 16 years was ascertained in 5,185 men and women classified according to their hemoglobin, blood pressure and cigarette habit on entry to the Framingham Study. Within the normal range of hemoglobin values, risk was found to be proportional to the blood hemoglobin concentration in both sexes. Men with hemoglobin values of 15 gm or greater and women with 14 gm or more had twice as many cerebral infarctions as did their cohorts with lower values. The risk of initial development of 82 cerebral infarctions was also strikingly related to antecedent blood pressure status in both sexes and to the cigarette habit in men. When allowance is made for associated blood pressure and cigarette habit--factors found to correlate with both blood hemoglobin values and incidence of cerebral infarction--hemoglobin level had only a modest residual effect, no longer statistically significant. The pathogenetic, preventive and therapeutic implications of the interrelationship of blood hemoglobin, blood pressure and the cigarette habit and their association with cerebral infarction require further exploration.