Lifestyle and hemostatic risk factors for ischemic heart disease - The Caerphilly Study

We have recently shown that fibrin D-dimer, tissue plasminogen activator (t PA) antigen, von Willebrand factor antigen, fibrinogen, plasma viscosity, a nd white cell count are associated with subsequent ischemic heart disease ( IHD) in men aged 49 to 65 years in the Caerphilly Study from South Wales. W e now report the contribution of major lifestyle factors to plasma levels o f these new risk predictors for IHD. Results were available for up to 2188 men. The contribution of factors associated with lifestyle (smoking, alcoho l, body mass index, leisure and work activity, social class, and use of pre scribed medicines) to variation in plasma levels of 8 hemostatic variables was examined. All results were adjusted for other lifestyle variables, age, and time of day. Most hemostatic variables increased with age and smoking habit. Increasing levels of alcohol consumption were associated with increa ses in tPA and plasminogen activator inhibitor (PAI-I) activity and with de creases in fibrinogen and white cell count, tPA, PAI-1, fibrinogen (nephelo metric), and viscosity were positively associated with body mass index. Inc reasing levels of leisure activity were inversely associated with D-dimer, von Willebrand factor, nephelometric fibrinogen, and viscosity. Use of pres cribed medicines (a marker for chronic illness) was associated with adverse levels of D-dimer, fibrinogen, plasma viscosity, and white cell count. tPA , PAI-1, and plasma viscosity were associated with blood pressure, choleste rol, and triglycerides but not with lipoprotein(a) or homocysteine. We conc lude that several lifestyle factors are associated with hemostatic risk pre dictors for II-ID. Lifestyle modifications may reduce IHD risk partly by al tering hemostatic function; large intervention studies are required to test this hypothesis.