Associations between white blood cell count and risk for cerebrovascular disease mortality: NHANES II mortality study, 1976-1992

PURPOSE: To examine associations between elevated white blood cell count (WBC) and cerebrovascular disease (CeVD) mortality independent of cigarette smoking and by gender. METHODS: We used Cox regression analyses of data from 8459 adults (3982 men; 4477 women) aged 30 to 75 years in the NHANES 11 Mortality Study (1976-1992) to estimate the relative risk of death from CeVD across quartiles of WBC. RESULTS: During 17 years of follow-up, there were 192 deaths from CeVD (93 men; 99 women). Compared with those with WBC (cells/mm(3)) < 5700, adults with WBC > 8200 were at increased risk of CeVD mortality (relative risk [RR], 2.1; 95% confidence interval [CI], 1.2-3.7) after adjustment for smoking and other cardiovascular disease risk factors. Similar results were observed among never smokers (1111, 2.0; 95% Cl, 1.0-3.8). The adjusted relative risk of CeVD mortality comparing those with WBC > 8200 to those with WBC < 5700 was 1.5 (95% Cl, 0.7-3.5) among men and 2.7 (95% Cl, 1.45.0) among women. CONCLUSIONS: Elevated WBC may predict CeVD mortality even after considering the effects of smoking and other cardiovascular disease risk factors. (C) 2004 Elsevier Inc. All rights reserved.