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October 11, 1985, Vol 254, No. 14 >
ARTICLE | October 11, 1985

Prognostic Importance of the White Blood Cell Count for Coronary, Cancer, and All-Cause Mortality FREE

Richard H. Grimm, Jr, MD, PhD; James D. Neaton, PhD; William Ludwig, MD
[+] Author Affiliations

Reprint requests to Division of Epidemiology, University of Minnesota, Stadium Gate 27, 611 Beacon St SE, Minneapolis, MN 55455 (Dr Grimm).


JAMA. 1985;254(14):1932-1937. doi:10.1001/jama.1985.03360140090031
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References

The relationship of white blood cell count (WBC) to fatal and nonfatal coronary heart disease (CHD) incidence and all-cause and cancer mortality was assessed in a subset of participants in the Multiple Risk Factor Intervention Trial (MRFIT). For this group of 6,222 middle aged men, total WBC count was found to be strongly and significantly related to risk of CHD, independent of smoking status. Change in WBC count from baseline to the annual examination just prior to the CHD event was found to be a significant and independent predictor of CHD risk. For each decrease in WBC count of 1,000/cu mm the risk for CHD death decreased 14%, controlling for baseline WBC count and other CHD risk factors (smoking, cholesterol level, diastolic blood pressure). The WBC count was strongly related cross-sectionally to cigarette smoking and smoking status as indicated by serum thiocyanate concentration. Smokers on average had a WBC count of 7,750/cu mm compared with 6,080/cu mm for nonsmokers. The WBC count was also significantly associated with cancer death, independent of reported smoking and serum thiocyanate levels.

(JAMA 1985;254:1932-1937)

REFERENCES

1 +
Howell RW:  Smoking habits and laboratory tests . Lancet 1970;;2:152.
2 +
Corre F, Lellouch J, Schwartz D:  Smoking and leukocyte counts: Results of an epidemiological survey . Lancet 1971;;2:632-634.
3 +
Friedman GD, Siegelaub AB, Seltzer CC, et al:  Smoking habits and leukocyte counts . Arch Environ Health 1973;;26:137-143.
4 +
Friedman GD, Klatsky AL, Siegelaub AB:  The leukocyte count as a predictor of myocardial infarction . N Engl J Med 1974;;290:1275-1278.
5 +
Friedman GD, Klatsky AL, Siegelaub AB:  Predictors of sudden cardiac death . Circulation 1975;;51,52( (suppl 3) ):164-169.
6 +
Zalokar JB, Richard JL, Claude JR:  Leukocyte count, smoking, and myocardial infarction . N Engl J Med 1981;;304:465-468.
7 +
Friedman GD, Petitti DB, Bawol RD, et al:  Mortality in cigarette smokers and quitters: Effect of base-line differences . N Engl J Med 1981;;304:1407-1410.
8 +
Prentice RL, Szatrowski TP, Fujidura T, et al:  Leukocyte counts and coronary heart disease in a Japanese cohort . Am J Epidemiol 1982;; 116:496-509.
9 +
Chan Yeung M, Buncio AD:  Leukocyte count, smoking, and lung function . Am J Med 1984;;76:31-37.
10 +
The Multiple Risk Factor Intervention Trial Group:  Statistical design considerations in the NHLI Multiple Risk Factor Intervention Trial . J Chronic Dis 1982;;30:261-275.
11 +
Multiple Risk Factor Intervention Trial Research Group:  Multiple Risk Factor Intervention Trial: Risk factor changes and mortality results . JAMA 1982;;248:1465-1477.
12 +
Sherwin R, Kaelber CT, Kezdi P, et al:  The Multiple Risk Factor Intervention Trial (MRFIT): II. The development of the protocol. Prev Med 1981;;10:402-425.
13 +
Manual of Laboratory Operations , vol 1, Lipid Research Clinics Program, US Dept of Health, Education, and Welfare publication DHEW (NIH) 75-628. National Institutes of Health, 1974;.
14 +
Butts WC, Kuehneman M. Widdowson GM:  Automated method for determining serum thiocyanate to distinguish smokers from non-smokers . Clin Chem 1974;;20:1344-1348.
15 +
Cox DR:  Regression models and life tables (with discussion) . J R Stat Soc 1972;:34:187-220.
16 +
Fleiss JL: Statistical Methods for Rates and Proportions . New York, John Wiley & Sons Inc, 1973;.
17 +
Fridovich I:  Biology of oxygen radicals . Science 1978;;201:875-880.
18 +
Babior BM:  Oxygen dependent microbial killing by phagocytes . N Engl J Med 1978;; 298:659-668.
19 +
Sachs TC, Moldow CF, Craddock PR, et al:  Oxygen radical mediated cell damage by complement stimulated granulocytes . J Clin Invest 1978;;61:1161-1167.
20 +
Klebanoff SJ:  Oxygen metabolism and the toxic properties of phagocytes . Ann Intern Med 1980;;93:480-489.
21 +
Ludwig PW, Hoidal JR:  Alterations in leukocyte oxidative metabolism in cigarette smokers . Am Rev Respir Dis 1982;;126:977-980.
22 +
Weitberg AB, Weitzman SA, Destrempes M, et al:  Stimulated human phagocytes produce cytogenetic changes in cultured mammalian cells . N Engl J Med 1983;;308:26-30.
23 +
Cohen AB:  Potential adverse effects of lung macrophages and neutrophils . Fed Proc 1979;;38:2644-2647.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Howell RW:  Smoking habits and laboratory tests . Lancet 1970;;2:152.
2 +
Corre F, Lellouch J, Schwartz D:  Smoking and leukocyte counts: Results of an epidemiological survey . Lancet 1971;;2:632-634.
3 +
Friedman GD, Siegelaub AB, Seltzer CC, et al:  Smoking habits and leukocyte counts . Arch Environ Health 1973;;26:137-143.
4 +
Friedman GD, Klatsky AL, Siegelaub AB:  The leukocyte count as a predictor of myocardial infarction . N Engl J Med 1974;;290:1275-1278.
5 +
Friedman GD, Klatsky AL, Siegelaub AB:  Predictors of sudden cardiac death . Circulation 1975;;51,52( (suppl 3) ):164-169.
6 +
Zalokar JB, Richard JL, Claude JR:  Leukocyte count, smoking, and myocardial infarction . N Engl J Med 1981;;304:465-468.
7 +
Friedman GD, Petitti DB, Bawol RD, et al:  Mortality in cigarette smokers and quitters: Effect of base-line differences . N Engl J Med 1981;;304:1407-1410.
8 +
Prentice RL, Szatrowski TP, Fujidura T, et al:  Leukocyte counts and coronary heart disease in a Japanese cohort . Am J Epidemiol 1982;; 116:496-509.
9 +
Chan Yeung M, Buncio AD:  Leukocyte count, smoking, and lung function . Am J Med 1984;;76:31-37.
10 +
The Multiple Risk Factor Intervention Trial Group:  Statistical design considerations in the NHLI Multiple Risk Factor Intervention Trial . J Chronic Dis 1982;;30:261-275.
11 +
Multiple Risk Factor Intervention Trial Research Group:  Multiple Risk Factor Intervention Trial: Risk factor changes and mortality results . JAMA 1982;;248:1465-1477.
12 +
Sherwin R, Kaelber CT, Kezdi P, et al:  The Multiple Risk Factor Intervention Trial (MRFIT): II. The development of the protocol. Prev Med 1981;;10:402-425.
13 +
Manual of Laboratory Operations , vol 1, Lipid Research Clinics Program, US Dept of Health, Education, and Welfare publication DHEW (NIH) 75-628. National Institutes of Health, 1974;.
14 +
Butts WC, Kuehneman M. Widdowson GM:  Automated method for determining serum thiocyanate to distinguish smokers from non-smokers . Clin Chem 1974;;20:1344-1348.
15 +
Cox DR:  Regression models and life tables (with discussion) . J R Stat Soc 1972;:34:187-220.
16 +
Fleiss JL: Statistical Methods for Rates and Proportions . New York, John Wiley & Sons Inc, 1973;.
17 +
Fridovich I:  Biology of oxygen radicals . Science 1978;;201:875-880.
18 +
Babior BM:  Oxygen dependent microbial killing by phagocytes . N Engl J Med 1978;; 298:659-668.
19 +
Sachs TC, Moldow CF, Craddock PR, et al:  Oxygen radical mediated cell damage by complement stimulated granulocytes . J Clin Invest 1978;;61:1161-1167.
20 +
Klebanoff SJ:  Oxygen metabolism and the toxic properties of phagocytes . Ann Intern Med 1980;;93:480-489.
21 +
Ludwig PW, Hoidal JR:  Alterations in leukocyte oxidative metabolism in cigarette smokers . Am Rev Respir Dis 1982;;126:977-980.
22 +
Weitberg AB, Weitzman SA, Destrempes M, et al:  Stimulated human phagocytes produce cytogenetic changes in cultured mammalian cells . N Engl J Med 1983;;308:26-30.
23 +
Cohen AB:  Potential adverse effects of lung macrophages and neutrophils . Fed Proc 1979;;38:2644-2647.

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