This is an article I reference frequently. Since it potentially contradicts the cholesterol hypothesis, my concern is that it - like other important publications - will be removed from the internet.
Simply put - white blood cell counts - when interpreted scientifically - are highly predictive of early mortality risk - especially from heart attack and strokes.
But these markers of INNATE IMMUNITY portent essentially every chronic disease.
Here is the article header. The full text is included below. Also, here is the link to the article.
Before you dive into the article, check your white blood cell counts against this optimal standard. Your WBC (total white blood cell count that includes the five (5) different type of white blood cells) should be between 4,000 and 5,700 cells per microliter. Depending upon the units of measure, you may see WBC presented as 4.0 and 5.7, for example. These are the same values - just different units.
Notice that I indicate your ideal WBC is between 4,000 and 5,700. However, this may not always be optimal. Optimal really is defined by looking at the amount and ratios of the individual white blood cells that include: neutrophils, lymphocytes, monocytes, basophils, and eosinophils. I have only included neutrophils and lymphocytes in this analysis. These two types of white blood cells are the most abundant and have the most data relating their levels to disease.
That being explained, IMHO - based on studying over 10,000 labs, the optimal WBC count is best described by two markers - total WBC and the neutrophil to lymphocyte ratio. The more markers that are included, the better the precision. However, these two markers have adequate precision to determine your innate immune health status in most cases.
The neutrophil to lymphocyte ratio is the absolute count of neutrophils divided by the absolute count of lymphocytes.
In general, neutrophils go up with bacterial infections and lymphocytes go down with viral infections. This is NOT a hard and fast rule. When the WBC total and the NLR does not look like that which I suggest is optimal, then the complete "differential" of white blood cell counts must be analyzed. That being said, probably 80% of the time, this is what you want your WBC total and your NLR:
Now for the article.....
White blood cell levels are a good predictor of strokes, heart attacks, and fatal heart disease in older women, according to a nationwide study. White cell counts can be easily measured by inexpensive, widely available tests, raising the possibility of lowering the toll of heart disease fatalities, the leading cause of death among women in the United States.
Lewis comment: The fascination with cholesterol, not white blood cells, is the reason cardiovascular disease continues to be the #1 killer in the United States
"For years, researchers have suspected a link between elevated white blood cell count and heart attack," notes JoAnn Manson, one of the study leaders and Elizabeth F. Brigham Professor of Women's Health at Harvard Medical School. "The present study is the largest to test this association and provides the strongest evidence to date that WBC (white blood cell) count predicts the risk of heart attack."
Lewis comment - "suspected?" - they know better than that. That statements is to justify the reliance on cholesterol - not WBC
As part of the federally supported Women's Health Initiative, investigators at medical centers all over the United States collected information on 72,242 postmenopausal women 50 to 79 years old. All were free of heart and blood vessel disease at the start of the study. During six years of follow-up, 1,626 heart disease deaths, heart attacks, and strokes occurred.
Women with more than 6.7 billion white cells per liter of blood had more than double the risk of fatal heart disease than women with 4.7 billion cells per liter or lower.
A count of 6.7 is considered to be in the upper range of normal, so what is "normal" may have to be redefined.
Lewis comment: This last statement is a big fat lie. The normal range for white blood cells published by most of the authorities - WebMD, Mayo Clinic, Cleveland Clinic, LabCorp, and Quest is 3,500 - 10,800. 6,700 is - in fact - in the LOW-NORMAL RANGE.
The black lines with arrows are the same length showing that 6,700 is in the lower range of normal - NOT the upper range.
Women with the highest counts had a 40 percent higher risk of nonfatal heart attack, 46 percent higher risk of stroke, and a
50 percent greater risk of death from all causes.
These research results are independent of other risk factors such as smoking, diabetes, high blood pressure, high cholesterol, obesity, and lack of physical activity. Therefore, WBC count may identify people with a high probability of heart disease who show none of the more obvious risk factors.
Lewis comment: The bolded text above is a key consideration.
Relevance for men
Asked if the same test would be as revealing for men, Manson answered, "We have every reason to believe so. Some small studies have suggested a similar link in men. There probably will be other studies to look at this link in greater depth."
Manson also believes that white blood cell counts apply to younger as well as older women. "They would apply, but women under 50 are less likely to have high counts," she says. "That's because they are less likely to have been exposed to risk factors that raise the counts and eventually lead to hardening and blockage of their arteries."
Women (or men) can take steps to keep their counts down, simply by reducing or avoiding things that tend to raise them, such as smoking, high cholesterol levels, and being overweight, Manson says. "We are also looking into the contribution of factors like high blood pressure and diabetes," she points out. "Although all these risk factors correlate with high WBC counts, the two are independent so WBC levels can be elevated in the absence of traditional factors."
Lewis comment: Lowering cholesterol has NO relationship with lowering WBC.
said another way...
Elevated cholesterol within standard of care limits has absolutely NOTHING to do with elevated WBC counts.
No new tests need to be developed, because blood-cell levels are now measured routinely in doctors' offices.
Lewis comment: Too bad they do not tell you what your WBC count means between threats to take statins.
The tests identify patients with infections or check for those at risk for infections, like cancer patients undergoing chemotherapy. "Physicians may want to look closer at WBC levels when obtaining the tests for other reasons," Manson notes. "However, infections can cause a high white blood cell count that may make it appear that a patient is at high risk for heart disease when she is not. Therefore, routinely giving everyone the test to screen for heart disease is premature. More research needs to be done."
Lewis comment: How ridiculous is this comment. Again, Harvard, you cannot have it the way you want it. When WBC values go up (or down), you have an infection - and this will always contribute to vascular diseases - and the myriad of chronic diseases that are currently being mismanaged - because WBC counts are NOT properly evaluated. See my figure at the beginning of this blog.
A companion test
High WBC levels signal the presence of inflammation in blood vessels, which doctors believe is involved in hardening and clogging arteries. Someday, this test might be combined with measurement of C-reactive protein, another marker for inflammation. The Women's Health Initiative study included measurements of CRP, and it turned out to be almost as good a predictor of heart disease.
Lewis comment: CRP is a good companion to the WBC counts. Inflammation can go up without elevated WBC, but CRP almost always goes up with WBC counts (up or down out of normal, that is).
"Used together, the two can provide additive and powerful information about risk," Manson comments. Women who showed high levels of both inflammation markers had seven times the risk of heart disease as those with low levels.
These results were published in the March 14 issue of the Archives of Internal Medicine. Besides Manson, the authors include Karen Margolis of the Hennepin County Medical Center in Minneapolis and colleagues at participating medical facilities in several other states.
Manson, who is also chief of the division of preventive medicine at Brigham and Women's Hospital in Boston, sums up their findings. "WBC count appears to be a very promising way to identify people at increased risk of heart disease. At this point, it may add information that physicians can use when evaluating a patient's risk factors. With additional research, it may become one of the routine screening tests for heart disease."
Lewis comment: I enjoy the comment - "with additional research." Really? We need to do additional research on the most fundamental set of biomarkers - white blood cells - which represent the response of our innate immune system? It is 2022 Harvard! Please do not insinuate you are that ignorant of immunity.
Final comment from Lewis: At least these people stuck their necks out and went against standard of care reference ranges - which are NOT science-based.
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