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 II 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/mm3)<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 (RR, 2.0; 95% CI, 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% CI, 0.7–3.5) among men and 2.7 (95% CI, 1.4–5.0) among women. Conclusions Elevated WBC may predict CeVD mortality even after considering the effects of smoking and other cardiovascular disease risk factors.