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

Ann Epidemiol. 2004 Jul;14(6):425-30. doi: 10.1016/j.annepidem.2003.11.002.


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/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 (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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Cerebrovascular Disorders / blood
  • Cerebrovascular Disorders / mortality*
  • Female
  • Health Surveys*
  • Humans
  • Leukocyte Count*
  • Leukocytosis / complications
  • Leukocytosis / epidemiology*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • United States / epidemiology


  • Biomarkers