Calculated effect of fluid retention upon velocity of blood flow and turbulence: implications for atherosclerosis.

Fluid retention increases intravascular volume and pressure. The calculations in this paper demonstrate that fluid retention increases the likelihood that blood will flow in a turbulent manner, in part due to an increase in stroke volume, regardless of whether or not blood pressure is increased. Increased turbulence will promote endothelial dysfunction, thereby contributing to the development of atherosclerotic cardiovascular disease. Accordingly, fluid retention is predictably detrimental to the cardiovascular system. The reason that some medications, such as cyclo-oxygenase-2 inhibitors, nonselective nonsteroidal anti-inflammatory drugs, estrogens, progestins, and rosiglitazone, are associated with an increased risk of myocardial infarcts and strokes may be that they cause fluid retention. Increased stroke volume and/or edema formation may indicate that a medication increases the risk of adverse cardiovascular events. For drugs that increase the risk of adverse cardiovascular events, it may be possible to reduce or neutralize the increased risk by simultaneously administering a diuretic.