Hemoconcentration and stress: a review of physiological mechanisms and relevance for cardiovascular disease risk.

Elevated levels of hematocrit and hemoglobin have been identified as an independent risk factor for the development of a number of diseases, including hypertension, coronary heart disease, and stroke. A growing body of evidence also indicates that elevations in hematocrit and hemoglobin are present in situations involving both physical and mental stressors. This paper reviews the evidence linking decreases in plasma volume causing hemoconcentration with hemodynamic adjustments associated with activation of the sympathetic nervous system, and the potential relevance of stress-induced hemoconcentration in triggering deleterious cardiovascular events. The importance of blood viscosity in understanding the effects of hemoconcentration is discussed, along with the need to evaluate the degree of hemoconcentration during stress for accurate interpretation of changes in certain blood constituents.