Red blood cell aging and risk of cardiovascular diseases.

We hypothesized that due to monthly bloodloss, the mechanical properties of blood of premenopausal women are superior to men, and place them at less risk for cardiovascular diseases than men in any age group. Rheological properties of blood of premenopausal women and age-matched men were compared. It was found that male blood possesses an increased viscosity, RBC aggregability and RBC rigidity. Additionally, male RBCs were found to have higher mechanical fragility. Since women in reproductive age have almost half as many old RBCs and almost twice as many young RBCs as men, we investigated the effect of in vivo aging of RBCs on their mechanical properties. Old RBCs were shown to have an increased mechanical fragility and aggregability, and decreased deformability as compared to young RBCs. Decreased deformability and increased aggregability of RBCs cause an increase in blood viscosity and are known as risk factors of cardiovascular diseases. Since men possess a higher number of old RBCs with suboptimum mechanical properties than premenopausal women, who due to monthly bloodloss have a higher number of young cells and a lower number of old RBCs than their male counterparts, our results suggest that an elevated hemorheological risk for males is associated with the age distribution of RBCs. This, in addition to significantly higher hematocrit, may be the reason for the increased risk of morbidity and mortality from cardiovascular diseases of men as compared to women of reproductive age.