LECTURE OUTLINE FOR "VASCULAR-RHEOLOGY"
Orthomolecular Health Medicine Society - Friday, February 27, 2004
by Richard P. Huemer, M.D.
I. General principles
A. Viscosity
1. Definition: resist flow or change of shape; resist shearing forces
2. Newtonian and non-Newtonian fluids; examples of the latter (honey; catsup)
3. Variable viscosity of blood: 4X water (flowing fast), 20X water (slow)
B. Laminar flow and shear rate
1. Observation of sticks in a brook
2. Mental experiment: dumping pingpong balls into the brook
a. Parabolic curve within boundary layer
b. Straight paths = laminar flow
c. Difference in velocity between layers = shear rate
C. Calculation of viscosity from flow measurements
1. Aircraft: hot-wire anemometer; 3D laser doppler velocimeter
2. Blood: rheometer from Rheologics; 9000 data points
a. Plot viscosity in cP vs. shear rate in sec
-1b. Sample of typical data
D. Turbulence
1. Stochastic motion, not laminar flow
2. Ratio between inertial and viscosity factors; Reynolds number
3. Relation to boundary layers, roughness of surface, and applied force
II. Clinical Relevance
A. Dr. Ken Kensey and the protective-adaptive theory of atherosclerosis
1. Turbulent flow upstream of bifurcations; work of the heart
2. Endothelial damage via turbulence, with protective callus formation -> plaque
3. Why atherosclerosis is localized rather than same throughout vessels
4. Shift from biochemical to biomechanical viewpoint
B. Things associated with increased blood viscosity:
1. Hematocrit
2. Fibrinogen
a. Smoking raises it; probable reason for association viscosity w/ smoking
b. Strong predictor of CAD, periphal AD, and all-cause mortality
3. Total protein
4. Diseases: diabetes, obesity (BMI), hypertension, use of Rx meds
5. Lipids: triglycerides, cholesterol, LDL
6. Age and male sex
C. Things associated with decreased blood viscosity
1. HDL
2. Lifestyle: alcohol (decrease fibrinogen), fish oil (?), leisure activities
3. Pharmacologic: HRT (mixed effect), lumbrokinase, nattokinase, Wobenzym, other
III. Practical recommendations
Lose weight; exercise; take fish oils, B3, Cr; don't smoke; drink a glass of wine
daily; become a regular blood donor; control BP; consider statins and kinases.