The stress polycythaemia syndromes and their haemorheological significance

Abstract

Research from many disciplines is coming together to give a more composite picture of the multitude of factors involved in cardiovascular and haematocrit control. In this review the term stress polycythaemia syndrome is used in its broadest sense, where all exogenous and endogenous stresses are considered. The contraction of plasma volume seen in association with the various stimuli is the end result of a final common pathway of neuroendocrine activation via the autonomic nervous system. In most circumstances the development of the stress polycythaemia syndrome is an appropriate response to a specific stimulus. However, there are haemorheological consequences which may not always be advantageous and in the presence of vascular disease may predispose the subject to the possibility of arterial occlusion. Management of the stress polycythaemia syndromes depends on identification and removal of the stimuli and correction of the haemorheological disturbances.