2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Background: Stroke remains a leading cause of mortality and long-term disability worldwide, with its pathophysiology strongly influenced by alterations in blood rheology, microcirculatory flow, and oxygen transport. Red blood cells (RBCs) are key determinants of hemorheological behavior, and both structural and functional abnormalities may impair vascular perfusion. Microcytic hypochromic anemia, characterized by reduced erythrocyte size and hemoglobin content, has been associated with altered deformability and aggregation properties that may influence cerebral microcirculation and contribute to cerebrovascular vulnerability.

Aim: This study aimed to investigate the relationship between RBC abnormalities in patients with microcytic hypochromic anemia and alterations in erythrocyte aggregation behavior, with potential implications for microvascular dysfunction and cerebrovascular risk.

Methods: A case–control study was conducted including 162 participants, comprising 78 patients diagnosed with microcytic hypochromic anemia and 84 age- and sex-matched healthy controls. Hematological parameters, including hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW), were measured using an automated hematology analyzer. RBC aggregation properties were evaluated using a Laser Optical Rotational Cell Analyzer (LORCA), which quantified aggregation amplitude (Amp; extent of RBC aggregation), aggregation index (AI; rate and magnitude of aggregate formation), half-time (t½; time required to reach 50% of maximal aggregation), and recovery time (Tr; time required for disaggregation and restoration of baseline cell distribution). Statistical analyses were performed to compare groups and assess correlations between hematological indices and aggregation parameters.

Results: Patients with microcytic hypochromic anemia demonstrated significantly lower Hb, Hct, MCV, MCH, and MCHC values, alongside significantly elevated RDW levels compared with controls (p < 0.05). In addition, RBC aggregation amplitude, aggregation index, and recovery time were significantly reduced in the patient group (p < 0.05), indicating altered erythrocyte aggregation dynamics. Correlation analysis revealed significant associations between hematological indices and aggregation parameters, suggesting that changes in RBC morphology and composition are closely linked to impaired hemorheological function.

Conclusion: Microcytic hypochromic anemia is associated with both quantitative hematological abnormalities and functional alterations in RBC aggregation behavior. These rheological impairments may contribute to compromised microcirculatory flow and potentially increase susceptibility to cerebrovascular dysfunction. Evaluation of RBC aggregation properties, alongside routine hematological indices, may provide additional insight into vascular risk stratification in affected patients.