Effects of anaemia and stepwise‐induced polycythaemia on maximal aerobic power in individuals with high and low haemoglobin concentrations

Increasing the haemoglobin concentration ([Hb]) improves the oxygen transport capacity but it also increases the viscosity of the blood. The influence of changes in [Hb] and viscosity on submaximal exercise capacity and maximal aerobic power was investigated in eight healthy males in varying states of training and with a normal resting [Hb] ([Hb] r ), ranging from 123 to 178 g] ‐1 . The subjects were venesected five times (450 ml per unit) and exercise tests were performed in the anaemic state. After 5–7 weeks, when [Hb] had returned to the ‘normal’ value, a stepwise re‐transfusion of three to five units of blood was performed with exercise tests after each transfusion. The [Hb] r was 137 ± 15 g l ‐1 in the anaemic state (A) and 170 ± 16 g l ‐1 after the last re‐transfusion (LT). The V o2 max rose from 3.94 ± 0.35 in A to 4.68 ± 0.30 1 min ‐1 after LT. Individual regression lines for [Hb] and V o2 max revealed a mean increase in V o2 max of 19 ± 6 ml min ‐1 per g l ‐1 change in [Hb]. This value did not differ between individuals with high and low normal [Hb]. Furthermore, in intra‐individual comparisons the relationship between [Hb] and V o2 max in high and low individual [Hb] ranges was not found to be statistically different despite a 40% increase in the in vitro viscosity from the anaemic to the polycythaemic state. The average individual correlation (based on five to seven measurements) between [Hb] at rest and after exercise and V o2 max was r = 0.89 ( P > 0.01) in the former case and r = 0.92 ( P > 0.01) in the latter. The running velocity corresponding to a blood lactate concentration of 4 mM (V Hla4.0 ) increased from 15.3 ± 2.3 in the control state to 15.6±2.3 km h 1 after the last transfusion ( P > 0.01). A leftward shift of the blood lactate curve, expressed as a percentage of V o2 max , was found. In conclusion, the results obtained indicate a close relationship between V o2 max and [Hb] up to at least 170 g l ‐1 . Furthermore, both inter‐and intra‐individual comparisons suggest that the influence of viscosity as such on V o2 max does not differ at high and low [Hb] levels.