However, the polycythemia itself, when physiologic and not sufficiently extreme to cause significant hyperviscosity, generally is associated with a normal lifespan. However, emerging evidence suggests that, at minimum, patients with congenital or familial primary polycythemia may have an increased risk of thrombosis. In patients with secondary polycythemia that is physiologic, determining the optimal hematocrit for a given patient may be very difficult. On the other hand, allowing the hematocrit to remain at a higher level in order to provide better oxygen delivery capacity may result in thrombosis or general impaired tissue oxygenation due to sluggish blood flow secondary to hyperviscosity. Medicine is a constantly changing science and not all therapies are clearly established.
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