The formation of clumps of RED blood cells under low or non-flow conditions, resulting from the attraction forces between the red blood cells. The cells adhere to each other in rouleaux aggregates. Slight mechanical force, such as occurs in the circulation, is enough to disperse these aggregates. Stronger or weaker than normal aggregation may result from a variety of effects in the erythrocyte membrane or in BLOOD plasma. The degree of aggregation is affected by erythrocyte deformability, erythrocyte membrane sialylation, masking of negative surface charge by plasma proteins, etc. blood viscosity and the ERYTHROCYTE SEDIMENTATION RATE are affected by the amount of erythrocyte aggregation and are parameters used to measure the aggregation.