Susanna Lövdahl1, Karin M Henriksson2, Fariba Baghaei3, Margareta Holmström4, Erik Berntorp1, Jan Astermark5. 1. Department of Translational Medicine, Clinical Coagulation Research Unit, Lund University, Malmö, Sweden. 2. Cardiovascular Epidemiology, Department of Medical Science, Uppsala University Hospital, Sweden; AstraZeneca, Department of Epidemiology, R&D, Mölndal, Sweden. 3. Coagulation Centre, Department of Medicine/Hematology and Coagulation Disorders, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. 4. Coagulation Unit, Hematology Centre, Karolinska University Hospital, Department of Medicine, Karolinska Institute, Stockholm, Sweden. 5. Department of Translational Medicine, Clinical Coagulation Research Unit, Lund University, Malmö, Sweden; Department of Hematology Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden. Electronic address: Jan.Astermark@med.lu.se.
Abstract
INTRODUCTION: Data on the prevalence of hypertension and cardiovascular diseases (CVD) among persons with haemophilia (PWH) vary. Sweden has a long tradition of maintaining population-based data registries, and there is extensive follow-up of haemophilia patients due to the use of prophylaxis over decades. We evaluated the prevalence of these diseases among Swedish PWH compared to matched controls using a longitudinal study design. METHODS: Data were obtained from the National Patient Registry and linked to records of persons with haemophilia enrolled in the haemophilia centres. For each subject, five gender and age matched controls were identified. RESULTS: We identified 193 (19.7%) diagnoses of hypertension in PWH born in 1978 or earlier over ≥30 years compared with 550 (11.2%) among controls. The median ages and interquartile ranges were 60.0 (42.8, 69.9) and 57.2 (42.6, 70.6) years. The hazard rate (HR) for hypertension, PWH vs. controls, was 2.1, 95% CI: [1.8; 2.5], p < 0.001. The findings were similar in subgroup analyses of patients with non-severe and severe haemophilia with or without HIV and/or viral hepatitis. Angina pectoris was diagnosed in 69 (4.8%) of patients censored at age 75 compared with 311 (4.3%) in controls, and myocardial ischemia in 84 (5.9%) compared with 442 (6.2%). As a cause of death, the HR for myocardial ischemia, comparing PWH and controls, was 0.58, 95% CI: [0.42, 0.80], p = 0.001. CONCLUSION: Our data support an increased prevalence of hypertension among persons with haemophilia. The prevalence of CVD seems to be similar to that of controls, but with lower mortality.
INTRODUCTION: Data on the prevalence of hypertension and cardiovascular diseases (CVD) among persons with haemophilia (PWH) vary. Sweden has a long tradition of maintaining population-based data registries, and there is extensive follow-up of haemophiliapatients due to the use of prophylaxis over decades. We evaluated the prevalence of these diseases among Swedish PWH compared to matched controls using a longitudinal study design. METHODS: Data were obtained from the National Patient Registry and linked to records of persons with haemophilia enrolled in the haemophilia centres. For each subject, five gender and age matched controls were identified. RESULTS: We identified 193 (19.7%) diagnoses of hypertension in PWH born in 1978 or earlier over ≥30 years compared with 550 (11.2%) among controls. The median ages and interquartile ranges were 60.0 (42.8, 69.9) and 57.2 (42.6, 70.6) years. The hazard rate (HR) for hypertension, PWH vs. controls, was 2.1, 95% CI: [1.8; 2.5], p < 0.001. The findings were similar in subgroup analyses of patients with non-severe and severe haemophilia with or without HIV and/or viral hepatitis. Angina pectoris was diagnosed in 69 (4.8%) of patients censored at age 75 compared with 311 (4.3%) in controls, and myocardial ischemia in 84 (5.9%) compared with 442 (6.2%). As a cause of death, the HR for myocardial ischemia, comparing PWH and controls, was 0.58, 95% CI: [0.42, 0.80], p = 0.001. CONCLUSION: Our data support an increased prevalence of hypertension among persons with haemophilia. The prevalence of CVD seems to be similar to that of controls, but with lower mortality.
Authors: Paul Van Der Valk; Michael Makris; Kathelijn Fischer; Robert C Tait; Pratima Chowdary; Peter W Collins; Karina Meijer; Lize F D van Vulpen; Eveline Mauser-Bunschoten; Roger E G Schutgens Journal: Blood Adv Date: 2022-02-08