Hemophilia Patients May Face Lower Risk of Heart Disease: 5-year Study

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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People with hemophilia may be less likely to develop cardiovascular disease (CVD) — disorders of the heart and blood vessels — according to a study from the U.K. and the Netherlands.

“A lower-than-predicted [cardiovascular disease] incidence was found, supporting the theory that hemophilia protects against CVD,” the researchers wrote.

The study, “Reduced cardiovascular morbidity in patients with hemophilia: results of a 5-year multinational prospective study,” was published in the journal Blood Advances.

With advances in treatment, people with hemophilia are living longer than they ever have before — and that means that age-related problems, such as cardiovascular disease are expected to become increasingly common in this population.

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Treating heart-related diseases in someone with hemophilia is challenging, because CVD often is driven by abnormal blood clotting, whereas hemophilia is caused by deficiencies in blood clotting.

Theoretically, the reduced blood clotting that defines hemophilia could lower the risk of CVD. However, there has been little hard evidence to support this idea.

Now, a group of scientists conducted an analysis using data from 579 men with hemophilia who were followed at sites in the U.K. and the Netherlands, with the goal of assessing CVD’s incidence and risk in this patient population.

Most of the men had hemophilia A, and their mean age was 46. Based on levels of blood clotting proteins, just over half of the participants had severe hemophilia.

At study inclusion, the participants’ QRISK score was calculated. This is a multi-factored assessment that predicts the risk of a future CVD event — for example, heart disease or stroke — in the general population. Patients were then followed for five years.

“Estimating the risk of a future cardiovascular event is of utmost importance for proper preventive management and counseling. In the general population, the QRISK has proven to be a valuable tool in this aspect and has been implemented in routine practice in the United Kingdom,” the researchers wrote.

Based on risk scores, analyses predicted there would be 24 CVD events among patients. However, there only were nine such events over the five-year study period.

Statistical analyses indicated the absolute risk of cardiovascular disease was about 2.4% lower among people with hemophilia than would be expected in the general population.

Further analyses found a significantly lowered CVD risk among those with severe, non-severe, and mild hemophilia. No significant differences in cardiovascular disease risk were found in patients receiving different types of treatment.

“We documented a lower-than-predicted CVD incidence during a 5-year follow-up,” the scientists wrote. “This finding indicates that the QRISK overestimates CVD events in patients with hemophilia.”

“It seems that all [patients with hemophilia] might be reclassified to a lower cardiovascular risk group,” they added.

Despite the apparently lower risk of CVD in people with hemophilia, researchers stressed that such events can still occur.

“Assessment of CVD risk factors and the risk profile is advised for all [patients with hemophilia], as in the general population,” the team wrote. “This assessment could be the task of a comprehensive care center, which provides lifelong treatment and care for [patients with hemophilia]. Treatment of risk factors and lifestyle education are mandatory.”