Hypertension and cardiovascular diseases in Swedish persons with haemophilia — A longitudinal registry study

Lövdahl, Susanna; Henriksson, Karin; Baghaei, Fariba; Holmström, Margareta; Berntorp, Erik; Astermark, Jan

doi:10.1016/j.thromres.2019.07.017

Cited by 17 publications

(30 citation statements)

References 19 publications

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“…The RR is comparable to our study. 11 In a retrospective registry study in Sweden 12 , like in our cohort 5 , an increased prevalence of hypertension was found, with similar prevalence of CVD, but with lower mortality when compared to a matched control group.…”

Section: Discussionsupporting

confidence: 66%

Reduced cardiovascular morbidity in patients with hemophilia: results of a 5-year multinational prospective study

et al. 2022

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Hemophilia is a congenital bleeding disorder caused by low clotting factor VIII or IX levels. Life expectancy of people with hemophilia (PWH) has increased with the availability of clotting factor concentrates. At the same time, the incidence of cardiovascular disease (CVD) has increased. In retrospective studies there are conflicting data if, despite this increase, the incidence is still lower than in the general population. We prospectively compared the incidence of CVD in PWH with the predicted incidence. This prospective, multicenter, observational study included adult PWH (>30y) from the Netherlands and United Kingdom (UK). They were followed for a 5-year period and CVD incidence was compared with a predicted event rate based on the QRISK2-2011 CVD risk model. The primary endpoint was the observed fatal and nonfatal CVD incidence after 5 years compared to the estimated events and in relation to severity of hemophilia. The study included 709 patients, of whom 687 (96.9%) completed 5 years follow up or reached an endpoint. For 108 patients the QRISK score could not be calculated at inclusion. For the remaining 579 fewer CVD events were observed than predicted: 9 versus 24 (RR 0.38; 95% CI: 0.18 - 0.80 p=0.01), corresponding with an absolute risk reduction of 2.4%. Severe hemophilia treated on demand had the highest risk reduction. There was no statistical significant relation between severity of hemophilia and incidence of CVD. In hemophilia a lower than predicted CVD incidence was found, supporting the theory that hemophilia protects against CVD. The study is registered at www.clinicaltrials.gov (identification number NCT01303900).

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Section: Discussionsupporting

confidence: 66%

Reduced cardiovascular morbidity in patients with hemophilia: results of a 5-year multinational prospective study

et al. 2022

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“…The prevalence of death by cardiovascular disease and cancer was less frequent in the haemophilia cohort compared with the general male population. This has previously been confirmed by Kamphuisen et al, 27 and more recently, Jardim et al, 20 Lövdahl et al 28 and Payne et al 29…”

Section: Discussionsupporting

confidence: 52%

Life expectancy and cause of death in individuals with haemophilia A and B in Norway, 1986‐2018

Skjefstad

Solberg

Glosli

et al. 2020

European J of Haematology

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Objectives: Evaluate trends over time in age-and cause of death in males with haemophilia (PWH) in Norway compared with the general male population and investigate its correlates with improvements in haemophilia treatment. Methods: Data about age and cause of death in the period of 1986-2018, from two independent, high-quality national registries: the Norwegian Cause of Death Registry (NCoDR) and the patient registry at Centre for Rare Disorders (CRD), Oslo University Hospital. Results: Life expectancy increased significantly from 1986 to 2018. However, PWH still had a decreased mean age at death of 56.8 years (SD = 24.7) in the NCoDR and 58.6 years (SD = 21.7) in the CRD data, compared with 73.9 years (SD = 16.3) in the general male population. There was a distinct shift in the most frequently reported haemophilia-related causes of death, such as haemorrhage and AIDS, to more agerelated causes of death, such as cancer, reflecting an ageing population. Conclusion: Haemophilia treatment has improved significantly in the last three decades. Despite treatment-related improvements, PWH in Norway still have a decreased life expectancy compared with the general male population.

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“…There is now concern that, as more people with hemophilia reach older age, there will be an increase in age‐related disorders such as overweight, obesity, cardiovascular disease, and cancer. Research suggests that the prevalence of age‐related disorders among people with hemophilia is probably at least comparable with that of the general population, 2‐4 though not uniformly so 5,6 …”

Section: Introductionmentioning

confidence: 99%

“…Research suggests that the prevalence of agerelated disorders among people with hemophilia is probably at least comparable with that of the general population, [2][3][4] though not uniformly so. 5,6 The UK government strategy to address cardiovascular risk factors such as inactivity, overweight, and obesity is to be "physically active including at least 150 minutes of moderate intensity activity each week, in bouts of 10 minutes or more, or 75 min of vigorous activity across a week or a mixture of moderate and vigorous activity." 7 Guidelines for the management of hemophilia recommend tailored physical activity focusing on bone health, muscle strengthening, coordination, physical functioning, healthy body weight, and positive self-esteem.…”

Section: Introductionmentioning

confidence: 99%

Project GYM: A randomized feasibility study investigating effect on motivation of personal trainer‐led exercise in young men with hemophilia

McLaughlin

Holland²,

Dodgson³

et al. 2021

Research and Practice in Thrombosis and Haemostasis

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Introduction Many young men with hemophilia engage in physical activity and sport but face challenges to participation because of their hemophilia. Project GYM aimed to investigate the feasibility of a hemophilia‐specific fitness program led by a personal trainer (PT) and its impact on gym activity, motivation, and adherence to exercise. Methods This was a nonblinded, randomized feasibility study, recruiting participants aged 18 to 25 years with hemophilia A or B (all severities, ± inhibitor) from three London hemophilia centers. All participants were given an activity tracker and free gym membership. Participants were randomized to a “gym only” or “gym and PT” arm. Participants completed questionnaires evaluating motivation to exercise, quality of life, physical activity levels, self‐efficacy, and self‐esteem at study start and study end. Results Of 142 eligible individuals, 19 agreed to participate. Participants were healthy, with mean body mass index and adiposity slightly lower than the UK average. They reported low bleed numbers and had good joint health (median Hemophilia Joint Health Score [HJHS], 0; range, 0‐13). The gym and PT group had more gym attendance than the gym‐only group. Seven participants increased their activity levels and nine stayed the same, with no statistical difference between groups. HJHS scores improved in 3 participants and were unchanged in 12. There was no bleeding associated with gym activity. Conclusion Project GYM has demonstrated the safety and feasibility of a tailored physical training program in young men with hemophilia. Increased gym attendance, with and without support from a PT, is associated with increased physical activity.

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Hypertension and cardiovascular diseases in Swedish persons with haemophilia — A longitudinal registry study

Cited by 17 publications

References 19 publications

Reduced cardiovascular morbidity in patients with hemophilia: results of a 5-year multinational prospective study

Reduced cardiovascular morbidity in patients with hemophilia: results of a 5-year multinational prospective study

Life expectancy and cause of death in individuals with haemophilia A and B in Norway, 1986‐2018

Project GYM: A randomized feasibility study investigating effect on motivation of personal trainer‐led exercise in young men with hemophilia

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