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CC BY-NC-ND 4.0 · Thromb Haemost 2024; 124(09): 842-851
DOI: 10.1055/a-2269-1123
Cellular Haemostasis and Platelets

Racial Differences in Bleeding Risk: An Ecological Epidemiological Study Comparing Korea and United Kingdom Subjects

Dong-Seon Kang   *
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Pil-Sung Yang   *
2   Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
,
Daehoon Kim
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Eunsun Jang
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Hee Tae Yu
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Tae-Hoon Kim
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Jung Hoon Sung
2   Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
,
Hui-Nam Pak
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Moon-Hyoung Lee
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Gregory Y.H. Lip    *
3   Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
4   Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
,
Boyoung Joung   *
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
› Author Affiliations Funding This research was supported by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (HC19C0130).
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Abstract

Background This study aimed to evaluate racial differences in bleeding incidence by conducting an ecological epidemiological study using data from Korea and the United Kingdom.

Methods We included healthy participants from the Korean National Health Insurance Service-Health Screening and the UK Biobank who underwent health examinations between 2006 and 2010 and had no comorbidities or history of medication use. Finally, 112,750 East Asians (50.7% men, mean age 52.6 years) and 210,995 Caucasians (44.7% men, mean age 55.0 years) were analyzed. The primary outcome was composed of intracranial hemorrhage (ICH) and bleeding from the gastrointestinal, respiratory, and genitourinary systems.

Results During the follow-up, primary outcome events occurred in 2,110 East Asians and in 6,515 Caucasians. East Asians had a 38% lower 5-year incidence rate compared with Caucasians (3.88 vs. 6.29 per 1,000 person-years; incidence rate ratio [IRR]: 0.62, 95% confidence interval [CI]: 0.59–0.65). East Asians showed a lower incidence of major bleeding (IRR: 0.86, 95% CI: 0.81–0.91), bleeding from the gastrointestinal (IRR: 0.53, 95% CI: 0.49–0.56), and genitourinary systems (IRR: 0.49, 95% CI: 0.44–0.53) compared with Caucasians. The incidence rates of ICH (IRR: 3.20, 95% CI: 2.67–3.84) and bleeding from the respiratory system (IRR: 1.28, 95% CI: 1.11–1.47) were higher in East Asians. Notably, East Asians consuming alcohol ≥3 times/week showed a higher incidence of the primary outcome than Caucasians (IRR: 1.12, 95% CI: 1.01–1.25).

Conclusion This ecological study revealed significant racial differences in bleeding incidence, influenced by anatomical sites and lifestyle habits, underscoring the need for tailored approaches in bleeding management based on race.

Keywords

racial differences - intracranial hemorrhage - gastrointestinal system

* These authors contributed equally to this work.


# These authors serve as Joint senior authors.


The review process for this paper was fully handled by Christian Weber, Editor in Chief.


Supplementary Material



Publication History

Received: 15 January 2024

Accepted: 13 February 2024

Accepted Manuscript online:
15 February 2024

Article published online:
08 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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