Increased prevalence of hypertension in haemophilia patients

Dietje E. Fransen van de Putte; Kathelijn Fischer; Michael Makris; R. Campbell Tait; Peter W. Collins; Karina Meijer; Goris Roosendaal; Pratima Chowdary; Roger E. G. Schutgens; Eveline P. Mauser-Bunschoten

doi:10.1160/TH12-05-0313

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2012; 108(04): 750-755
DOI: 10.1160/TH12-05-0313

Cardiovascular Biology and Cell Signalling

Schattauer GmbH

Increased prevalence of hypertension in haemophilia patients

Dietje E. Fransen van de Putte

¹Van Creveldkliniek, Department of Haematology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Kathelijn Fischer

¹Van Creveldkliniek, Department of Haematology, University Medical Center Utrecht, Utrecht, The Netherlands

²Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

,

Michael Makris

³Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK

,

R. Campbell Tait

⁴West of Scotland Haemophilia and Thrombosis Centre, Royal Infirmary, Glasgow, UK

,

Peter W. Collins

⁵Arthur Bloom Haemophilia Centre, School of Medicine, Cardiff University and University Hospital of Wales, Cardiff, UK

,

Karina Meijer

⁶Division of Haemostasis and Thrombosis, Department of Haematology, University Medical Center Groningen, Groningen, The Netherlands

,

Goris Roosendaal

¹Van Creveldkliniek, Department of Haematology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Pratima Chowdary

⁷Katharine Dormandy Haemophilia Centre and Haemostasis Unit, Royal Free Hospital, London, UK

,

Roger E. G. Schutgens

¹Van Creveldkliniek, Department of Haematology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Eveline P. Mauser-Bunschoten

¹Van Creveldkliniek, Department of Haematology, University Medical Center Utrecht, Utrecht, The Netherlands

› Author Affiliations

Abstract

Summary

An increased prevalence of hypertension is reported in haemophilia patients, but data from large, unbiased studies are lacking. The aim of our study was to cross-sectionally assess the prevalence of hypertension in a large cohort of 701 haemophilia patients. Blood pressure (BP) measurements performed in 386 Dutch and 315 UK haemophilia patients aged 30 years or older were analysed and compared with the general age-matched male population. Mean values of up to three BP measurements were used when available. Hypertension was defined as BP over 140/90 mmHg and/or the use of antihypertensive medication. A total of 49% of patients had severe haemophilia. Mean age was 49.8 years. The prevalence of hypertension was significantly higher in haemophilia patients (49%, 95% confidence interval [CI] 45–53) than in the general population (40%, 95% CI 37–43). The prevalence of hypertension was higher in patients with severe haemophilia than in those with non-severe disease, but similar across haemophilia types and in Dutch and UK patients. Multiple BP measurements were available for 70%.The prevalence of hypertension was similar in patients with multiple BP measurements and the complete cohort. Hypertension was not significantly associated with renal function, a history of renal bleeding or with infection with hepatitis C or HIV, but it was associated with overweight/obesity and age. In conclusion, the prevalence of hypertension is higher in haemophilia patients than in the general population. The cause of this increased prevalence is unknown. Blood pressure measurements should be part of standard care in haemophilia patients aged 30 years or older.

Keywords

Haemophilia - hypertension

Full Text

References

References
1 Darby SC, Kan SW, Spooner RJ. et al. Mortality rates, life expectancy, and causes of death in people with hemophilia A or B in the United Kingdom who were not infected with HIV. Blood 2007; 110: 815-825.
2 Plug I, Van Der Bom JG, Peters M. et al. Mortality and causes of death in patients with hemophilia, 1992-2001: a prospective cohort study. J Thromb Haemost 2006; 4: 510-516.
3 Rosendaal FR, Varekamp I, Smit C. et al. Mortality and causes of death in Dutch haemophiliacs, 1973–86. Br J Haematol 1989; 71: 71-76.
4 Tuinenburg A, Mauser-Bunschoten E P, Verhaar MC. et al. Cardiovascular disease in patients with hemophilia. J Thromb Haemost 2009; 7: 247-254.
5 Rosendaal FR, Briet E, Stibbe J. et al. Haemophilia protects against ischaemic heart disease: a study of risk factors. Br J Haematol 1990; 75: 525-530.
6 Siboni SM, Mannucci PM, Gringeri A. et al. Health status and quality of life of e l derly p ersons w ith severe hem op hilia b o r n b e f o re t he a d vent of mod e rn re pl a cement therapy. J Thromb Haemost 2009; 7: 780-786.
7 Biere-Rafi S, Baarslag MA, Peters M. et al. Cardiovascular risk assessment in haemophilia patients. Thromb Haemost 2011; 105: 274-278.
8 Lim MY, Pruthi RK. Cardiovascular disease risk factors: prevalence and management in adult hemophilia patients. Blood Coagul Fibrinolysis 2011; 22: 402-406.
9 Bilora F, Zanon E, Petrobelli F. et al. Does hemophilia protect against atherosclerosis? A case-control study. Clin Appl Thromb Hemost 2006; 12: 193-198.
10 Foley CJ, Nichols L, Jeong K. et al. Coronary atherosclerosis and cardiovascular mortality in hemophilia. J Thromb Haemost 2010; 8: 208-211.
11 Walsh M, MacGregor D, Stuckless S. et al. Health-related quality of life in a cohort of adult patients with mild hemophilia A. J Thromb Haemost 2008; 6: 755-761.
12 Kearney PM, Whelton M, Reynolds K. et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217-223.
13 Viet AL, van den Hof S, Elvers LH. et al. Risk factors and health in the Netherlands: a survey on Municipal Health Services. 2002 RIVM report 260854003/2002..
14 Primatesta P, Poulter NR. Improvement in hypertension management in England: results from the Health Survey for England 2003. J Hypertens 2006; 24: 1187-1192.
15 Kulkarni R, Soucie JM, Evatt B. Renal disease among males with haemophilia. Haemophilia 2003; 9: 703-710.
16 Ljung RC. Intracranial haemorrhage in haemophilia A and B. Br J Haematol 2008; 140: 378-384.