Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA.
Haemophilia. 2011 Jul;17(4):597-604. doi: 10.1111/j.1365-2516.2010.02463.x. Epub 2011 Feb 15.
The primary objective of the study was to examine the prevalence of cardiovascular disease (CVD) events and their known risk factors among persons with haemophilia (PWH). This cross-sectional study, covering a 5-year period, included PWH aged ≥35 years who were cared for at a single haemophilia treatment centre in the United States. Medical records were extensively reviewed to collect the information about CVD events and their risk factors such as obesity, hypertension, diabetes, hypercholesterolemia and smoking. Prevalence rates were compared with national population estimates and associations between risk factors and CVD events were examined using logistic regression. The study cohort comprised 185 PWH (102 haemophilia A and 83 haemophilia B). Lifetime prevalence of a CVD event was 19.5% (36/185, 95% confidence interval [CI] 13.8-25.2%). CVD mortality was 5.4% (10/185, 95% CI 2.7-8.1). Compared with US non-Hispanic White males (NHWH), PWH had about twice the prevalence of coronary artery disease, stroke and myocardial infarction. The prevalence of CVD risk factors for PWH was similar to that for US NHWM with 39.5% of PWH exposed to two or more of these risk factors. Both hypertension and smoking were associated significantly with CVD events, with odds ratios of 4.9 and 6.3, respectively. In conclusion, this study revealed that both CVD events and its risk factors were at least equally prevalent among PWH and might have been even higher than among the US NHWM in the United States. Therefore, it is imperative to implement strategies for CVD prevention among PWH.
本研究的主要目的是调查美国某单一血友病治疗中心的≥35 岁血友病患者(PWH)中心血管疾病(CVD)事件及其已知危险因素的流行情况。本横断面研究覆盖了 5 年时间,共纳入 185 名 PWH(102 名血友病 A 和 83 名血友病 B)。详细查阅了病历以收集 CVD 事件及其危险因素(如肥胖、高血压、糖尿病、高胆固醇血症和吸烟)的信息。采用逻辑回归分析比较了危险因素与 CVD 事件之间的相关性。研究队列包括 185 名 PWH(102 名血友病 A 和 83 名血友病 B)。CVD 事件的终生患病率为 19.5%(36/185,95%置信区间[CI]为 13.8-25.2%)。CVD 死亡率为 5.4%(10/185,95%CI 为 2.7-8.1%)。与美国非西班牙裔白人男性(NHWH)相比,PWH 的冠心病、卒中和心肌梗死的患病率约为其两倍。PWH 的 CVD 危险因素的患病率与美国 NHWM 相似,有 39.5%的 PWH 暴露于两种或两种以上这些危险因素中。高血压和吸烟均与 CVD 事件显著相关,比值比分别为 4.9 和 6.3。总之,本研究表明,PWH 中心血管疾病事件及其危险因素的患病率至少与美国 NHWM 相当,甚至可能更高。因此,必须在 PWH 中实施 CVD 预防策略。