Berger K, Schopohl D, Lowe G, Holme P A, Tait R C, Combescure C, Rauchensteiner S, Klamroth R
Department of Haematology/Oncology, University Hospital of Munich, Munich, Germany.
Haemophilia Centre, Glasgow, UK.
Haemophilia. 2016 Sep;22(5):e406-16. doi: 10.1111/hae.13069.
Studies on the prevalence of cardiovascular disease (CVD) and risk factors in patients with haemophilia (PWH) in comparison to the general population have generated inconsistent results. The ADVANCE Working Group collected data on CV comorbidities in PWH aged ≥40 years (H(3) Study).
Identification of German epidemiological data on CVD for the general population, evaluation for appropriateness, and execution of comparisons with PWH.
Identification of data sources by structured literature (EMBASE, MEDLINE) searches.
German general population, CVD and risk factors, gender/age stratification, sample size >500 male persons, age groups ≥40 years, current data collection, language English/German. Comparison of data on CVD and risk factors in PWH (H(3) Study) with published German general population data.
Criteria for data source appropriateness were defined. Of five national and three international epidemiological studies, the DEGS1 Study (German Health Interview and Examination Survey for Adults) was identified as the most suitable comparator. Compared with men from DEGS1, hypertension was significantly more prevalent in PWH aged 50-59 years (41.7% [95% CI: 37.3-46.2] vs. 52.0% [95% CI: 43.7-60.1], P = 0.03). Coronary artery/heart disease (CHD) was significantly less prevalent in PWH aged ≥60 years (60-69 years: 19.5% [95% CI: 15.9-23.7] vs. 8.1% [95% CI: 3.3-16.1], P = 0.02; 70-79 years: 30.5% [95% CI: 25.9-35.5] vs. 11.8% [95% CI: 5.2-21.9], P = 0.002). No statistically significant difference for ischaemic cerebrovascular disease/stroke was detected.
Increased prevalence of hypertension in PWH should trigger regular screening. CHD does occur in PWH aged ≥60 years though apparently with lower prevalence. Given the growing population of elderly PWH, guidelines for prevention and treatment of CVD should be developed.
与普通人群相比，关于血友病患者（PWH）心血管疾病（CVD）患病率及其风险因素的研究结果并不一致。ADVANCE工作组收集了年龄≥40岁的PWH的心血管合并症数据（H(3)研究）。
确定德国普通人群心血管疾病的流行病学数据，评估其适用性，并与PWH的数据进行比较。
通过结构化文献检索（EMBASE、MEDLINE）确定数据来源。
德国普通人群、心血管疾病及其风险因素、性别/年龄分层、样本量>500名男性、年龄组≥40岁、当前数据收集、语言为英语/德语。将PWH的心血管疾病及其风险因素的数据（H(3)研究）与已发表的德国普通人群数据进行比较。
定义了数据来源适用性的标准。在五项国内和三项国际流行病学研究中，DEGS1研究（德国成人健康访谈和检查调查）被确定为最合适的比较对象。与DEGS1研究中的男性相比，50 - 59岁的PWH中高血压患病率显著更高（41.7% [95%置信区间：37.3 - 46.2] 对 52.0% [95%置信区间：43.7 - 60.1]，P = 0.03）。≥60岁的PWH中冠状动脉/心脏病（CHD）患病率显著更低（60 - 69岁：19.5% [95%置信区间：15.9 - 23.7] 对 8.1% [95%置信区间：3.3 - 16.1]，P = 0.02；70 - 79岁：30.5% [95%置信区间：25.9 - 35.5] 对 11.8% [95%置信区间：5.2 - 21.9]，P = 0.002）。未检测到缺血性脑血管疾病/中风的统计学显著差异。
PWH中高血压患病率的增加应促使进行定期筛查。≥60岁的PWH中确实会发生CHD，尽管患病率明显较低。鉴于老年PWH人群不断增加，应制定心血管疾病的预防和治疗指南。
