Division of Blood Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Synergy America, Inc., Duluth, Georgia, USA.
Haemophilia. 2022 Nov;28(6):986-995. doi: 10.1111/hae.14647. Epub 2022 Aug 4.
Increased survival among men with haemophilia has brought with it an increased risk of age-related comorbidities that may be challenging to treat in the presence of a bleeding disorder.
Estimate the prevalence of several age-related comorbidities among older males with haemophilia receiving care in the U.S. haemophilia treatment center (HTC) network compared to that among the general population.
People with bleeding disorders who receive care in network HTCs can volunteer to participate in a surveillance registry that collects detailed clinical information including the presence of comorbid conditions at annual visits. We used registry data collected on males with haemophilia age 45 years and older to calculate lifetime prevalence of obesity, diabetes, hypertension, cardiovascular disease, renal disease, cancer, anxiety and depression. Comparable data on the U.S. general male population was obtained from the National Health Interview Survey.
During the surveillance period, 1592 middle-aged (45-64 years) and 645 older (≥65 years) patients with haemophilia had comorbidity data collected during 6435 HTC visits. Most haemophilia patients in both age groups had a higher prevalence of anxiety, depression and diabetes, but a lower prevalence of hypertension, coronary heart disease, stroke and myocardial infarction compared to the general U.S. male population. In addition, middle-aged patients had lower rates of leukemia, whereas older patients had higher rates of obesity than the general population.
These findings highlight the mental stress associated with this chronic condition and support continued public health obesity prevention efforts in the haemophilia community.
男性血友病患者的生存率提高带来了与年龄相关的合并症风险增加,这些合并症在存在出血性疾病的情况下可能难以治疗。
估计美国血友病治疗中心(HTC)网络中接受治疗的老年男性血友病患者中几种与年龄相关的合并症的患病率,与普通人群相比。
在网络 HTC 接受治疗的出血性疾病患者可以自愿参加一项监测登记处,该登记处收集详细的临床信息,包括每年就诊时的合并症情况。我们使用登记处收集的年龄在 45 岁及以上的男性血友病患者的数据,计算肥胖、糖尿病、高血压、心血管疾病、肾脏疾病、癌症、焦虑和抑郁的终身患病率。美国普通男性人群的可比数据来自国家健康访谈调查。
在监测期间,1592 名中年(45-64 岁)和 645 名老年(≥65 岁)血友病患者在 6435 次 HTC 就诊期间收集了合并症数据。两个年龄组的大多数血友病患者都有更高的焦虑、抑郁和糖尿病患病率,但高血压、冠心病、中风和心肌梗死的患病率低于美国普通男性人群。此外,中年患者的白血病发病率较低,而老年患者的肥胖率高于普通人群。
这些发现强调了这种慢性疾病带来的精神压力,并支持在血友病社区继续开展公共卫生肥胖预防工作。