Heart Health and Hemophilia

Hemophilia not protective against heart disease
Author: Sarah Aldridge

In the past decade, research has shown that people with hemophilia are just as prone to heart conditions as the general public.

In a six-state study of more than 3,400 men with hemophilia, investigators working with the Centers for Disease Control and Prevention in Atlanta uncovered some hints about heart health and adults with hemophilia. “After HIV and intracranial hemorrhage, the third most common cause of death was heart disease,” says Roshni Kulkarni, MD, director of pediatric and adolescent hematology/oncology and professor in the Department of Pediatrics at Michigan State University in East Lansing. She was lead author of the study, published in the American Journal of Hematology in 2005. Using data from hospital records, Kulkarni and associates found the incidence of ischemic heart disease (reduced blood supply to the heart usually from coronary artery disease) was not significantly different when compared to nonhemophilic men. “They were at risk for heart disease just like the rest of the population, so hemophilia was not protective.”

In a 2009 research study published in Haemophilia, Barbara Konkle, MD, and colleagues identified cardiovascular disease as a co-morbidity of older men with hemophilia. A 2010 study in the Journal of Thrombosis and Haemostasis then showed that men with hemophilia had equivalent incidences of atherosclerosis (narrowing of the arteries) as men in the general population. A study of 185 men with hemophilia at the Indiana Hemophilia & Thrombosis Center in Indianapolis, published in Haemophilia in 2011, further showed they were twice as likely to develop coronary artery disease, stroke or heart attack as non-Hispanic white males. High blood pressure and smoking were contributing risk factors.

Further, exposure to high factor levels can trigger increased clot formation. This is a greater concern for patients with hemophilia B or inhibitors who use activated prothrombin complex concentrates (APCCs). “Taking an APCC is clearly a risk factor for heart disease,” Kulkarni says. “If you have bad blood vessels in your heart, they can form a clot there.”

Routine Heart Screenings

Primary care providers (PCPs) who perform routine screenings for cholesterol and triglycerides, can help identify and treat conditions that lead to heart disease.

So if you’re anxious about the angina that runs in your family, schedule an appointment with your PCP today. You’ll do your heart a favor.