Written by: David Clark, PhD, chair of the Coalition for Hemophilia B

Hemophilia patients appear to be at a higher risk of hypertension, commonly known as high blood pressure (HBP) than the general population. HBP also develops in younger patients with hemophilia, so it is important to keep track of your blood pressure. 

A 2018 study suggested that inhibitor patients might have a higher risk of cardiovascular disease than non-inhibitor patients, but the study included too few inhibitor patients to be certain. A new study looked at 691 hemophilia patients, including 44 with inhibitors, at four U.S. and Canadian hemophilia treatment centers (HTCs). Included were 533 subjects with hemophilia A and 157 with hemophilia B. For A and B combined, 419 patients were positive for hepatitis C virus (HCV) and 128 were HIV-positive.

A study showed that at age 50, hemophilia B patients had a probability of having high blood pressure of about 90% compared to about 40% in hemophilia A patients.

The researchers found that subjects with inhibitors, or with a history of inhibitors, had no increased risk of HBP. However, after looking at subsets of the data, they found that hemophilia B patients had a greatly increased risk of HBP compared with hemophilia A patients. Bs actually had a lower risk than As until their early 30s, but then the risk started increasing markedly, peaking in the late 40s/early 50s and decreasing slightly after that. At age 50, Bs had a probability of having HBP of about 90% compared to about 40% in As. By age 70, both were at about 80%. They also found that subjects who were HCV- or HIV-positive, or who had a history of those infections, had an increased risk of HBP. 

There are still many unanswered questions here, but it points out that hemophilia B patients should keep a close eye on their blood pressure.

REFERENCE:

Risk of High Blood Pressure in Inhibitor Patients and in Hemophilia B Patients (Abstract 1633 from 62nd ASH [American Society of Hematology] Annual Meeting and Exposition)