Risk factors for cardiovascular disease in children and young adults with haemophilia
Jacqueline Limjoco1, Courtney D Thornburg1,2
1Rady Children's Hospital San Diego, San Diego, California.
Insights
Cardiovascular risk factors like obesity and hypertension are common in children with hemophilia. Early identification during clinic visits can help reduce risks through targeted interventions.
Area of Science:
- Pediatric Cardiology
- Hematology
- Public Health
Background:
- Cardiovascular disease (CVD) risks begin in childhood.
- Congenital hemophilia A or B patients require specialized care.
- Comprehensive care models may include CVD risk assessment.
Purpose of the Study:
- Determine the prevalence of cardiovascular risk factors in pediatric hemophilia patients.
- Investigate the link between weight, physical activity, and factor consumption.
- Assess the feasibility of identifying CVD risks during routine clinic visits.
Main Methods:
- Cross-sectional cohort study design.
- Standardized measurements of weight, height, waist circumference, blood pressure, glucose, and lipids.
- Questionnaires for medical history, family history, and lifestyle; medical record abstraction.
Main Results:
- High prevalence of overweight/obesity, (pre)hypertension, and abnormal lipids identified.
- Normal weight subjects reported more physical activity than overweight/obese.
- Higher weight correlated with increased factor consumption (r=0.88, P<0.001).
Conclusions:
- Modifiable cardiovascular risk factors are prevalent in pediatric hemophilia patients.
- Cardiovascular risk reduction can be integrated into Hemophilia and Thrombosis Treatment Center (HTC) care.
- Behavioral interventions may be developed to target CVD risk reduction.
Introduction:
The origins of cardiovascular disease (CVD) begin in childhood. The primary objective of this cross-sectional cohort study was to determine the prevalence of cardiovascular risk factors in patients with congenital haemophilia A or B followed at Rady Children's Hospital San Diego Hemophilia and Thrombosis Treatment Center (HTC). We hypothesized that cardiovascular risk factors could be identified as part of a comprehensive clinic visit.
Materials And Methods:
Standardized measurement of weight, height, waist circumference and blood pressure plus non-fasting glucose and lipid panel were performed. Participants and/or caregivers completed questionnaires about family history, medical history and lifestyle. Clinical data were abstracted from the medical record. Descriptive statistics, Student's t test, correlation, Mann-Whitney U test and chi-square test were performed to analyse the data.
Results:
Forty-three males (mean 12 years, range 5-20 years) enrolled. High rates of overweight and obesity, (pre)hypertension and abnormal lipids were identified. Subjects with normal weight had more days of >60 minutes of physical activity compared with those with overweight or obesity (5.2 ± 2.4 vs. 3.8 ± 2.5 day; P = 0.07). Higher weight was correlated with higher factor consumption (cor = 0.88; P < 0.001). There was no difference in target joints based on weight category (30% in normal weight vs. 25% in overweight or obese, χ2 = 0.11, P = 0.74), which may be attributed to high rates of prophylaxis.
Conclusions:
Modifiable risk factors for CVD were identified as part of the study during comprehensive clinic visits. The HTC team may develop behavioural interventions to target cardiovascular risk reduction as part of the comprehensive care model.
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