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Cardiovascular Benefits for Blood Donors? A Systematic Review
Franke A Quee1, Karlijn Peffer1, Anique D Ter Braake1
1Department of Donor Medicine Research, Sanquin Research, Amsterdam, North Holland, The Netherlands.
Insights
Blood donation
Area of Science:
- Cardiovascular Science
- Hematology
- Public Health
Background:
- Cardiovascular disease is a leading cause of mortality worldwide.
- The potential cardioprotective effects of blood donation have been suggested.
- Existing evidence is largely based on observational studies with varying quality.
Purpose of the Study:
- To systematically review and evaluate observational and experimental studies on blood donation and cardiovascular disease.
- To assess the impact of blood donation on cardiovascular risk factors in donor and general populations.
- To identify gaps in the current research and guide future study design.
Main Methods:
- Systematic literature search of PubMed and EMBASE databases up to March 2019.
- Inclusion of observational and experimental studies, excluding patient populations and extreme age groups.
- Independent screening and quality assessment of eligible studies using validated scoring systems.
Main Results:
- 44 studies met the inclusion criteria (41 observational, 3 experimental).
- Of 14 high-quality studies, 9 suggested a protective effect of blood donation, while 5 found no effect.
- Results for other outcomes were inconsistent, and overall study quality was generally poor.
Conclusions:
- The protective effect of blood donation against cardiovascular disease remains unclear.
- The healthy donor effect may confound studies showing benefits.
- High-quality, large-scale randomized controlled trials or cohort studies are needed to establish a definitive association.
Abstract:
It has been proposed that blood donation could be protective against cardiovascular disease. The aim of this study is to systematically summarize and evaluate existing observational and experimental studies on effects of blood donation on cardiovascular risk and disease in donor and general populations. The electronic databases PubMed and EMBASE were searched until March 2019 for experimental and observational studies on blood donation and cardiovascular risk or disease. Excluded were studies performed in patient populations or with controls compared to a patient population, and studies performed in individuals aged <18 or >70. All identified studies were independently screened for eligibility and quality using validated scoring systems by 2 reviewers. A total of 44 studies met all criteria. We included 41 observational studies and 3 experimental studies. 14 studies had a quality assessment score of 7 or higher. Of those, a majority of 9 studies reported a protective effect of blood donation, while 5 studies found no effects on cardiovascular risk factors. Results on other various outcomes were inconsistent and study quality was generally poor. Whether or not blood donation protects against cardiovascular disease remains unclear. Studies showing beneficial effects may have inadequately dealt with the healthy donor effect. High quality studies are lacking and therefore definite conclusions cannot be drawn. Large RCTs or cohort studies of high quality with sufficient follow-up should be conducted to provide evidence on the possible association between blood donation and cardiovascular disease.
