Reducing the risk of atherosclerotic cardiovascular disease in people with hemophilia: the importance of primary prevention.

Autor:	Dix C; Haemophilia & Thrombosis Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK., Dolan G; Haemophilia & Thrombosis Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK., Hunt BJ; Haemophilia & Thrombosis Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK. Electronic address: beverley.hunt@gstt.nhs.uk.
Jazyk:	angličtina
Zdroj:	Journal of thrombosis and haemostasis : JTH [J Thromb Haemost] 2024 May; Vol. 22 (5), pp. 1304-1312. Date of Electronic Publication: 2024 Feb 01.
DOI:	10.1016/j.jtha.2024.01.017
Abstrakt:	Revolutionary advances in the treatment of hemophilia has led to a significant improvement in life expectancy. Associated with this has been an increase in age-related diseases especially atherosclerotic cardiovascular disease (CVD). While people with hemophilia (PWH) develop atherosclerosis at rates similar to those of the general population, rates of atherothrombosis and mortality related to CVD have been much lower, due to their hypocoagulable state. Changing treatment paradigms, aimed at reducing the risk of bleeding by improving hemostasis to levels approaching normality, has meant that the protection they are thought to have had may be lost. CVD risk factors are just as common in PWH as in the general population, but appear to be undertreated. In particular, primary prevention of CVD is vital in all individuals, but particularly in PWH as treatment of established CVD can be difficult. Active identification and management of CVD risk factors, such as obesity, physical inactivity, hypertension, and hypercholesterolemia, is required. In particular, statins have been shown to significantly reduce cardiovascular and all-cause mortality with few adverse events and no increased risk of bleeding in the general population, and their use needs urgent assessment in PWH. Further longitudinal research into preventing CVD in PWH, including accurate CVD risk assessment, is required to optimize prevention and management. Competing Interests: Declaration of competing interests There are no competing interests to disclose. Caroline Dix is a recipient of the HSANZ New Investigator Clinical Fellowship (Copyright © 2024 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu