Pathology

Description

In a study of male survivors of heart disease, researchers found that there were fewer patients who were Type A before age 55 than would have been otherwise expected. (4)

A 1981 German study of 13,175 patients showed a prevalence of Blood Type A in all forms of heart disease examined. A relationship between erythrocytic antigens of the ABO and Rh blood systems and cardiovascular pathology was revealed by comparing the distribution of blood groups in 13,175 patients and 7,800 donors. Prevalence of A gene and Rh+ phenotype in congenital and acquired heart diseases and ischemic heart disease was found. The frequency of B gene is increased in patients with acquired heart diseases.

An eight-year study of 7662 men published in the prestigious British Medical Journal found Blood Type A is linked to a higher incidence of ischaemic heart disease, as well as having higher total serum cholesterol concentrations. Whincup PH, Cook DG, Phillips AN, Shaper AG. ABO blood group and ischaemic heart disease in British men. BMJ 1990 Jun 30;300(6741):1679-1682

Results from the NHLBI Family Heart Study also showed a higher risk of coronary heart disease (odds ratio was 2.0 (95% confidence interval = 1.2 to 3.1) for Lewis (a-b-) versus other Lewis groups. Triglycerides were significantly higher in the Lewis (a-b-) subjects. Among women, there was also a trend towards increased risk of CHD among Lewis negative phenotypes; however, the trend is dramatically weaker than among male subjects. (1)

Additional research has also duplicated these results, supporting and adding to the weight of evidence linking Lewis negative phenotype Lewis (a-b-) as a marker of high risk for the development of ischemic heart disease. Even excluding the Lewis negative phenotype, the secretor phenotype Lewis (a-b+) was found to be a genetic marker of resistance against the development of ischemic heart disease, while ABH non-secretor status is a risk factor predisposing individuals towards heart disease. (2)

It was found that blood-group phenotypes represent an important biophysiopathological action in regard to articular rheumatism and its cardiac consequences, in myocardial infarction and in hypertension, males only. It shows itself in: -- a significant negative association with group O and positive association with group A in the myocardial infarction; -- a significant negative association with group O and positive for the others in the valvulopathic (rheumatic) diseases; -- a positive association with A phenotype and negative with B in arterial hypertension, males only; -- no association with ABO blood-groups and congenital heart disease. (3)

In a retrospective study in 3100 patients of different ages the relationship between blood group and cardiac infarction was investigated in 450 patients. The patients were divided in two age groups: those who were 65 yr old and older and younger patients (age less than 65 yr). The predominance of blood group A in patients with cardiac infarction was highly significant in both age groups (P less than 0.005, two-tailed Chi-square test). Step-wise excluding all patients with at least one of the risk factors, hypertension, hyperuricemia, diabetes mellitus, smoking, and hyperlipemia similar results were found: the predominance of blood group A in the elderly patients with cardiac infarction was even higher than before excluding the risk factors (P less than 0.001). The predominance of blood group A was also demonstrated at a lower level in younger patients with cardiac infarction (P less than 0.05). Our investigation strongly suggests the existence of a genetic factor associated with blood group A and independent of the other risk factors which is also responsible for a greater incidence of cardiac infarction.

References

1. Ellison RC, Zhang Y, Myers RH, et al. Lewis blood group phenotype as an independent risk factor for coronary heart disease (the NHLBI Family Heart Study). Am J Cardiol 1999 Feb 1;83(3):345-8

2. Zhiburt BB, Chepel' AI, Serebrianaia NB, The Lewis antigen system as a marker of IHD risk. Ter Arkh 1997;69(1):29-31 [Article in Russian] Slavchev S, Tsoneva M, Zakhariev Z. The secretory type of persons who have survived a myocardial infarct. Vutr Boles 1989;28(2):31-4

3. G Ital Cardiol 1975;5(5):744-751 [ABO blood-group phenotypes and pathogenesis of cardiovascular diseases. Congenital, rheumatic and coronaric heart disease and arterial hypertension]. Galeazzi L, Gualandri V

4. Allan TM. ABO blood groups, age and work in ischaemic heart disease. Atherosclerosis 1975 May; 21(3):459-461

5. Br J Haematol 1994 Nov;88(3):601-607 Factor VIII, ABO blood group and the incidence of ischaemic heart disease. Meade TW, Cooper JA, Stirling Y, Howarth DJ, Ruddock V, Miller GJ

6. JAMA 1983 Nov 25;250(20):2801-2806 Myocardial infarction in women under 50 years of age. Rosenberg L, Miller DR, Kaufman DW, Helmrich SP, Van de Carr S, Stolley PD, Shapiro S

7. Arch Gerontol Geriatr 1985 Oct;4(3):241-249 ABO blood group system, age, sex, risk factors and cardiac infarction. Platt D, Muhlberg W, Kiehl L, Schmitt-Ruth R

8. Meshalkin EN, Okuneva GN, Vlasov IuA, Vel'tmander NN [ABO and Rh blood groups in cardiovascular pathology]. Kardiologiia 1981 Apr;21(4):46-50

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