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Blood Groups and Cardiovascular Disease Abstracts


ABO blood group system and vegetative-vascular disorders in children.

Zh Nevropatol Psikhiatr 1981;81(10):1487-1488 
Ismagilov MF, Petrova SE

The distribution of the blood groups of the ABO system was examined in 159 children with various vegetovascular disorders. The results were compared with the data on the distribution of the same blood groups in local population. A statistically significant (P less than 0.001) prevalence of persons with blood group A(II) and a lesser number of persons with blood group O(I) was revealed among the patients. It is assumed that the blood group A(II) is an unfavourable factor for children with vegetovascular disorders. An analogy is drawn with various diseases and cerebral circulation impairments in adults in whom a number of authors consider the blood group A(II) to be a risk factor. 

Factor VIII, ABO blood group and the incidence of ischaemic heart disease.

Br J Haematol 1994 Nov;88(3):601-607 
Meade TW, Cooper JA, Stirling Y, Howarth DJ, Ruddock V, Miller GJ
MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, Medical College of St Bartholomew's Hospital, London. 

Relations of factor VIII activity, FVIIIC, and von Willebrand factor antigen (vWFAg), with ischaemic heart disease (IHD) were examined in 1393 men aged between 40 and 64 years at entry to the Northwick Park Heart Study (NPHS) who experienced 178 first major episodes of IHD during an average follow-up period of 16.1 years. Thus, an increase of 1 standard deviation in FVIIIC raised the risk of fatal IHD by about 28%. vWFAg was also significantly associated with fatal events. FVIIIC and vWFAg were strongly correlated (r = 0.57) and in statistical terms there may be little to choose between them in long-term studies of IHD. Taking account of evidence that haemophiliacs seem to experience less IHD than expected, high factor VIII levels may contribute to the incidence of IHD by increasing thrombogenic potential. The incidence of IHD was significantly higher in those of blood group AB than in those of groups O or B, particularly for fatal events. There was no evidence that the FVIIIC and vWFAg associations with IHD are determined by ABO group. The factor VIII and ABO blood group effects therefore appeared to be independent. GroupAB may be a genetic markers of characteristics influencing other indices of IHD risk such as short stature, NPHS men (though not women) of group AB being about 2 cm shorter than those of other groups. 

ABO and Rh blood groups in cardiovascular pathology.

Kardiologiia 1981 Apr;21(4):46-50 
Meshalkin EN, Okuneva GN, Vlasov IuA, Vel'tmander NN

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. 

Association between polymorphic blood markers and risk factors for cardiovascular disease in a large pedigree.

Genet Epidemiol 1987;4(4):267-275 
George VT, Elston RC, Amos CI, Ward LJ, Berenson GS
Department of Biometry and Genetics, Louisiana State University Medical Center, New Orleans 70112-1393. 

A large pedigree with high prevalence of heart disease is investigated to analyse the association between polymorphic blood markers and quantitative risk factors for cardiovascular disease. The analysis incorporates a familial correlation structure among the individuals in the pedigree and a generalized power transformation to induce approximate residual normality of the risk factors. A total of 380 marker/risk factor combinations are analysed, and at the normal 1% significance level, positive associations are found between the A antigen of the ABO locus and both serum total cholesterol and low-density lipoprotein cholesterol, and negative associations are found between the B antigen of the ABO locus and serum total cholesterol, and between the B allele of acid phosphatase (AP) locus and systolic blood pressure

ABO blood groups and coronary heart disease (CHD). A study in subjects with severe and latent CHD.

Thromb Haemost 1980 Jun 18;43(2):137-140 
Erikssen J, Thaulow E, Stormorken H, Brendemoen O, Hellem A

The view based on epidemiological and laboratory data that blood group A subjects (=A) have clinically significant higher thrombotic potential than blood group 0 subjects (=O), is supported by the present finding of a significantly higher platelet retention in A than 0. The completely normal AB0 distribution found among 71 cases of proven latent CHD, and the disproportionate excess of 0 vs. A in a consecutive series of 191 coronary artery bypass candidates apparently conflict with epidemiological data indicating a higher risk of achieving CHD in A than 0. The conflict may be solved by suggesting a) that the "thrombotic proneness" in A compared with 0 causes a poorer prognosis in CHD among the former, leaving a disproportionate excess of 0 among longterm CHD survivors, and b) that AB0-related factors have had an insignificant, independent impact on the evolution of preclinical coronary artery disease in our 71 men with latent CHD. 


ABO blood-group phenotypes and pathogenesis of cardiovascular diseases. Congenital, rheumatic and coronaric heart disease and arterial hypertension.

G Ital Cardiol 1975;5(5):744-751 
Galeazzi L, Gualandri V

Many cases of cardiovascular diseases have been examined in reference to the distribution of ABO blood-groups, in order to calculate the relative risk of disease and the hemogroupal distributive significance in our samples as related to those of other authors, using combined calculation. The analysis concerned the following cases: 746 with arterial hypertension, 3258 with congenital heart disease, 4503 with articular rheumatism, 1047 with acquired valvulopathia, and respective controls. 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. 

ABO blood groups, age and work in ischaemic heart disease.

Atherosclerosis 1975 May;21(3):459-461 
Allan TM

In a series of male survivors of ischaemic heart disease there were fewer patients belonging to the risk-factor blood group (group A) before than after age 55 who were either non-infarction patients in light work or infarction patients in active or heavy work. Conversely, there were more A's before than after age 55 who were either non-infarction patients in active or heavy work or infarction patients in light work. 

ABO blood group and ischaemic heart disease in British men.

BMJ 1990 Jun 30;300(6741):1679-1682 
Whincup PH, Cook DG, Phillips AN, Shaper AG
Department of Public Health and Primary Care, Royal Free Hospital, School of Medicine, London. 

OBJECTIVE--To establish whether ABO blood group is related to ischaemic heart disease on an individual and geographic basis in Britain. DESIGN--Prospective study of 7662 men with known ABO blood group selected from age-sex registers in general practices in 24 British towns. END POINTS--Eight year follow up of fatal and nonfatal ischaemic heart disease events achieved for 99% of study population. RESULTS--Towns with a higher prevalence of blood group O had higher incidences of ischaemic heart disease. In individual subjects, however, the incidence of ischaemic heart disease was higher in those with group A than in those with other blood groups (relative risk 1.21, 95% confidence limits 1.01 to 1.46). Total serum cholesterol concentration was slightly higher in subjects of blood group A. No other cardiovascular risk factor (including social class) was related to blood group. CONCLUSIONS--Blood group A is related to the incidence of ischaemic heart disease in individual subjects. Geographic differences in the distribution of ABO blood groups do not explain geographic variation in rates of ischaemic heart disease in Britain. The findings do not support the view that ABO blood group and social class are related. 

Myocardial infarction in women under 50 years of age.

JAMA 1983 Nov 25;250(20):2801-2806 
Rosenberg L, Miller DR, Kaufman DW, Helmrich SP, Van de Carr S, Stolley PD, Shapiro S

Risk factors for first nonfatal myocardial infarction (MI) in women younger than age 50 years were evaluated in a case-control study of 255 women with MI and 802 controls. The relative risk of MI increased with the amount smoked. The estimated risk of MI for current smokers of 35 or more cigarettes per day was ten times that of women who never smoked; an estimated 65% of MIs were attributable to cigarette smoking. The relative risk of MI increased markedly with increasing levels of total plasma cholesterol and decreasing levels of high-density lipoproteins, and the effects of the two factors appeared to be independent. Other factors significantly associated with MI were hypertension, angina pectoris, diabetes mellitus, blood group A, and a history of MI or stroke before age 60 years in a mother or sibling. Factors not significantly associated with MI were obesity, history of preeclamptic toxemia, and type A personality. Women who were postmenopausal appeared to have a lower risk of MI than premenopausal women of similar ages. Of the identified risk factors, the most prominent was cigarette smoking, a habit that is amenable to change. 

ABO blood group system, age, sex, risk factors and cardiac infarction.

Arch Gerontol Geriatr 1985 Oct;4(3):241-249 
Platt D, Muhlberg W, Kiehl L, Schmitt-Ruth R

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. 

Relation of serum lipoproteins and lipids to the ABO blood groups in patients with intermittent claudication.

J Cardiovasc Surg (Torino) 1989 Jul;30(4):533-537 
Horby J, Gyrtrup HJ, Grande P, Vestergaard A
Department of Urology and Vascular Surgery H, University of Copenhagen, Gentofte Hospital, Hellrup, Denmark. 

In the present study we investigated the serum lipoprotein and lipid levels in patients with intermittent claudication (n = 66), divided according to their blood groups in the ABO system (bloodtype A, n = 40 and bloodtype "non-A", n = 26). We again found the expected predominance of blood type A (61%). However, we found no significant differences in any of the biochemical variables between patients belonging to blood group A and "non-A". Fifty-seven of the patients had arteriographies done and the arteriograms were evaluated blindly by a radiologist according to occlusive and stenotic atherosclerotic lesions. However, as previously suggested by other investigators, we were not able to demonstrate any significant differences between the number of occlusions and stenotic lesions when dividing the patients into blood group A and "non-A". The biochemical differences between patients with either occlusive or stenotic atherosclerotic lesions were also tested and found without any significance. In conclusion: the serum lipoprotein and lipid levels in the present study do not give an obvious explanation, why patients with blood group A seem more liable to develop atherosclerosis than those with blood group "non-A". 

Investigation of associations between ABO blood groups and coagulation, fibrinolysis, total lipids, cholesterol, and triglycerides.

Hum Genet 1979 Apr 27;48(2):221-230 
Colonia VJ, Roisenberg I

To investigate possible associations between ABO blood system and coagulability levels, fibrinolysis, total lipids, cholesterol, and triglycerides, the plasma and serum of 300 Rh-positive male blood donors were tested. The tests performed were: RT, PTT, K-PTT, PT, F.V, F.II, F.VII, Complex II, VII, and X, TGT, fibrinogen, HAE 0.2, HAE 0.5, ELT, LIP, Col.1, Col.2 and TRI. Analysis of the laboratory data shows a lower coagulability in O blood group individuals. This result was obtained in coagulation tests (RT, PTT, and K-PTT) specific for factor VIII level. In addition, a higher sensitivity to the in vitro heparin anticoagulant effect in O group individuals was confirmed. Nevertheless, these conclusions are specific for Negroids, the same effects not being observed in Caucasians. None of the other laboratory tests revealed any differences related to either blood group or race. 

Platelet function and ABO blood group.

Am J Clin Pathol 1989 Jan;91(1):79-81 
Sweeney JD, Labuzetta JW, Hoernig LA, Fitzpatrick JE
Department of Laboratory Medicine, Roswell Park Memorial Institute, Buffalo, New York 14263. 

An influence of the ABO blood group on von Willebrand and Factor VIII:C levels is known. Von Willebrand factor interacts with at least two platelet membrane receptors, but the effect of ABO group on platelet function is an unstudied area. The authors examined platelet function in 40 plateletpheresis donors using an impedance lumi-aggregometer. Aggregation responses to collagen, adenosine diphosphate (ADP), and ristocetin were measured and the adenosine triphosphate (ATP) release to thrombin. Twenty donors were Group O and 20 were Group A. Measurements of von Willebrand factor antigen (vWf:Ag), Factor VIII: C, and ristocetin co-factor (RiCoF) in the same group showed reduced levels of vWf:Ag and Factor VIII:C in Group O, as previously reported. The aggregation response to collagen and ADP and the release of ATP did not differ. The aggregation response to ristocetin, however, was better in Group O than in Group A despite the lower vWf:Ag levels. The explanation for this is unclear, but the data suggest an influence of blood group antigens on the interaction between von Willebrand's factor and platelets. 

Venous thromboembolism and ABO blood groups in a Brazilian population.

Hum Genet 1980;55(1):129-131 
Robinson WM, Roisenberg I

The ABO blood groups were determined in 125 patients suffering from venous thrombosis in a Brazilian population. There is a clear effect of the sex on the disease incidence, women being more frequently affected, but the mean age was not different regarding the sex. No differences were found in the disease incidence when Caucasians and Negroids were compared. An excess of blood group A and a decrease of blood group O was observed among the patients. The analysis of the combined data from ten different published series shows a A/O relative incidence significantly higher than unity. 

Factor VIII and factor IX in a twin population. Evidence for a major effect of ABO locus on factor VIII level.

Orstavik KH, Magnus P, Reisner H, Berg K, Graham JB, Nance W
Am J Hum Genet 1985 Jan;37(1):89-101 

In order to establish the relative importance of genetic factors on the variation in plasma concentration of coagulation factors VIII and IX, these parameters were determined in 74 monozygotic and 84 like-sexed dizygotic twin pairs. The twins belonged to two age groups: 33-39 years and 57-62 years. Factor VIII was determined as factor VIII coagulant antigen (VIIICAg) and as factor VIII-related antigen (VIIIRAg). A significant correlation was found between values for VIIIRAg and VIIICAg (r = .56). For VIIICAg, it could be demonstrated that the age effect was secondary to the age effect on VIIIRAg. The concentration of VIIICAg and VIIIRAg varied among ABO blood types, being lowest in type O individuals, higher in A2 individuals, and highest in A1 and B individuals. The effect of the ABO locus on VIIICAg was secondary to an effect on VIIIRAg. Analysis of variance revealed a significant genetic influence on the variance of VIIICAg and VIIIRAg with a heritability estimate of .57 for VIIICAg and .66 for VIIIRAg. This is in agreement with a previous hypothesis of an effect of several autosomal genes on factor VIII concentration. Thirty percent of the genetic variance of VIIIRAg was due to the effect of ABO blood type. The ABO locus is therefore a major locus for the determination of factor VIII concentration. No significant genetic effect on the variation in plasma concentration of IXAg could be detected. 
ABH Secretor/ Clotting Factors

Relationship among Lewis phenotype, clotting factors, and other cardiovascular risk factors in young adults.

J Lab Clin Med 1995 Mar;125(3):334-339 
Green D, Jarrett O, Ruth KJ, Folsom AR, Liu K
Department of Medicine, Northwestern University Medical School, Chicago, IL. 

An increased risk of ischemic heart disease has been reported in men with the Lewis blood group phenotype Le(a-b-). We have investigated the relationship between Lewis phenotype and cardiovascular risk factors in 1714 participants in the Coronary Artery Risk Development in Young Adults Study, an ongoing investigation on life-styles and evolution of cardiovascular risk factors. However, in white men with blood groups A, B, or AB, and the Le(a-b-) phenotype, significantly higher levels of factor VIII (p < 0.01) and von Willebrand factor (p < 0.03) were observed than in those with other Lewis phenotypes (Le[a+b-] or Le[a-b+]). Two-way analysis of variance indicated a significant interaction between blood group and Lewis phenotype (p = 0.0053) in terms of relationship to factor VIII. A similar trend was observed in black men with blood type A, B, or AB, and phenotype Le(a-b-) for factor VII/von Willebrand factor and in women with blood type A, B, or AB, and phenotype Le(a-b-) for factor VIII. Our data suggest that the Le(a-b-) phenotype and blood groups A, B, and AB, by virtue of their association with raised levels of factor VIII and von Willebrand factor, may be risk markers for future atherothrombotic disease. 

Longitudinal study of the association between ABO phenotype and total serum cholesterol level in a Japanese cohort.

Genet Epidemiol 1992;9(6):405-418 
Wong FL, Kodama K, Sasaki H, Yamada M, Hamilton HB
Department of Statistics, Radiation Effects Research Foundation, Hiroshima, Japan. 

The relationship between ABO blood phenotype and total serum cholesterol (TC) level was examined in a Japanese population to determine whether an elevated TC level is associated with phenotype A, as has been demonstrated in many West European populations. Such studies in nonwhite populations are scarce, and findings generally failed to demonstrate the relationship. The statistical method of growth curve analysis, through the mixed effect model of Laird and Ware [1982], was used to model age-dependent changes in cholesterol levels within individuals. The effects of the ABO polymorphism in modifying the resultant growth curve are examined. We demonstrate that TC levels are elevated on average by about 4 mg/dl in phenotype A compared to non-A in the Japanese (P < 0.00001), and that this relationship is maintained from early to late adulthood, independent of sex, body mass index, cohort status, or city of residence. Thus, phenotype A individuals may be more predisposed to cardiovascular disease through one of its major risk factors. This is the first study of the ABO-cholesterol association in the Japanese, and the first based on a cohort with longitudinally collected TC data. 

Blood groups, serum cholesterol, serum uric acid, blood pressure, and obesity in adolescents.

J Natl Med Assoc 1991 Aug;83(8):682-688 
Gillum RF
Office of Analysis and Epidemiology, National Center for Health Statistics, Hyattsville, Maryland 20782. 

To assess the association of blood groups with coronary risk factors, data were examined from the third cycle of the National Health Examination Survey. In a nationwide sample of more than 6000 black and white adolescents aged 12 to 17 years, ABO blood group, haptoglobin phenotype, selected other genetic markers of blood and secretions, and coronary risk factor levels were measured. Blood group A1 was associated with significantly higher serum total cholesterol levels in white females independent of multiple potential confounders, in white males independent of age and weight, and in southern black females independent of age and weight. ABO blood group was not significantly associated with blood pressure, resting heart rate, or subscapular skinfold thickness. An association with serum uric acid in white males was not independent of weight. In white males only, haptoglobin phenotype 2-2 was associated with significantly higher serum cholesterol levels than 1-1 or 2-1 adjusting for age and weight. No consistent associations were found between Rh types, ABH secretor ability, or group-specific component types and risk factors. This analysis of national data confirms previously reported associations of blood group A with higher serum total cholesterol levels in white adults and adolescents.