Cardiovascular mortality by blood type
Hemodialysis patients with blood type A were found to have lower risks of cardiovascular mortality.
Image Credit: Osaka Metropolitan University
Scientific Frontline: Extended "At a Glance" Summary: Hemodialysis Mortality and ABO Blood Types
The Core Concept: Hemodialysis patients with blood type A exhibit significantly lower risks of both all-cause and cardiovascular mortality compared to those with other blood types. This finding directly contrasts with the general population, where blood type O is typically associated with the lowest risk of cardiovascular disease.
Key Distinction/Mechanism: In the general public, blood type O presents a lower cardiovascular risk due to inherently reduced levels of plasma von Willebrand factor (a blood glycoprotein) and factor VIII (a blood-clotting protein). Because dialysis patients with blood type A demonstrate lower cardiovascular mortality, researchers deduce that cardiovascular disease in hemodialysis patients develops through unique pathological mechanisms entirely independent of these specific protein levels.
Major Frameworks/Components:
- Prospective Cohort Study: A longitudinal five-year observation of 1,671 patients across 17 medical facilities to accurately track mortality and health outcomes over time.
- Mortality Categorization: Statistical modeling that specifically separated all-cause, cardiovascular, and non-cardiovascular mortality (such as infections and malignancies) to determine exact associations with ABO blood types.
- Protein and Factor Analysis: The evaluation of von Willebrand factor and factor VIII as traditional markers for cardiovascular risk, which were ruled out as the primary mechanisms for dialysis patients.
Branch of Science: Nephrology, Cardiology, Hematology, and Epidemiology.
Future Application: While current clinical treatments will not change immediately based on a patient's blood type, these findings provide a foundation for future research into the distinct mechanisms of cardiovascular disease in dialysis patients. This will eventually guide highly targeted, specialized preventive and therapeutic clinical strategies.
Why It Matters: Cardiovascular disease is the leading cause of death among dialysis patients. Identifying the unique physiological risk profiles and disease pathways in this specific demographic is critical for mitigating high mortality rates that traditional cardiovascular models fail to address.
Do you know your blood type?
It is important information used for blood transfusions, but few realize blood types could also be linked to disease risks. In the general population, people with blood type O reportedly have a lower risk of cardiovascular disease and cardiovascular mortality. Other noncardiovascular conditions are also associated with ABO blood types, such as certain cancers and infectious diseases. However, these statistics do not take into consideration the population of hemodialysis patients, who face higher risks than the general population.
Cardiovascular disease is the leading cause of death among dialysis patients, but its relationship to blood type has often been overlooked. To address this, a research group led by Dr. Masafumi Kurajoh at Osaka Metropolitan University’s Graduate School of Medicine conducted a large-scale prospective cohort study to examine whether the association between blood type and cardiovascular risk seen in the general population also exists in patients undergoing hemodialysis. The study included 1,671 patients receiving hemodialysis at 17 medical facilities in Osaka Prefecture. Participants' health was tracked for approximately five years, and the associations between ABO blood type and all-cause, cardiovascular, and noncardiovascular mortality were analyzed.
During the follow-up period, 464 patients died, including 278 from cardiovascular disease. The researchers found that patients with blood type A had lower risks of both all-cause and cardiovascular mortality. In contrast, blood type was not associated with noncardiovascular mortality, including deaths due to infections or malignancies.
“A particularly notable finding is that, while blood type O has been associated with lower cardiovascular risk in the general population, blood type A was associated with lower risk in dialysis patients,” said Dr. Kurajoh. “These results suggest that cardiovascular disease may develop through different mechanisms in hemodialysis patients.”
Moreover, blood type O’s association with a lower risk is partially due to lower plasma von Willebrand factor (VWF), a blood glycoprotein, and factor VIII, a blood-clotting protein. However, the finding that dialysis patients with blood type A have lower cardiovascular mortality risks indicates that differences in VWF and factor VIII levels are unlikely to be the root cause.
“At present, our findings do not support changing treatment or prevention strategies based on blood type,” Dr. Kurajoh added. “However, understanding why blood type A was associated with lower cardiovascular mortality may provide new insights into the mechanisms of cardiovascular disease in dialysis patients and help guide future preventive and therapeutic approaches.”
Funding: This study was partly supported by grants from the Japan Kidney Foundation (JKFB 15-43), Astellas Pharma Inc. (RS01442), Chugai Pharmaceutical Co., Ltd. (AC-1-20150630164707-161208), and Daiichi Sankyo (A16-0602).
Published in journal: Kidney International Reports
Title: ABO Blood Types and Mortality in Patients Undergoing Hemodialysis
Authors: Masafumi Kurajoh, Tetsuo Shoji, Shinya Nakatani, Yuki Nagata, Hisako Fujii, Yasuo Imanishi, Masanori Emoto, and Tomoaki Morioka
Source/Credit: Osaka Metropolitan University
Edited by: Scientific Frontline
Reference Number: med072126_01
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