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Association of ABO Blood Types with Atherosclerosis Risk Factors And http://www.cjmb.org Open Access Original Article Crescent Journal of Medical and Biological Sciences Vol. 3, No. 1, January 2016, 28–32 eISSN 2148-9696 Association of ABO Blood Types With Atherosclerosis Risk Factors and Number of Involved Coronary Arteries Ali Golmohammadi1,2, Salva Razavi2, Mina Bakhshayeshi2, Mohammadreza Taban Sadeghi1*, Razieh Parizad1 Abstract Objective: Cardiovascular disease (CVD) is a common cause of morbidity and mortality. The relationship between ABO blood groups and main risk factors of CVD is unknown. So this study was designed to investigate whether there is an association between ABO blood groups and cardiovascular risk factors in otherwise healthy people. Materials and Methods: In this cross-sectional study, risk factors for CVD were screened in 300 patients with coronary artery disease (CAD) who were hospitalized in Madani hospital (biggest heart center in Tabriz) in 2013-2014 and evaluated by a questionnaire that aimed to extract information about age, sex, smoking, blood group type, weight, height, blood pressure, diabetes mellitus and family history of CVD. Data were analyzed with SPSS 17. Results: Of the total selected 300 patients, 69.3% were male, 35.3% were smoker, 61% were hypertensive, 30.3% were diabetic mellitus, 31% had hyperlipidemia, 70.97% were obese and 17.3% had family history of CVD. The mean age was 62.06 ± 11.40 years. Blood groups O (28%), A (43.3%), B (19%) and AB (7.3%) were the most frequent ones, respectively. According to our results, we found that the rate of CAD in individuals with the blood group A was higher than the other blood groups. Regarding the risk factors, however, no significant difference was observed between the blood groups. Conclusion: A correlation was found between blood group A and the incidence of CAD and there was no significant difference between the blood groups and cardiovascular risk factors and number of involved coronary arteries. Keywords: ABO blood-group system, Cardiovascular diseases, Risk factors Introduction hol drinking and physiological and biochemical factors Cardiovascular diseases (CVDs), especially coronary or including hypertension, body weight, blood glucose and cerebral artery atherosclerosis, hypertension and its com- blood cholesterol. Modifying any one of these factors may plications, are the most important health problems in de- reduce CVD (5). veloped countries. In developing countries, mortality due Dr. Landsteiner introduced the ABO blood types as the to infectious diseases and malnutrition are reduced sig- first distinguished blood grouping system in 1901. The nificantly, but CVDs are growing (1). It is predicted that clinical significance of blood type ABO extends beyond CVD will be the most common cause of premature death the blood transfusion or bone marrow transplantation. and disability around the world by 2020 (2). In Iran, one of There has been a lot of research into the relationship be- the main causes of deaths is CVD, and the cause of half of tween blood groups as a cause of various disease or effec- all deaths of people aged 55 to 79 years is CVD (3). Now- tive factor on prognosis or treatment of disease and can- adays, CVD accounting for 25%-45% of all deaths in the cers (6,7). Although the explanation for the relationship world has become a major public health problem, the first between ABO blood groups and some of the diseases has cause of death and the fifth-leading cause of disability. In not yet been fully known, several reports have suggest- our country, according to the World Health Organization ed the relationship between ABO blood types and some (WHO) reports 41.3% of all deaths in 2005 were caused by diseases such as breast cancer, pancreatic cancer, gastric CVD and it is expected to increase to 44.8% by 2030 (4). cancer, periodontal and CVDs (8-12). Although about Many risk factors have been known to be associated with 400 blood grouping antigens have been reported, the coronary heart disease. Early detection and modification ABO and Rh are recognized as major clinically significant of these risk factors may lead to reduced incidence of the blood group antigens. It has been found in some previous disease. Risk factors of coronary artery disease (CAD) are studies that, individuals with the A blood type phenotype generally divided into two categories; modifiable and non- are more susceptible to ischemic heart diseases in some modifiable. Modifiable risk factors include lifestyle-relat- communities (13-18). In contrast, another study showed ed factors such as physical activity, diet, smoking, alco- that in cities which O blood type is more common, there is Received 9 July 2015, Revised 12 November 2015, Accepted 21 December 2015, Available online 1 January 2016 1Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 2Faculty of Medical Sciences, Islamic Azad University, Tabriz, Iran. *Corresponding author: Mohammadreza Taban Sadeghi, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: +984133363880, Email: [email protected] Golmohamadi et al a higher mortality rate from CVDs (19). In another study of 62.06 ± 11.4 years. The minimum and maximum ages it was found an increased risk of CAD in men with the were 25 and 84 years, respectively. Two hundred thirty pa- Lewis blood phenotype Le; it seems to be independent of tients (76.7%) were living in urban and 70 patients (23.3%) common risk factors for CVD such as smoking, obesity, in rural areas. In the study 52 patients (17.3%) had a posi- diabetes, high cholesterol, triglycerides, etc. (20). tive family history of ischemic heart disease. The mean left Some studies also have shown a relationship between ventricular ejection fraction (LVEF) was 47.22% ± 8.79. blood groups and severity of lower extremity venous Also 4.9% of patients had a history of ischemic cerebro- thrombosis (21,22). In fact, increased levels of factor VIII vascular disease, 61% hypertension, 31% hyperlipidemia, (22,23), von Willebrand factor (23,24), prothrombin frag- 30.3% diabetes mellitus and 33% ischemic heart disease ment (25), and a low PTT (24) have been found in non-O (IHD). This study showed that 35.3% of patients had a blood types. Some previous studies have shown that there history of cigarette smoking, 2% opium use, 1% Hookah is not a significant relationship between blood groups smoking and 1% alcohol drinking. Studying the body and risk factors of CVD (26). Only people with A blood mass index (BMI) showed the mean BMI of patients was type with CVD are younger than those of other blood 28.97±14.67 (Min=16.44, Max=54.93). In angiography, 63 groups (27). patients had one-vessel, 116 had two-vessel and 121 pa- There are conflicting results about the relationship be- tients had three- vessel involvement. Distribution of cor- tween blood groups and other risk factors of CVDs based onary vessels involvement based on patient’s blood type is on research areas. Although blood type cannot be modi- shown in Figure 1. fied as a risk factor, but having the knowledge of the rela- Studying the relationship between atherosclerosis risk fac- tionship between blood groups and heart disease can help tors and blood groups showed that there is not any sig- to improve the control of other modifiable risk factors of nificant association between the risk factors and blood atherosclerosis. groups (Table 1). Relationship between BMI, hemoglobin, Coronary heart disease is a multifactorial disease, involv- creatinin, ejection fraction and blood groups is shown in ing the interactions between genetic and environmental Table 2. factors. This study aimed to investigate the relationship between ABO blood groups and major risk factors of cor- Discussion onary heart disease and the number of involved vessels in In this study, blood groups of participants were A type: the angiography in patients admitted in Shahid Madani 43.3%, B type: 19%, AB type: 7.3% and O type: 28%. Dis- Heart Center, Tabriz. tribution of blood groups in East Azerbaijan province was as follows: A type: 36.24%, B type: 21.25%, AB type: 8.62% Materials and Methods and O type 33.91%. Considering the distribution of blood This study was a descriptive-analytic research. Three groups in East Azerbaijan, the patients had a normal dis- hundred patients with confirmed diagnosis of coronary tribution. disease by angiography were selected as available conve- In our study, there was no relationship between blood nience sampling method between 2013-2014. After sign- groups and number of involved vessels (P = 0.18). In ing the informed consent form, a questionnaire was set for a study on 653 patients at the Heart Institute of Boston all patients through interviews and records. The research- in 1980 and 1985 about the relationship between blood ers designed questionnaire included demographic infor- groups, serum cholesterol and ischemic heart disease, it mation (age, gender), place of residence, education level, Chart Title occupation, weight, height and body mass index, the his- 60% tory of cigarette and hookah smoking, opium use, alcohol drinking and a family history of premature CAD, the pa- 50% tient’s echocardiogram results, blood testing, kidney and liver function tests, lipid profile, and the patient’s previous 40% medical history (ischemic heart disease, hypertension, di- abetes mellitus, hyperlipidemia). Angiographic results were reviewed and reported by two 30% cardiologists. Distribution of blood groups in East Azer- baijan province was obtained from Iranian Blood Transfu- 20% sion Organization. To investigate the relationship between risk factors and the type of cardiovascular involvement, 10% the chi-square test and variance analysis were used. P val- 0% ue less than 0.05 was considered to be significant. Data A B AB O were analyzed with SPSS 17. 1VD 22.30% 26.30% 22.70% 16.30% 2VD 42.30% 29.80% 54.50% 36% 3VD 35.40% 43.90% 22.70% 47.70% Results Of the total 300 patients examined in this study, 208 were Figure 1.
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