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ABO blood groups, age and work in ischaemic heart disease
Atherosclerosis,
21 (1975) 459-461
459
0 Elsevier Scientific Publishing Company, Amsterdam - Printed in The Netherlands
Short Communication
ABO
BLOOD
GROUPS,
AGE
AND
WORK
IN
ISCHAEMIC
HEART
DISEASE
T. M. ALLAN Blood Transfusion
Centre, Royal Infirmary,
Aberdeen
AB9 2ZW
(Great
Britain)
(Received October 31st, 1974) (Accepted December 9th, 1974)
-. SUMMARY
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.
Key words : ABO
blood groups - Age - Ischaemic heart disease - Work
This communication deals with a point missed in the original analysis of an Aberdeen series of surviving male ischaemic heart disease patientsl. In this series, which combines with other&s to indicate that IHD is associated in some way with blood group A, the incidence of A patients changes markedly with advancing age in relation to the only other two factors in respect of which there were data for every patient. These factors were, firstly, whether the patients’ work was light or, alternatively, active or heavylO at the time of their initial attack of ischaemia, and secondly, whether or not that attack resulted in myocardial infarction. It has hitherto been assumed that the aforesaid age-changes were gradual, but the right-hand side of Table 1 shows that, instead, they were abrupt. The table also shows (foot) that, in sum, there were fewer A’s up to than after age 55 who were non-infarction patients employed in light work (7/l 1) or infarction patients in active or heavy work (19/27), whereas, in contrast, there were more A’s up to than after age 55 who were non-
460 TABLE
SHORT COMMUNICATION
1 BY AGEGROLJP,TYPEOF WORK
A,
INCIDENCEOFBLOODGROUPSOAND MYOCARDIAL
INFARCTION, IN AN
AND PRESENCEORABSENCE
OF
ABERDEEN SERIESOF SURVIVING MALE ISCHAEMICHEART DISEASE
PATIENTS
Surviving male IHD patients’ age groups
Group 0 male patients in light work
without infarction
with infarction
Group A male patients in active or heavy work
without injhrction
with infarction
in fight work
without infarction
in active or heavy work
with infarction
without infarction
with infarction
< 45 4549
5 6
3 5
5 4
5 5
4 2
7
8
11
9
8 7
5&54
8
9
5
8
1
15
9
4
55-59
8
14
10
9
3
4
4
13
60-64
3
8
10
7
I
8
6
10
> 65
2
5
5
4
1
1
2
4
TotaI Mean age (years)
32 52.9
44 55.6
39 55.1
38 54.8
18 54.8
46 51.8
38 51.3
46 52.9
< 55 > 55
19 13
17 27
14 25
18 20
I 11
33 13
26 12
19 27
X2(3,
4.78; P > 0.10
---
13.15; P < 0.005
infarction patients in active or heavy work (26/12) or infarction patients in light work (33/13). These differences are large enough (X2(3) = 13.15; P < 0.005) to suggest a need for further series designed to show whether or not they are due to chance. In the event of their confirmation one hypothesis worth considering to account for them might be that of some kind of hormonal ‘threshold dichotomy’ll. ACKNOWLEDGEMENTS
I am grateful for helpful comment by Dr. H. B. M. Lewis, Dr. A. E. Mourant, Dr. A. C. KopeC, Dr. A. A. Dawson and Professor D. F. Kerridge.
REFERENCES ALLAN, T. M. AND DAWSON, A. A., ABO blood groups and iscbaemic heart disease in men, Brit.
Heart J., 30 (1968) 377. GERTLER, M. M. AND WHITE, P. D., Coronary
Heart Disease in Young Adults,
Harvard University
Press, Cambridge, Mass., 1954. MOURANT, A. E., KOPEC, A. C. AND DOMANIEWSKA-SOBCZAK, K.,
Blood-groups
and blood-
clotting, Lancet, 1 (1971) 223. MEDALIE, J. H., LEVENE,C., PAPIER, C., GOLDBOURT, U., DREYFUS, F., ORON, D., NEUFELD, H. AND Rns, E., Blood groups, myocardial infarction and angina pectoris among 10,000 adult males,
New Engl. J. Med., 285 (1971) 1348.
SHORT COMMUNICATION
461
5 BOSTONCOLLABORATIVE DRUG SURVEILLANCE PROGRAM, Relation between digoxin arrhythmias and ABO blood groups, Circulation, 45 (1972) 352. 6 VAN HOUTE,0. AND KESTELOOT,H., An epidemiological survey of risk factors for ischaemic heart disease in 42,804 men, Acta Cardiol., 27 (1972) 527. 7 RBVAI, S. AND KBNIG, E., HBufigkeit des Vorkommens eines Myokardinfarkts innerhalb der 27 (1972) 2127. Blutgruppen A, B, 0, Deut. Gesundheitsw., 8 CISWICKA~ZNAJDERMAN,M., SZNAJDERMAN,M., JANUSZEWICW,W., DZIERZYKRAY-R~GALSKI, T., PROMINSKA,E. AND CHARZEWSKI,J., Studi clinici e metabolici in soggetti giovani, Minerva Med., 64 (1973) 399. 9 SZCZEPANSKI,L. AND JACH, A., Rozklad grup krwi systemu ABO i Rh w zawale serca, Pal. Tygod. Lek., 28 (1973) 1264. 10 MORRIS, J. N. AND CRAWFORD, M. D., Coronary heart disease and physical activity of work, &it. Med. J., 2 (1958) 1485. I 1 WRIGHT, S., Evolution and the Genetics of Populations, Vol. I, Chicago University Press, Chicago and London, 1968.
21 (1975) 459-461
459
0 Elsevier Scientific Publishing Company, Amsterdam - Printed in The Netherlands
Short Communication
ABO
BLOOD
GROUPS,
AGE
AND
WORK
IN
ISCHAEMIC
HEART
DISEASE
T. M. ALLAN Blood Transfusion
Centre, Royal Infirmary,
Aberdeen
AB9 2ZW
(Great
Britain)
(Received October 31st, 1974) (Accepted December 9th, 1974)
-. SUMMARY
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.
Key words : ABO
blood groups - Age - Ischaemic heart disease - Work
This communication deals with a point missed in the original analysis of an Aberdeen series of surviving male ischaemic heart disease patientsl. In this series, which combines with other&s to indicate that IHD is associated in some way with blood group A, the incidence of A patients changes markedly with advancing age in relation to the only other two factors in respect of which there were data for every patient. These factors were, firstly, whether the patients’ work was light or, alternatively, active or heavylO at the time of their initial attack of ischaemia, and secondly, whether or not that attack resulted in myocardial infarction. It has hitherto been assumed that the aforesaid age-changes were gradual, but the right-hand side of Table 1 shows that, instead, they were abrupt. The table also shows (foot) that, in sum, there were fewer A’s up to than after age 55 who were non-infarction patients employed in light work (7/l 1) or infarction patients in active or heavy work (19/27), whereas, in contrast, there were more A’s up to than after age 55 who were non-
460 TABLE
SHORT COMMUNICATION
1 BY AGEGROLJP,TYPEOF WORK
A,
INCIDENCEOFBLOODGROUPSOAND MYOCARDIAL
INFARCTION, IN AN
AND PRESENCEORABSENCE
OF
ABERDEEN SERIESOF SURVIVING MALE ISCHAEMICHEART DISEASE
PATIENTS
Surviving male IHD patients’ age groups
Group 0 male patients in light work
without infarction
with infarction
Group A male patients in active or heavy work
without injhrction
with infarction
in fight work
without infarction
in active or heavy work
with infarction
without infarction
with infarction
< 45 4549
5 6
3 5
5 4
5 5
4 2
7
8
11
9
8 7
5&54
8
9
5
8
1
15
9
4
55-59
8
14
10
9
3
4
4
13
60-64
3
8
10
7
I
8
6
10
> 65
2
5
5
4
1
1
2
4
TotaI Mean age (years)
32 52.9
44 55.6
39 55.1
38 54.8
18 54.8
46 51.8
38 51.3
46 52.9
< 55 > 55
19 13
17 27
14 25
18 20
I 11
33 13
26 12
19 27
X2(3,
4.78; P > 0.10
---
13.15; P < 0.005
infarction patients in active or heavy work (26/12) or infarction patients in light work (33/13). These differences are large enough (X2(3) = 13.15; P < 0.005) to suggest a need for further series designed to show whether or not they are due to chance. In the event of their confirmation one hypothesis worth considering to account for them might be that of some kind of hormonal ‘threshold dichotomy’ll. ACKNOWLEDGEMENTS
I am grateful for helpful comment by Dr. H. B. M. Lewis, Dr. A. E. Mourant, Dr. A. C. KopeC, Dr. A. A. Dawson and Professor D. F. Kerridge.
REFERENCES ALLAN, T. M. AND DAWSON, A. A., ABO blood groups and iscbaemic heart disease in men, Brit.
Heart J., 30 (1968) 377. GERTLER, M. M. AND WHITE, P. D., Coronary
Heart Disease in Young Adults,
Harvard University
Press, Cambridge, Mass., 1954. MOURANT, A. E., KOPEC, A. C. AND DOMANIEWSKA-SOBCZAK, K.,
Blood-groups
and blood-
clotting, Lancet, 1 (1971) 223. MEDALIE, J. H., LEVENE,C., PAPIER, C., GOLDBOURT, U., DREYFUS, F., ORON, D., NEUFELD, H. AND Rns, E., Blood groups, myocardial infarction and angina pectoris among 10,000 adult males,
New Engl. J. Med., 285 (1971) 1348.
SHORT COMMUNICATION
461
5 BOSTONCOLLABORATIVE DRUG SURVEILLANCE PROGRAM, Relation between digoxin arrhythmias and ABO blood groups, Circulation, 45 (1972) 352. 6 VAN HOUTE,0. AND KESTELOOT,H., An epidemiological survey of risk factors for ischaemic heart disease in 42,804 men, Acta Cardiol., 27 (1972) 527. 7 RBVAI, S. AND KBNIG, E., HBufigkeit des Vorkommens eines Myokardinfarkts innerhalb der 27 (1972) 2127. Blutgruppen A, B, 0, Deut. Gesundheitsw., 8 CISWICKA~ZNAJDERMAN,M., SZNAJDERMAN,M., JANUSZEWICW,W., DZIERZYKRAY-R~GALSKI, T., PROMINSKA,E. AND CHARZEWSKI,J., Studi clinici e metabolici in soggetti giovani, Minerva Med., 64 (1973) 399. 9 SZCZEPANSKI,L. AND JACH, A., Rozklad grup krwi systemu ABO i Rh w zawale serca, Pal. Tygod. Lek., 28 (1973) 1264. 10 MORRIS, J. N. AND CRAWFORD, M. D., Coronary heart disease and physical activity of work, &it. Med. J., 2 (1958) 1485. I 1 WRIGHT, S., Evolution and the Genetics of Populations, Vol. I, Chicago University Press, Chicago and London, 1968.