Aging
Haemophilia and you

Haemophilia and comorbidities

Managing health challenges as you get older

As you age, you may face additional challenges due to the impact of haemophilia or other health conditions. (1)

There are actions you can take that could preserve your health and independence in later life. Find out more in this article.

 

As you get older, your body naturally goes through changes – like losing muscle strength, feeling stiffer in the joints, and having weaker bones.2 If you are living with haemophilia, ageing can also bring additional health challenges, including those related to the condition.1 

These age-related health conditions – also known as comorbidities – can include joint damage from past bleeds (called haemophilic arthropathy), hypertension, cardiovascular disease, cancer, kidney problems, stroke, irregular heart rhythm, blood clots in a vein, diabetes and osteoporosis.1 Although certain health conditions are common as people get older, people with haemophilia may experience certain health problems more often than those without the condition.3   

Joint damage (haemophilic arthropathy)

Repeated joint bleeding in haemophilia can lead to synovitis; this means that the lining of the joint becomes inflamed, causing pain, swelling and stiffness.4,5 Over time, if not appropriately treated, joint bleeding and synovitis can eventually lead to joint damage (haemophilic arthropathy).1,4,6 Haemophilic arthropathy can cause long-term pain, unstable joints and difficulties in moving joints.6,7 Other factors, such as osteoporosis, low physical activity and carrying excess weight, can contribute to joint damage progression.1 

Inflamed and damaged joints can be more likely to bleed, leading to a cycle of damage and pain:1,4,5

Some considerations:

  • Early treatment of bleeds and synovitis can support in preventing joint damage.1,8,9
  • Treatment to protect you from bleeding could avoid or help to break the cycle of joint pain;5,10,11 synovitis may be reversible in its early stages.12
  • Pain can also be managed by techniques such as physiotherapy, massage, applying heat or cold, and relaxation practices; pain medication; or a combination of these.2,10,11
  • Staying active can improve your mobility, balance, strength and help maintain a healthy weight.2 Your physiotherapist can work with you to discuss appropriate exercises, including strength training to build muscle,2 and your healthcare team can provide nutritional counselling to assist with weight management.1
  • Surgery may be an option to maintain movement of joints and ease chronic pain.5,10,11
  • Liaise with your healthcare team, who can provide advice and support to manage your joint health and pain, helping you to maintain your mobility, participate in your usual activities and remain independent as you get older.1,2 

Osteoporosis

Osteoporosis results in weaker bones due to reduced bone density, leading to a higher risk of breaks and falls.2,13 The risk of low bone mineral density is four times higher for people with haemophilia,14 and the consequences of a fracture or fall may be more serious due to lower bone density and bleeding tendency.2 Among men over 50 years of age with haemophilia, osteoporosis has been reported in approximately 25–44% of men.13 Among men over 50 years of age in the general population, the prevalence has been reported at 6.6%.15 Osteoporosis is more common in women who are carriers of haemophilia (6.4%), than women without a bleeding disorder (3.5%).16

Some considerations:

  • Your healthcare team may monitor your bone density routinely as you get older using a type of scan called DXA (Dual‑Energy X‑ray Absorptiometry).13
  • Treatments for osteoporosis are available. These include medications and lifestyle changes – a healthy diet, containing calcium and vitamin D, and weight-bearing activities can support in maintaining bone health.2,13
  • Talk to your healthcare team about how to monitor your bone health and discuss treatment options.

Hypertension and cardiovascular disease

Hypertension is one of the most common comorbidities in people with haemophilia;17,18 it is more common than in the general population.19 Hypertension can also contribute to the risk of cardiovascular disease; however, the frequency of cardiovascular disease is similar among people living with and without haemophilia.1,20

Some considerations:

  • Your healthcare team can monitor your blood pressure and check to see whether you have any other risk factors for cardiovascular disease.1
  • They can provide appropriate guidance on any treatments required.1
  • Your haemophilia treatment may need to be adapted depending on any other treatments you might be receiving that could affect how your blood clots.1,20,21

 

  1. Srivastava A, et al. Haemophilia 2020;26(Suppl. 6):1–158.
  2. The Haemophilia Society. Ageing with a bleeding disorder: Managing trips, falls and mobility. Available at: https://haemophilia.org.uk/wp-content/uploads/2024/11/Managing-trips-falls-mobility_-FINAL-for-printing.pdf. Accessed November 2025.
  3. Steen Carlsson K, et al. Haemophilia 2025;31:401–11.
  4. Cuesta-Barriuso R, et al. J Blood Med 2022;13:589–601.
  5. van Vulpen LFD, et al. Haemophilia 2021;27(Suppl. 3):96–102.
  6. Dargaud Y, et al. Blood Rev 2025;101304.
  7. Lobet S, et al. J Blood Med 2014;5:207–18.
  8. National Hemophilia Foundation. Nursing Working Group – nurses’ guide to bleeding disorders. Common bleeding episodes. Available at:  https://www.hemophilia.org/sites/default/files/document/files/nurses-guide-chapter-4-common-bleeding-episodes.pdf. Accessed November 2025.
  9. van Bergen EDP, et al. Haemophilia 2023;29:1580–8.
  10. Auerswald G, et al. Blood Coagul Fibrinolysis 2016;27:845–54.
  11. Stromer W, et al. Wien Klin Wochenschr 2021;133:1042–56.
  12. Gualtierotti R, et al. Res Prac Thromb Haemost 2024;8:102314.
  13. Kempton CL, et al. Haemophilia 2021;27(Suppl. 3):37–45
  14. Zhou H, et al. J Orthop Surg Res 2024;19:52.
  15. International Osteoporosis Foundation. Epidemiology, Burden and Treatment of Osteoporosis for 29 European countries (2021). Available at: https://www.osteoporosis.foundation/facts-statistics/key-statistic-for-europe. Accessed November 2025.
  16. Citla-Sridhar D, et al. Haemophilia 2022;28:671–8.
  17. Day JR, et al. Haemophilia 2022;28:532–41.
  18. Curtis R, et al. J Blood Med 2022;13:229–41.
  19. Badescu MC, et al. Diagnostics 2022;12:2937.
  20. Franchini M, et al. Haematologica 2023;108:1748–57.
  21. Mannucci PM, et al. Blood 2009;114:5256–63.

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NP-46266 created February 2025