The relationship between ABO histo‐blood group, factor VIII and von Willebrand factor

. ABO histo‐blood group is a major determinant of plasma levels of factor VIII (FVIII) and von Willebrand factor (vWF). Blood group O individuals have significantly (approximately 25%) lower plasma levels of both glycoproteins. This association is of clinical significance. Low plasma levels of either FVIII or vWF have long been established as causes of excess bleeding. Conversely, there is accumulating evidence that elevated FVIII–vWF levels may represent an important risk factor for ischaemic heart disease and venous thromboembolic disease. In spite of the well‐documented association between ABO blood group and FVIII–vWF levels, the underlying mechanism remains unknown. However, it has been established that the ABO effect is primarily mediated through a direct functional effect of the ABO locus on plasma vWF levels.