Donor health beyond donation: cardiovascular risk factors in blood donor populations. A cross-sectional study

Abstract

Background -  Blood donors are often regarded as healthier than the general population, a phenomenon described as the “healthy donor effect”. This perception arises from strict donor selection criteria and routine pre-donation screening, yet these evaluations focus largely on hemoglobin, vital signs, and a short medical history, thereby providing only a partial assessment of donor health. As cardiovascular disease (CVD) remains the leading global cause of mortality, assessing cardiovascular risk factors in blood donors provides an opportunity to evaluate whether this group is genuinely healthier or simply appears so due to selection bias.

Materials and methods - A cross-sectional study was conducted among 1,543 Slovenian blood donors. All donors completed a medical questionnaire, underwent a physical examination, and vital signs measurements. Body mass index (BMI) was calculated from self-reported weight and height. Information on diseases, medication use, smoking, and physical activity was also collected. A subgroup of 506 donors without reported illness and not taking medication was classified as “healthy”. This subgroup underwent additional laboratory investigations, including complete blood count, lipoproteins, and high-sensitivity C-reactive protein. A composite CVD risk score was developed by integrating traditional and novel risk factors.

Results - Overall, 32% of donors reported at least one chronic condition and 19% reported medication use, most frequently antihypertensive therapy. Median BMI was 26.3 kg/m², with 56% of donors overweight or obese. Nearly 40% had elevated BP, including 7% with systolic BP ≥160 mmHg. According to the CVD risk score, 49% were low risk, 29% moderate, and 25% high, with men more often at increased risk.

Discussion - Despite eligibility screening, many donors exhibited subclinical CVD risk factors. These findings confirm that transfusion services can contribute beyond donor and recipient safety, offering a valuable platform for prevention and early detection, and strengthening public health surveillance.