Profile of Relative Systemic Hypertension in Patients with Sickle Cell Disease: An Observational Study from Ogbomoso, Nigeria

Abstract

Abstract Introduction: Sickle cell anemia (SCA) is a hemoglobinopathy that manifests as a cardiovascular risk factor with extensive macrovascular and microvascular complications. Hypertension has a low prevalence in SCA. However, many organ-system dysfunctions have been described in SCA normotensives. This has necessitated the description of a new term, relative systemic hypertension (RSH), which is sustained blood pressure of 120–139 mmHg systolic and 70–89 mmHg diastolic. The correlation of RSH with many organ system abnormalities in SCA has not been well described. Methods: Subjects with SCA in steady state were recruited from the hematology clinic after obtaining ethical committee approval. Anthropometric, clinical, laboratory, spirometric, electrocardiographic, and echocardiographic variables were collected. Analysis was performed using SPSS version 25. P < 0.05 was considered significant. Results: Forty-eight SCA subjects were recruited. The prevalence of RSH was 20.8%. All those with RSH were predominantly female and had a history of stroke; they also had a shorter PR interval. These individuals tended to have a lower ankle-brachial index, spend more time covering a 10-m walk, and cover a shorter 6-min walking distance. They also exhibited lower transtricuspid E velocities, lower transtricuspid E/A ratios, and eccentric left ventricular hypertrophy (LVH). In addition, they had hematuria, proteinuria, and a decreased estimated glomerular filtration rate. Conclusions: Among patients with SCA, RSH was more commonly associated with female gender, in the 3 rd decade of life, history of stroke, decreased renal function, eccentric LVH, and decreased walking distance.