Relative systemic hypertension in patients with sickle cell disease is associated with risk of pulmonary hypertension and renal insufficiency

Victor R. Gordeuk, Vandana Sachdev, James G. Taylor, Mark T. Gladwin, Gregory Kato, Oswaldo L. Castro

Research output: Contribution to journalArticle

Abstract

We analyzed entry data from 163 adult hemoglobin SS and Sβ0 thalassemia patients enrolled in the prospective Sickle Cell Pulmonary Hypertension Screening Study and stratified their ECHO-determined tricuspid regurgitant jet velocity (TRV) and serum creatinine concentration according to three systemic blood pressure categories. TRV was ≥2.5 m/sec in 27% of the patients with systolic blood pressure (SBP) < 120 mmHg and diastolic blood pressure (DBP) <70 mmHg, in 37% with SBP 120-139 mmHg or DBP 70-89 mmHg, and in 93% with SBP 140 mmHg or DBP 90 mmHg or higher (P < 0.0005 for trend). Serum creatinine concentration was 1.0 mg/dL or higher in 7% of patients with SBP < 120 mmHg and DBP < 70 mmHg, in 17% with SBP 120-139 mmHg or DBP 70-89 mmHg and 50% with SBP 140 mmHg or DBP 90 mmHg or higher (P < 0.0005 for trend). Over 2 years of follow-up, there were trends for more frequent progression to elevated TRV (P = 0.073) or creatinine (P = 0.037) values according to the higher systemic blood pressure categories. Our findings suggest that systemic SBP 120-139 mmHg or DBP 70-89 mmHg defines a category of relative systemic hypertension in patients with sickle cell disease that is associated with increased risk for pulmonary hypertension and renal dysfunction. Whether antihypertensive and/or nitric oxide donor therapy in sickle cell disease patients with relative hypertension prevents these and other complications should be determined by clinical trials.

Original languageEnglish (US)
Pages (from-to)15-18
Number of pages4
JournalAmerican journal of hematology
Volume83
Issue number1
DOIs
StatePublished - Jan 1 2008

ASJC Scopus subject areas

  • Hematology

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