Hypertension Unit, First Department of Cardiology, University of Athens Medical School, Hippokratio Hospital, Athens, Greece.
First Department of Internal Medicine, University of Athens Medical School, Laiko Hospital, Athens, Greece.
J Hum Hypertens. 2014 May;28(5):328-32. doi: 10.1038/jhh.2013.102. Epub 2013 Oct 24.
Thalassemia minor (Tm), the β-thalassemia carrier state, is followed by favorable lipidemic profile and seems to protect against myocardial infarction mainly in men. However, the cardiovascular risk factor (CRF) and metabolic profile of these subjects has not been thoroughly addressed, although it is not known whether gender differences are involved. We evaluated CRFs, metabolic parameters and risk-prediction equations along with renal function and selected echocardiographic indices in 23,680 consecutive subjects, that is, 11,192 women and 12,488 men, with newly diagnosed hypertension according to the presence or absence of Tm. Of 23,680 patients, 548 (2.3%) had Tm. Compared with patients without Tm, Tm cases had similar gender distribution, age, body mass index and blood pressure. Besides having a better lipidemic profile, Tm patients were less frequently smokers (25% vs. 32%, P<0.001), had a lower prevalence of metabolic syndrome (26% vs. 39%, P<0.001) and lower HeartSCORE and INTERHEART scores (P<0.001). Tm patients also had lower levels of fibrinogen and plasminogen activator inhibitor-1 (P<0.001), lower serum creatinine and higher estimated glomerular filtration rate (P<0.001), lower prevalence of left ventricular hypertrophy (35% vs. 48%, P<0.001) and higher total and mid-wall fractional shortening (P=0.03 and <0.001, respectively). Most of these differences were consistent in both genders, whereas the HeartSCORE and the echo indices were significantly better in Tm only in women. Among patients with newly diagnosed hypertension, those with Tm have a better overall CRF and metabolic profile, beyond the well-known differences in serum lipids. Compared with men, women seem to be at least equally protected.
地中海贫血轻度(Tm),即β地中海贫血携带者状态,血脂谱良好,似乎主要在男性中预防心肌梗死。然而,这些患者的心血管危险因素(CRF)和代谢特征尚未得到充分研究,尽管尚不清楚是否存在性别差异。我们评估了 23680 例连续患者的 CRF、代谢参数和风险预测方程,以及肾功能和选定的超声心动图指标,这些患者均根据是否存在 Tm 被诊断为新发高血压。在 23680 例患者中,有 548 例(2.3%)患有 Tm。与无 Tm 的患者相比,Tm 患者的性别分布、年龄、体重指数和血压相似。除了血脂谱更好之外,Tm 患者吸烟的比例较低(25%比 32%,P<0.001),代谢综合征的患病率较低(26%比 39%,P<0.001),HeartSCORE 和 INTERHEART 评分较低(P<0.001)。Tm 患者的纤维蛋白原和纤溶酶原激活物抑制剂-1 水平也较低(P<0.001),血清肌酐水平较低,肾小球滤过率估计值较高(P<0.001),左心室肥厚的患病率较低(35%比 48%,P<0.001),总壁和中壁节段缩短率较高(P=0.03 和 <0.001)。这些差异在两性中大多是一致的,而只有在女性中,Tm 患者的 HeartSCORE 和超声心动图指标才明显更好。在新发高血压患者中,患有 Tm 的患者的整体 CRF 和代谢特征更好,除了血清脂质的已知差异之外。与男性相比,女性似乎至少受到同等程度的保护。