1st Pediatric Department, Aristotle University Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece.
Hypertension-24h ABPM ESH Center of Excellence, 3rd Department of Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.
J Clin Hypertens (Greenwich). 2020 Aug;22(8):1444-1449. doi: 10.1111/jch.13957. Epub 2020 Aug 6.
Sickle cell disease (SCD) is associated with increased risk of cardiovascular disease, although blood pressure (BP) levels have been reported to be lower in SCD patients compared to general population. Aims of the present study were to investigate the prevalence of BP phenotypes and levels of arterial stiffness in pediatric patients with SCD and to assess the differences with children at risk for hypertension. We included in the study 16 pediatric SCD (HbS/β-thalassemia, S/β-thal) patients and 16 consecutive children at risk for hypertension referred to our hypertension clinic that served as high-risk controls. All patients underwent ambulatory BP monitoring and measurement of carotid-femoral pulse wave velocity (PWV). S/β-thal patients had lower office systolic BP than the high-risk control group (115.43 ± 10.03 vs 123.37 ± 11.92, P = .05) but presented similar levels of day and night ambulatory BP. Office hypertension was found in 12.5% of the S/β-thal patients and in 43.8% of the high-risk controls (P = .06), while 18.8% of the S/β-thal patients and 25% of the high-risk controls presented hypertension by ambulatory BP levels (P = .21). All of the S/β-thal patients with ambulatory hypertension had night hypertension (one combined night and day hypertension) with office normotension (masked hypertension). S/β-thal patients and high-risk controls presented equal prevalence of masked hypertension (18.8%). Children and adolescents with S/β-thal present similar prevalence of BP phenotypes and levels of PWV with children at risk for hypertension. A significant number of children and adolescents with S/β-thal may have masked nighttime hypertension despite normal office BP levels.
镰状细胞病（SCD）与心血管疾病风险增加有关，尽管与普通人群相比，SCD 患者的血压（BP）水平较低。本研究的目的是调查儿科 SCD 患者的 BP 表型和动脉僵硬程度的患病率，并评估其与高血压风险儿童的差异。我们纳入了 16 例儿科 SCD（HbS/β-地中海贫血，S/β-地中海贫血）患者和 16 例连续就诊于高血压门诊的高血压风险儿童作为高危对照组。所有患者均接受了动态血压监测和颈动脉-股动脉脉搏波速度（PWV）测量。S/β-地中海贫血患者的诊室收缩压低于高危对照组（115.43±10.03 对 123.37±11.92，P=0.05），但日间和夜间的动态血压水平相似。S/β-地中海贫血患者中 12.5%存在诊室高血压，而高危对照组中为 43.8%（P=0.06），而 S/β-地中海贫血患者中 18.8%和高危对照组中 25%的患者通过动态血压水平存在高血压（P=0.21）。S/β-地中海贫血患者中所有具有动态高血压的患者均具有诊室正常的夜间高血压（一种同时存在夜间和日间高血压的高血压）（隐匿性高血压）。S/β-地中海贫血患者和高危对照组的隐匿性高血压发生率相同（18.8%）。S/β-地中海贫血的儿童和青少年与高血压风险儿童的 BP 表型和 PWV 水平具有相似的患病率。尽管诊室血压水平正常，但相当数量的 S/β-地中海贫血儿童和青少年可能存在隐匿性夜间高血压。
