Nguweneza Arthemon, Ngo Bitoungui Valentina Josiane, Mnika Khuthala, Mazandu Gaston, Nembaware Victoria, Kengne Andre P, Wonkam Ambroise
Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
Front Med (Lausanne). 2022 Jul 19;9:924722. doi: 10.3389/fmed.2022.924722. eCollection 2022.
Increased blood pressure (BP) has been associated with higher risk of stroke and mortality in Sickle Cell Disease (SCD). We investigated risk factors associated with Relative Systemic Hypertension (RSH) or systemic hypertension in SCD patients in Cameroon. Using R, Multivariate multinomial logistic regression modeling was used to examine the effects of the demographic, anthropometric, clinical, and laboratory factors to determine risk factors. A total of 815 individuals with SCD, including 380 (46.6%) males were analyzed. At baseline, the median age [interquartile range] was 18.0 [12.0-25.0] years, ranging from 3 to 66 years. Approximately three-quarters of the patients ( = 645; 79.1%) had normal BP, 151 (18.5%) had RSH and 19 (2.3%) had hypertension. Age ( < 0.001) and gender ( = 0.022) were significantly different across the BP categories. Weight ( < 0.001), height ( < 0.001), BMI ( < 0.001), pulse pressure ( = 0.020), history of stroke ( = 0.012), hemoglobin level ( = 0.002), red blood cell count ( = 0.031), creatinine ( < 0.001), and (estimated glomerular filtration rate) eGFR ( = 0.002) was also significantly different across the three BP categories. After adjustment, the significantly associated factors of RSH in the SCD patients were age [OR = 1.03, (95% CI = 1.01-1.06), < 0.010], male gender [OR = 1.54, (95% CI = 1.04-2.27), = 0.029], BMI [OR = 1.10, (95% CI = 1.04-1.17), = 0.001]. After adjustment, the independent variables significantly associated factors of Hypertension in the SCD patients were age [OR = 1.05, (95% CI = 1.01-1.10), = 0.034], male gender [OR = 3.31, (95% CI = 1.04-10.52), = 0.042], BMI [OR = 1.14, (95% CI = 1.01-1.29), = 0.027]. Creatinine was significantly associated with RSH [OR =1.31 (1.05-1.63), = 0.016]. SCD patients with RSH or hypertension maybe at increased risk of renal dysfunction. We found relatively high prevalence of RSH and hypertension (20.8%) in SCD patients in Cameroon. Tailored Interventions that consider major risk factors (age, gender, and BMI) may lower BP pressure and prevent severe complications.
血压升高与镰状细胞病（SCD）患者中风风险和死亡率升高相关。我们调查了喀麦隆SCD患者中与相对性系统性高血压（RSH）或系统性高血压相关的危险因素。使用R软件，采用多变量多项逻辑回归模型来检验人口统计学、人体测量学、临床和实验室因素的影响，以确定危险因素。共分析了815例SCD患者，其中包括380例（46.6%）男性。基线时，年龄中位数[四分位间距]为18.0[12.0 - 25.0]岁，范围为3至66岁。约四分之三的患者（n = 645；79.1%）血压正常，151例（18.5%）有RSH，19例（2.3%）有高血压。不同血压类别之间年龄（P < 0.001）和性别（P = 0.022）存在显著差异。体重（P < 0.001）、身高（P < 0.001）、体重指数（BMI，P < 0.001）、脉压（P = 0.020）、中风病史（P = 0.012）、血红蛋白水平（P = 0.002）、红细胞计数（P = 0.031）、肌酐（P < 0.001）和估算肾小球滤过率（eGFR，P = 0.002）在三个血压类别之间也存在显著差异。调整后，SCD患者中与RSH显著相关的因素为年龄[比值比（OR）= 1.03，95%置信区间（CI）= 1.01 - 1.06，P < 0.010]、男性[OR = 1.54，95% CI = 1.04 - 2.27，P = 0.029]、BMI[OR = 1.10，95% CI = 1.04 - 1.17，P = 0.001]。调整后，SCD患者中与高血压显著相关的独立变量因素为年龄[OR = 1.05，95% CI = 1.01 - 1.10，P = 0.034]、男性[OR = 3.31，95% CI = 1.04 - 10.52，P = 0.042]、BMI[OR = 1.14，95% CI = 1.01 - 1.29，P = 0.027]。肌酐与RSH显著相关[OR = 1.31（1.05 - 1.63），P = 0.016]。患有RSH或高血压的SCD患者可能肾功能不全风险增加。我们发现喀麦隆SCD患者中RSH和高血压的患病率相对较高（20.8%）。考虑主要危险因素（年龄、性别和BMI）的针对性干预措施可能会降低血压并预防严重并发症。
