Blood Pressure of Children and Adolescents with Sickle Cell Anemia in Basra, Iraq

Background: Blood pressure in patients with sickle cell anemia (SCA) is influenced by autonomic cardiovascular dysfunction, endocrinopathies, nephropathy and nutritional factors. We aimed to evaluate systemic and diastolic blood pressure and its severity among children and adolescents with SCA and determine its association with clinical and hematological variables. Methods: This case-control study included 112 patients with SCA (6-17 years old), registered at Basra Center for Hereditary Blood Diseases and 133 age and sex-matched healthy subjects as a control group. Complete examination was done for all subjects including anthropometric and BP measurements. Complete blood count, blood urea and serum creatinine were measured for all participants. A multivariate correlation analysis was used to assess contributing factors in BP. Results: The systolic BP (SBP) and diastolic BP (DBP) curves of patients with SCA showed lower levels than control group for all age groups. Although both SBP and DBP readings were comparable at late adolescence. Pre-hypertension was reported in 5 (4.4%) patients and 3 (2.4%) healthy subjects. Multivariate analysis revealed that SBP and DBP among patients with SCA had significant positive association with age, weight, height, body mass index, hemoglobin and blood transfusion history and a negative association with heart rate ( P<0.05). Conclusion: Our findings supported previous reports of lower BP in patients with SCA. Furthermore, routine BP measurements in pediatric patients with SCA is important for early detection of pre-hypertension to establish an effective treatment.