Blood Pressure Indices in Children with Sickle Cell Disease, of Age 8-18 Yrs. at a Tertiary Care Centre in Chhattisgarh- A Cross Sectional Study.

ABSTRACT

Sickle cell disease is the commonest haemoglobinopathy. Anaemia leads to a hyperdynamic circulation, decreased systemic resistance, and sickle polymerization causing hyperviscosity, natriuresis and hyposthenuria that blunt the maximal plasma volume expansion interplay to affect blood pressure indices. Asian and African continents have a high share of sickle cell population, being historically malaria endemic areas. These populations have previously witnessed early death due to complications from sickle cell disease. With the recent advanced therapeutic approaches, sickle cell patients are surviving beyond adulthood. Increased survival has resulted in a new subset of sickle cell patients which is exposed to the effects of persistent haemolytic anaemia and the haemodynamic alterations. These effects have not been studied in sickle cell patients in the state of Chhattisgarh. Most of the studies conclude that sickle subjects have lower systolic, diastolic and mean blood pressure and higher pulse pressure. METHODSParticipants were all sickle cell anaemia patients with SS pattern under the age group 8 to 18 yrs. from the Paediatric Department of the Pt J N M Medical College and associated Dr B R A M Hospital, Raipur and the controls were healthy age matched patients without any haemoglobinopathy. This study documented blood pressure indices - systolic blood pressure, diastolic blood pressure, mean blood pressure and pulse pressure in children with sickle cell disease and comparable controls presenting to a tertiary medical college hospital in Chhattisgarh. RESULTSThe present cross sectional study reveals no difference in these blood pressure indices of systolic blood pressure, diastolic blood pressure, mean blood pressure and pulse pressure between sickle and control subjects. Data was tabulated for 50 patients of sickle cell disease and 50 healthy controls without any haemoglobinopathy. The study concluded that the mean systolic blood pressure in sickle cell patients and control group was 119.46 ± 8.32 & 117.14 ± 8.10 (p=0.161), the diastolic blood pressure was 73.42 ± 7.88 & 72.60 ± 6.62 (p=0.575), mean blood pressure was 137.71 ± 11.44 & 135.85 ± 9.91 (p=0.385) and the pulse pressure was 46.04 ± 10.13 & 44.52 ± 9.00 (p=0.430) respectively. CONCLUSIONSThe blood pressure indices in sickle cell patients in India vary from those observed in other studies from other countries. It is possible that the sickle population in the present study may be having relative systemic hypertension that can be ascertained with future studies.