Blood Pressure Abnormalities Amongst Children with Sickle Cell Anaemia in Steady State and in Crises Attending a Tertiary Hospital in South East Nigeria

Abstract

Background: Sickle cell anaemia (SCA) is a hereditary haemoglobin disorder associated with significant cardiovascular complications. Blood pressure abnormalities, including both hypertension and hypotension, are increasingly recognized as important contributors to morbidity in affected children. This study aims to determine the prevalence of hypertension and hypotension among children with SCA in steady state and during vaso-occlusive crisis, and to compare these findings with age- and sex-matched controls with normal haemoglobin genotype (HbAA).

Methodology: This cross-sectional study included 135 children with SCA aged 2–17 years, evaluated during both steady state and crisis, alongside age- and sex-matched HbAA controls. Blood pressure was measured using a standard mercury sphygmomanometer (Accoson) with appropriately sized cuffs. Data were analysed using appropriate statistical methods, with significance set at p<0.05.

Results: In the steady state, 4.4% of children with SCA were hypertensive, and 11.1% were hypotensive. During the crisis, 6.7% were hypertensive and 6.7% hypotensive. Among controls, 4.4% were hypertensive and 2.2% hypotensive. Mean systolic and diastolic blood pressures were comparable across steady state, crisis, and control groups (p=0.462). In the crisis group, haemoglobin concentration showed a significant negative correlation with diastolic blood pressure (r = −0.37, p = 0.011). Age demonstrated strong positive correlations with both systolic and diastolic blood pressures in the steady state (r = 0.78 and 0.79, respectively; p = 0.001) and during crisis (r = 0.66 and 0.57, respectively; p = 0.001).

Conclusion: Blood pressure abnormalities, encompassing both hypertension and hypotension, occur in children with SCA irrespective of clinical status. Despite comparable mean blood pressure values, acute crises are associated with dynamic variations influenced by age and haemoglobin levels. Routine and vigilant blood pressure monitoring is essential for early detection and optimal management.