Prevalence and Risk Factors for Hypertension in Hemophilia

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 62; no. 1; pp. 209 - 215
• Main Authors: von Drygalski, Annette, Kolaitis, Nicholas A, Bettencourt, Ricki, Bergstrom, Jaclyn, Kruse-Jarres, R, Quon, Doris V, Wassel, Christina, Li, Ming C, Waalen, Jill, Elias, Darlene J, Mosnier, Laurent O, Allison, Matthew
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Heart Association, Inc 01-07-2013; Lippincott Williams & Wilkins
• Subjects: Adult; Arterial hypertension. Arterial hypotension; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Hematologic and hematopoietic diseases; Hemophilia A - complications; Humans; Hypertension - epidemiology; Hypertension - etiology; Hypertension - physiopathology; Male; Medical sciences; Platelet diseases and coagulopathies; Prevalence; Retrospective Studies; Risk Assessment - methods; Risk Factors; United States - epidemiology; United States; Endocrinopathy; Hypertension; Prevalence; cardiovascular disease risk factors; Diabetes mellitus; Cardiovascular disease; Hemopathy; Epidemiology; Phlebology; BP; Genetic disease; Vascular disease; Atherosclerosis; Risk factor; Hemophilia; Cardiovascular risk; NHANES; Circulatory system; Cardiology; Coagulopathy; hemophilia; prevalence; hypertension
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.113.01174

Hypertension (HTN) is a major risk factor for intracranial hemorrhage. We, therefore, investigated the prevalence, treatment, and control of HTN in adult patients with hemophilia (PWH). PWH≥18 years (n=458) from 3 geographically different cohorts in the United States were evaluated retrospectively for HTN and risk factors. Results were compared with the nationally representative sample provided by the contemporary National Health and Nutrition Examination Survey (NHANES). PWH had a significantly higher prevalence of HTN compared with NHANES. Overall, the prevalence of HTN was 49.1% in PWH compared with 31.7% in NHANES. At ages 18 to 44, 45 to 64, 65 to 74, and ≥75 years, the prevalence of HTN for PWH was 31.8%, 72.6%, 89.7%, and 100.0% compared with 12.5%, 41.2%, 64.1%, and 71.7% in NHANES, respectively. Of treated hypertensive PWH, only 27.1% were controlled, compared with 47.7% in NHANES (all P<0.05). Age, body mass index, diabetes mellitus, and renal function were independently associated with HTN. Among patients with moderate or severe hemophilia there was a trend (≈1.5-fold) for higher odds of having HTN compared with patients with mild hemophilia. On the basis of these results, new care models for adult PWH and further studies for the causes of HTN in hemophilia are recommended.