Hypertension is an established risk factor for subsequent cardiovascular and renal disease in children as well as adults. Sickle cell disease (SCD) is a genetic disorder associated with chronic hemolytic anemia with the major manifestation of vaso-occlusive crises. Although this disease entity involves most organ systems causing vascular and pulmonary injury, little is known about blood pressure (BP) levels or prevalence of hypertension in children with SCD. A cross-sectional study was conducted on 56 children with SCD (54 with hemoglobin SS disease; 2 with hemoglobin Sβ0 thalassemia; 29 females). Study participants underwent 24-hour ambulatory BP monitoring (ABPM). Serum creatinine and cystatin C were obtained to assess estimated glomerular filtration rate with age-based formulas. A random urine sample was obtained to estimate urine osmolality and urine albumin to creatinine ratio. Mean age range was 11.9 (±4.5) years. Seventeen participants (30%) met criteria for hypertension based on ABPM. Of the 17 participants classified with hypertension, three had office hypertension with ambulatory hypertension, and 14 had masked hypertension detected on ABPM. Another 28 participants (50%) had some abnormal ABPM parameters in the form of either prehypertension and/or lack of normal nocturnal dipping status. The prevalence of confirmed hypertension, largely manifest by masked hypertension, is high in children, as young as 6 years of age with SCD. Early identification of hypertension in SCD children can confer benefit as it is an important modifiable risk factor for progression of cardiovascular and renal disease.

中文翻译：

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镰状细胞病儿科队列中的动态高血压。

高血压是儿童和成人随后发生心血管和肾脏疾病的既定危险因素。镰状细胞病 (SCD) 是一种与慢性溶血性贫血相关的遗传性疾病，主要表现为血管闭塞性危象。尽管该疾病实体涉及导致血管和肺损伤的大多数器官系统，但对 SCD 儿童的血压 (BP) 水平或高血压患病率知之甚少。对 56 名 SCD 儿童（54 名患有血红蛋白 SS 疾病；2 名患有血红蛋白 Sβ0 地中海贫血症；29 名女性）进行了一项横断面研究。研究参与者接受了 24 小时动态血压监测 (ABPM)。获得血清肌酐和胱抑素 C 以使用基于年龄的公式评估估计的肾小球滤过率。获得随机尿样以估计尿渗透压和尿白蛋白与肌酐比。平均年龄范围为 11.9 (±4.5) 岁。17 名参与者 (30%) 符合基于 ABPM 的高血压标准。在被归类为高血压的 17 名参与者中，3 人患有门诊高血压并伴有动态高血压，14 人在 ABPM 上检测到隐匿性高血压。另外 28 名参与者 (50%) 有一些异常 ABPM 参数，表现为高血压前期和/或缺乏正常的夜间浸渍状态。确诊高血压（主要表现为隐匿性高血压）的患病率在 6 岁 SCD 儿童中很高。早期识别 SCD 儿童的高血压可以带来益处，因为它是心血管和肾脏疾病进展的重要可改变风险因素。