Children and adolescents with sickle cell disease (SCD) have higher systolic blood pressure (BP) values than the general pediatric population, according to a new study published in BMC Pediatrics. This study contradicts the current belief that children with SCD have lower BP levels.

“This is an important step for recognizing abnormal BP as a risk factor for cardio- and neurovascular events in SCD,” the authors wrote.

The higher systolic BP was observed in both obese and nonobese populations. On the other hand, diastolic BP was similar between children with SCD and children without SCD.

In addition, the results suggested that height percentiles were lower in children with SCD than in children without SCD.

“Because height percentiles were lower in SCD than general populations, the BP elevation in these children is even higher: our results are likely biased away from the null of no effect because short children have lower BPs than tall children,” the authors wrote.

Read more about comorbidities of SCD

Kupferman et al used BP values from the Silent Cerebral Infarct Multicenter Clinical Trial (SIT) for children with SCD and the 2017 Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents as reference data.

However, they recognized some limitations to their approach. For instance, this study assumed that BP data from the SIT trial were representative of the SCD population without comorbidities. In addition, they had limited knowledge of the characteristics of the SCD population, which only included children with HbSS or HbSβ° genotypes, with and without silent strokes.

Early studies suggested that children with SCD had lower BP levels than children without SCD. However, increasing evidence suggests the opposite.

Reference

Kupferman JC, Rosenbaum JE, Lande MB, et al. Blood pressure in children with sickle cell disease is higher than in the general pediatric population. BMC Pediatr. 2022;22(1):549. doi:10.1186/s12887-022-03584-9