Journal
HYPERTENSION
Volume 44, Issue 6, Pages 924-929Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/01.HYP.0000148506.73622.ba
Keywords
arteries; wave reflections
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We tested the hypothesis that lower blood pressure and increased vasodilatation reported in sickle cell disease (SCD) patients with hemoglobin SS genotype ( SS) are translated by lower arterial stiffness determined by pulse wave velocity (PWV) and wave reflections assessed by augmentation index ( AI). We enrolled 20 SS ( 8 females; 12 male) patients closely matched for age, gender, height, and body mass index to 20 subjects with hemoglobin AA genotype (AA). Carotid - femoral PWV (PWVCF) and carotid - radial PWV (PWVCR) were recorded with the Complior device. Aortic AI was derived from pressure wave analysis (SphygmocoR). PWVCF and PWVCR were lower in SS than in AA (4.5 +/- 0.7 m/s versus 6.9 +/- 0.9 m/s, P < 0.0001 and 6.6 +/- 1.2 m/s versus 9.5 +/- 1.4 m/s, P < 0.0001, respectively). AI was lower in SS than in AA (2 +/- 14% versus 11 +/- 8%, P = 0.02). Multivariate analysis revealed that both PWVCF and PWVCR were negatively associated with hemoglobin SS type and positively related to mean arterial pressure ( MAP), whereas AI was positively associated with MAP and total cholesterol ( all P < 0.0001). Multivariate analysis restricted to SS indicated a positive association between PWVCF and PWVCR with age but a negative association with MAP (R-2 = 0.57 and 0.51, respectively, both P < 0.001), whereas MAP and heart rate were independently associated with AI (R-2 = 0.65, P < 0.001). This study provides the first evidence that SCD is associated with both lower arterial stiffness and wave reflections. SS patients have a paradoxical negative association between PWV and MAP, suggesting that low MAP does not protect them against arterial stiffness impairment.
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