title: Prevalence and Risk Factors Associated With Hypertension in Hemophilia: Cross-Sectional Analysis of a National Discharge Register.
abstract: BACKGROUND
  Improved life expectancy of persons with hemophilia (PWHs) has led to a greater interest in the role of age-related chronic diseases, such as hypertension, in this cohort. Several observational studies have reported an increased prevalence of hypertension in PWHs; however, this has not been assessed using a large, national database in the United States.
  
  
  OBJECTIVE
  We hypothesized the prevalence of hypertension is increased in PWHs and compared the prevalence of hypertension and associated risk factors among patients with and without hemophilia.
  
  
  METHODS
  A cross-sectional analysis was performed using discharge data among adult males from the National Inpatient Sample over the 3-year period, 2009 to 2011. Hypertension was compared across groups using Rao-Scott χ2test. Multivariable logistic regression was used to estimate the odds of hypertension in patients with hemophilia after adjustment for hypertension-associated risk factors.
  
  
  RESULTS
  The prevalence of hypertension in patients with hemophilia was less than the prevalence of hypertension in patients without hemophilia (39.5% vs 56.3%, P < .001). Hemophilia was associated with a decreased odds of hypertension after adjusting for associated risk factors (odds ratio: 0.87; 95% confidence interval: 0.81-0.94).
  
  
  CONCLUSIONS
  In contrast to the findings of several other recent studies, we report a decreased prevalence of hypertension in PWHs. The discrepancy among the reported prevalence of hypertension in our study and several others highlights the potential biases inherent to retrospective and cross-sectional studies and underscores the need for well-designed prospective studies to determine the true incidence of hypertension in PWHs, which may lie somewhere in between our findings and the findings of others.
authors.affiliation: 1 Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.|2 Hemophilia Center of Western Pennsylvania, Pittsburgh, PA, USA.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Seaman
authors.affiliation: 3 Division of Hematology/Oncology, Department of Medicine, West Penn Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Mariya
authors.initials: M
authors.lastname: Apostolova
authors.affiliation: 4 Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Yabes
authors.affiliation: 4 Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Comer
authors.affiliation: 1 Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.|2 Hemophilia Center of Western Pennsylvania, Pittsburgh, PA, USA.
authors.forename: Margaret V
authors.initials: MV
authors.lastname: Ragni
mesh_terms: D003430:Cross-Sectional Studies; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D014481:United States
keywords: and hemostasis; cardiovascular disease; hemophilia; hypertension