title: Prevalence and Risk Factors Associated With Hypertension in von Willebrand Disease.
abstract: BACKGROUND
  von Willebrand factor (VWF) is a biomarker for endothelial damage. Increased VWF levels are observed in hypertension (HTN) and disorders of endothelial dysfunction, for example, atherosclerotic heart disease (ASHD) and diabetes. Whether low VWF protects against HTN is unknown.
  
  
  METHODS
  To determine prevalence and risk factors for HTN in patients with von Willebrand disease (VWD), we conducted a cross-sectional analysis of discharge data from the National Inpatient Sample, 2009 to 2011. Group comparisons were performed by Rao-Scott χ2test. Odds of HTN and HTN outcomes in VWD were estimated by weighted multivariable logistic regression.
  
  
  RESULTS
  The prevalence of hypertension in patients with VWD (N = 7556), 37.35%, was significantly lower than that in non-VWD patients (N = 19 918 970), 49.40%, P < .0001. Hypertension risk factors (hyperlipidemia, diabetes, smoking, hepatitis C, and HIV) and HTN outcomes (ASHD, myocardial infarction [MI], ischemic stroke, and renal failure) were less common in patients with VWD than in non-VWD patients, all P ≤ .0001. Patients with VWD were younger, 49.67 versus 57.30 years, Caucasian, 82.23% versus 68.35%, and female, 75.44% versus 59.61%, P < .0001. Patients with HTN were older, 67.55 versus 47.29 years, male, 45.99% versus 34.90%, and had more HTN risk factors and HTN outcomes than those without HTN, all P < .0001, including male and female subgroups, each P < .0001. The unadjusted odds of HTN in patients with VWD (odds ratio [OR] = 0.611, P < .0001) and of HTN outcomes in patients with VWD (ASHD, OR = 0.509; MI, OR = 0.422; ischemic stroke, OR = 0.521; renal failure, OR = 0.420, all P < .0001) became insignificant after adjustment for HTN risk factors plus demographics (age/race/gender), OR = 1.035, P = .260.
  
  
  CONCLUSIONS
  The risk of HTN is reduced in patients with VWD, but not after adjustment for HTN risk factors plus demographics, as patients with VWD not having HTN are also typically young, Caucasian, and female.
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: Mariya H
authors.initials: MH
authors.lastname: Apostolova
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 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: 3 Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Yabes
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: D000367:Age Factors; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014842:von Willebrand Diseases / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology
keywords: atherosclerosis; cardiovascular disease; endothelial damage; essential hypertension; von Willebrand disease; von Willebrand factor