title: Rates and risk factors of hypertension in adolescents and adults with sickle cell anaemia in Tanzania: 10 years' experience.
abstract: Data on the magnitude and risk factors for hypertension in sickle cell anaemia (SCA) are limited. A retrospective analysis of individuals with SCA aged ≥15 years enrolled from 2004-2014 at Muhimbili National Hospital, Tanzania was conducted to determine the prevalence, incidence and risk factors for hypertension. A total of 1013 individuals with SCA were analysed, of whom 571(56%) were females. The median age [interquartile range] was 17 [15-22] years. Four hundred and forty-one (44%) of the patients had relative hypertension [systolic blood pressure (SBP) 120-139 mmHg or diastolic blood pressure (DBP) 70-89 mmHg], and 79 (8%) had hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). The incidence of hypertension was 64/1000 person years of observation and the 5-year survival rate was 0·71 [95% confidence interval (CI): 0·67-0·75]. In multivariate analysis, age>18 years, Hazard ratio (HR) 1·50 (95% CI: 1·03-2·18); pulse pressure, HR 0·64 (95% CI: 0·42 to 0·98); pulse rate, 1·02 (95% CI: 1·01-1·03); body mass index (BMI), HR 1·08 (95% CI: 1·03-1·13); blood transfusion, HR 2·50 (95% CI: 1·01-6·21) and haemoglobin, HR 1·12 (95% CI: 1·05-1·33) were independently associated with hypertension. In conclusion, despite the younger age, hypertension in this population was higher than that reported in others studies. Age, BMI, pulse pressure and haemoglobin were independently associated with hypertension in SCA.
authors.affiliation: School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.|Muhimbili Wellcome Programme, Dar es Salaam, Tanzania.|Muhimbili National Hospital, Dar es Salaam, Tanzania.
authors.forename: Abel
authors.initials: A
authors.lastname: Makubi
authors.affiliation: Muhimbili Wellcome Programme, Dar es Salaam, Tanzania.|National Institute of Medical Research, Tanga, Tanzania.
authors.forename: Bruno P
authors.initials: BP
authors.lastname: Mmbando
authors.affiliation: Department of Medicine, Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Novelli
authors.affiliation: Muhimbili National Hospital, Dar es Salaam, Tanzania.|Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.
authors.forename: Johnson
authors.initials: J
authors.lastname: Lwakatare
authors.affiliation: Muhimbili Wellcome Programme, Dar es Salaam, Tanzania.
authors.forename: Deogratius
authors.initials: D
authors.lastname: Soka
authors.affiliation: Muhimbili Wellcome Programme, Dar es Salaam, Tanzania.
authors.forename: Harvest
authors.initials: H
authors.lastname: Marik
authors.affiliation: Muhimbili National Hospital, Dar es Salaam, Tanzania.|Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.
authors.forename: Kemi
authors.initials: K
authors.lastname: Tibarazwa
authors.affiliation: Muhimbili Wellcome Programme, Dar es Salaam, Tanzania.
authors.forename: Mariam
authors.initials: M
authors.lastname: Ngaeje
authors.affiliation: Muhimbili Wellcome Programme, Dar es Salaam, Tanzania.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Newton
authors.affiliation: Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.|Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Gladwin
authors.affiliation: School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.|Muhimbili Wellcome Programme, Dar es Salaam, Tanzania.|Nuffield Department of Clinical Medicine, University of Oxford, London, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Makani
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015994:Incidence; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
keywords: Tanzania; hypertension; incidence; prevalence; sickle cell