title: Hypertension, haematuria and renal functioning in haemophilia - a cross-sectional study in Europe.
abstract: OBJECTIVE
  This cross-sectional, epidemiological study sought to assess the prevalence and extent of potential risk factors for hypertension, particularly renal function related to haematuria and their associations in people with haemophilia.
  
  
  METHODS
  Demographic and medical data were collected at a single time-point in patients with haemophilia over 40 years of age from 16 European centres. Associations with diagnosis of hypertension were tested in univariate and multivariate analyses.
  
  
  RESULTS
  We enrolled 532 patients (median age 52 years, range 40-98) with haemophilia A (n = 467) or haemophilia B (n = 65). Haemophilia was severe (<0.01 IU mL-1) in 313 patients (59%). Hypertension was diagnosed in 239 patients (45%). In multivariate analyses, age and body mass index (BMI) were significantly and independently associated with hypertension (adjusted odds ratio (OR) 18.1, P < 0.001, in elderly patients and OR = 25.1, P < 0.001, in patients with BMI >30 kg m-2). Estimated glomerular filtration rate (eGFR) <70 mL min-1(OR = 2.7, P = 0.047) was significantly associated with hypertension, but mean eGFR was significantly higher for severe than mild haemophilia. Further variables with OR > 2.8 were diabetes (OR = 2.8, P = 0.04), coronary artery disease (OR = 3.3, P = 0.052) and family history of hypertension (OR = 4.4, P < 0.001). Neither severity of haemophilia nor history of haematuria was significantly associated with hypertension in univariate or multivariate analyses.
  
  
  CONCLUSIONS
  As in the general population, age and BMI were major risk factors for hypertension in people with haemophilia. Renal dysfunction was associated with hypertension, but the prevalence of renal dysfunction was not extensive and furthermore not significantly correlated with haematuria. The associations of other variables with hypertension require further studies to confirm causal relationships over time.
authors.affiliation: Department of Haematology, Oslo University Hospital and Institute of Clinical Medicine University of Oslo, Oslo, Norway.
authors.forename: P A
authors.initials: PA
authors.lastname: Holme
authors.affiliation: University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Combescure
authors.affiliation: Royal Infirmary, Glasgow, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Tait
authors.affiliation: Lund University, Malmö, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Berntorp
authors.affiliation: Bayer Healthcare, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Rauchensteiner
authors.affiliation: University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: de Moerloose
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006417:Hematuria / Q000453:epidemiology*; D006467:Hemophilia A / Q000453:epidemiology*; D002836:Hemophilia B / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged
keywords: cardiovascular disease; epidemiological study; haematuria; haemophilia; hypertension; renal disease