Effect of hemoglobin levels on cardiovascular outcomes in patients with isolated systolic hypertension and left ventricular hypertrophy (from the LIFE study)

Hematologic disorders during essential hypertension

BACKGROUND

Besides the traditional risk factors, hematological changes may be involved in the development of arterial hypertension and in its pathogenesis.

METHODS

The study, conducted on a sample of 545 subjects, 215 with hypertension and 330 witnesses, were evaluated for peripheral blood parameters in western Algeria; Logistic regression analysis was used to predict hypertension with hematological parameters.

RESULTS

The characters studied related significantly; lower red blood cell levels have a three-and-a-half-fold risk of developing hypertension compared to those who have normal red blood cell counts (OR = 3.64, 95% CI = 1.37-9.65, p < 0.05). Subjects who have mean corpuscular volume rate below 80 fl are more exposed to hypertension (OR = 13.58, 95% CI = 4.68-39.41, p = 0.000). The mean corpuscular hemoglobin concentration reveals that subjects who have a lower than normal (<27 pg) are once less exposed to hypertension (OR = 0.04, 95% CI = 0.01-0.13, p = 0.000). Subjects who have lower platelet count than normal are twelve times more exposed to hypertension (OR = 12.13, 95% CI = 1.45-101.18, P = 0.021). Finally, the increase in sedimentation rate at one hour increases the risk of hypertension by 56.63 times compared to subjects with normal sedimentation rate (OR = 56.63, 95% CI = 3.37-597.33, P = 0.001).

CONCLUSIONS

Hematological profile associated with essential hypertension retained Red blood cells ratio, mean corpuscular volume, mean corpuscular hemoglobin concentration, platelet ratio, and sedimentation rate at one hour.

A comparative cross-sectional study of some hematological parameters of hypertensive and normotensive individuals at the university of Gondar hospital, Northwest Ethiopia

Background

Hypertension is a major health problem worldwide. It can lead to cardiovascular disease and also leads to functional disturbances including hematological parameters. The abnormalities of haematological parameters may enhance an end-organ damage. Therefore, the aim of this study was to assess some hematological parameters of hypertensive individuals in comparison with normotensive individuals at University of Gondar hospital, northwest Ethiopia.

Methods

A cross sectional comparative study was conducted from October to November 2015 on a total of 126 hypertensive and 126 normotensive individuals at University of Gondar Hospital. All participants after taking informed consent were interviewed for detailed history and 3 ml of blood was collected for hematological test analysis. Independent t-test and the Mann Whitney u-test were used to find out significant difference and Pearson’s and Spearman’s correlation were used for correlation test. P values less than 0.05 was considered the level of significance.

Result

From a total of 252 study subjects, about 67.5% were females. The mean age of study subjects was 50.3 ± 11 years for hypertensive individuals and 49.8 ± 11.6 years for normotensive individuals with range of 18–65 years. In the present study, the median (IQR) value of WBC, RBC, Hgb, HCT, MCV and the mean value of MCHC, RDW, MPV and PDW were significantly higher in hypertensive group compared to apparently healthy normotensive groups. Additionally, WBC, RBC, Hgb, HCT and PLT showed statistically significant positive correlations with blood pressure indices. Platelet count and MCH did not show statistically significant difference between the two groups.

Conclusion

Hypertension has impact on hematological parameters. In this study, the mean and median values of haematological parameters in hypertensive individuals were significantly different compared to apparently healthy normotensive individuals. Hence, hematological parameters can be used to monitor the prognosis of the disease and manage hypertensive related complications, and it is important to assess hematological parameters for hypertensive individuals which may help to prevent complications associated hematological disorders.

Electronic supplementary material

The online version of this article (doi: 10.1186/s12878-017-0093-9) contains supplementary material, which is available to authorized users.

Association of serum phosphorus with left ventricular mass in men and women with stable cardiovascular disease: data from the Heart and Soul Study

BACKGROUND

Higher serum phosphorus levels are associated with cardiovascular disease (CVD) events in the general population, an association that may be stronger in men. Estradiol has phosphaturic properties. Whether higher serum phosphorus levels are associated with left ventricular (LV) mass in persons without end-stage renal disease and whether the association is modified by sex is unknown.

STUDY DESIGN

Cross-sectional observational study.

SETTING & PARTICIPANTS

978 outpatients with stable CVD.

PREDICTOR

The primary predictor variable was serum phosphorus level. Sex was evaluated as an effect modifier.

OUTCOME & MEASUREMENTS

LV mass using transthoracic echocardiography.

RESULTS

The association of serum phosphorus level with LV mass differed by sex (interaction P=0.04). In models adjusted for age, race, kidney function, smoking, diabetes, blood pressure, cholesterol level, C-reactive protein level, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, each 1-mg/dL higher serum phosphorus level was associated with 4.52-g/m2 greater LV mass (95% CI, 1.04-8.01; P=0.01) in men. Conversely, in women, no statistically significant association was found between serum phosphorus level and LV mass.

LIMITATIONS

Older adult population with stable CVD; 19% were women.

CONCLUSIONS

In outpatients with stable CVD, higher serum phosphorus levels are associated with greater LV mass in men, but not women. Whether sex hormones may account for these differences requires future study.

Systemic blood pressure profile in hypertensive patients with low hemoglobin concentrations

The purpose of the present study was to determine the relationship between anemia and parameters derived from 24-hour ambulatory blood pressure monitoring. We found that patients with anemia had significantly elevated nocturnal systolic and mean blood pressure and a trend for increased diastolic blood pressure. In addition, anemic patients had significantly lower dipping status compared to patients with normal hemoglobin levels.