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(Hypertension. 2004;44:924.)
© 2004 American Heart Association, Inc.

Scientific Contributions

Arterial Stiffness and Wave Reflections in Patients With Sickle Cell Disease

Daniel Lemogoum; Luc Van Bortel; Boutaina Najem; Anasthase Dzudie; Charles Teutcha; Ernest Madu; Marc Leeman; Jean-Paul Degaute; Philippe van de Borne

From the Department of Cardiology (D.L., B.N., M.L., J.-P.D., P.v.d.B.), Erasme Hospital, Brussels, Belgium; Heymans Institute of Pharmacology (L.V.B.), Gent, Belgium; Department of Internal Medicine (A.D., C.T.), Central Hospital, Yaoundé, Cameroon; Division of Cardiovascular Medicine (E.M.), Vanderbilt University Medical Center, Nashville, Tenn.

Correspondence to Daniel Lemogoum, Hypertension Clinic, Department of Cardiology, Erasme Hospital, 808 Lennik Road, 1070 Brussels, Belgium. E-mail pvandebo{at}ulb.ac.be

We tested the hypothesis that lower blood pressure and increased vasodilatation reported in sickle cell disease (SCD) patients with hemoglobin SS genotype (SS) are translated by lower arterial stiffness determined by pulse wave velocity (PWV) and wave reflections assessed by augmentation index (AI). We enrolled 20 SS (8 females; 12 male) patients closely matched for age, gender, height, and body mass index to 20 subjects with hemoglobin AA genotype (AA). Carotid–femoral PWV (PWV_CF) and carotid–radial PWV (PWV_CR) were recorded with the Complior device. Aortic AI was derived from pressure wave analysis (SphygmocoR). PWV_CF and PWV_CR were lower in SS than in AA (4.5±0.7 m/s versus 6.9±0.9 m/s, P<0.0001 and 6.6±1.2 m/s versus 9.5±1.4 m/s, P<0.0001, respectively). AI was lower in SS than in AA (2±14% versus 11±8%, P=0.02). Multivariate analysis revealed that both PWV_CF and PWV_CR were negatively associated with hemoglobin SS type and positively related to mean arterial pressure (MAP), whereas AI was positively associated with MAP and total cholesterol (all P<0.0001). Multivariate analysis restricted to SS indicated a positive association between PWV_CF and PWV_CR with age but a negative association with MAP (R²=0.57 and 0.51, respectively, both P<0.001), whereas MAP and heart rate were independently associated with AI (R²=0.65, P<0.001). This study provides the first evidence that SCD is associated with both lower arterial stiffness and wave reflections. SS patients have a paradoxical negative association between PWV and MAP, suggesting that low MAP does not protect them against arterial stiffness impairment.

Key Words: arteries • wave reflections