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Abstract Details
Diabetes, hepatitis C and human immunodeficiency virus influence hypertension risk differently in cohorts of haemophilia patients, veterans and the general population
1Department of Medicine, University of California San Diego, San Diego, California, USA.
2Department of Primary Care, Veterans Affairs Medical Center, San Diego, California, USA.
3Department of Medicine, University of Alberta, Edmonton, Canada.
4West Coast Hematology, Vancouver, British Columbia, Canada.
5Washington Center for Bleeding Disorders at Bloodworks Northwest, Seattle, Washington, USA.
6Orthopaedic Institute for Children, Los Angeles, California, USA.
Abstract
Introduction: The reasons for the high prevalence of hypertension in persons with haemophilia (PWH) are poorly understood.
Aim: To examine the roles of diabetes, Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) in the etiology of hypertension for PWH.
Methods: Retrospective cross-sectional design. Adult PWH (n = 691) were divided into two groups: (A) free of diabetes, HCV and HIV; (B) with diabetes and/or HCV positivity and/or HIV positivity. Each group was matched by race and age with random samples from the general population of the US (National Health and Nutrition Examination Surveys, NHANES) and outpatients at the Veterans Affairs Medical Center (VAMC) in San Diego. Generalized additive models (GAMs) were fitted for graphical analysis of hypertension risk over the lifespan.
Results: In Group A, PWH had the highest prevalence of hypertension compared to NHANES and VAMC, especially in young adults. In Group B, diabetes increased the risk of hypertension for all three cohorts (PWH, NHANES and VAMC), especially for PWH. In PWH, hypertension risk was also increased by HIV, in NHANES by HCV, and in VAMC by HCV and HIV.