Blood pressure dynamics in sickle cell vaso-occlusive crisis: A mini-review

Author(s): Richard Onalo, Antoinette Cilliers

Systemic hypertension during a sickle cell vaso-occlusive crisis is an important determinant of outcome of a vaso-occlusive episode in children with sickle cell disease. Previous studies related to blood pressure dynamics in sickle cell crisis lack scientific rigor and have not documented patterns of swings in blood pressure during crises. A significant proportion of patients develop transient but significant systemic hypertension, particularly those with severe vaso-occlusive crisis and pain scores of at least 8 in a 10-point scale. The hypertensive episodes usually respond to pain control with adequate doses of analgesics. However, those with blood pressures recorded in excess of stage 2 hypertension thresholds may require short-term non-pharmacological and pharmacological interventions to prevent escalation to hypertensive emergency.