Strategies and innovations in hypertension management for sickle cell patients: A narrative review

Sickle cell disease (SCD) remains a challenging hematologic disorder, characterized by chronic hemolysis, vaso-occlusive events, and multi-organ complications. Hypertension, a prevalent comorbidity in SCD, poses significant clinical implications, exacerbating the complexities of disease management and impacting patient outcomes. Understanding the intricate interplay between SCD and hypertension is pivotal. Mechanistic insights uncover a landscape characterized by chronic hemolysis, endothelial dysfunction, altered nitric oxide bioavailability, and increased oxidative stress, contributing to elevated blood pressure and heightened cardiovascular risks in individuals with SCD. The diagnostic challenges inherent in identifying and monitoring hypertension in SCD patients necessitate novel approaches. Current treatment paradigms encompass a spectrum of lifestyle modifications, pharmacological interventions, and multidisciplinary care models. However, the limitations and complexities inherent in managing hypertension in SCD call for innovative strategies. Tailored approaches, personalized treatments, and emerging therapeutic avenues geared explicitly toward SCD patients mark a shift toward more effective management. Advancements in technology, including wearable devices and remote monitoring systems, present opportunities to revolutionize blood pressure monitoring, enhancing patient engagement and compliance while providing more accurate and frequent measurements. Moreover, the review underscores the importance of integrated care models and multidisciplinary collaborations. Collaborative frameworks involving hematologists, cardiologists, nephrologists, and primary care physicians are integral in optimizing hypertension management and addressing the specific needs of individuals with SCD.