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Impact of β-thalassemia trait carrier state on inflammatory status in patients with newly diagnosed hypertension

Triantafyllou, Athanasios I.a; Farmakis, Dimitrios T.b,c; Lampropoulos, Konstantinos M.a; Karkalousos, Petros L.d; Triantafyllou, Epameinondas A.a; Papingiotis, Georgiosb; Megalou, Aikaterinia; Karpanou, Eva A.e

Journal of Cardiovascular Medicine: May 2019 - Volume 20 - Issue 5 - p 284–289
doi: 10.2459/JCM.0000000000000787
Research articles: Prevention

Background B-thalassemia carrier state or thalassemia minor confers cardiovascular protection through favorable lipidemic and blood pressure profile. However, its impact on inflammatory status—a common denominator of the above conditions—has not been addressed.

Methods We investigated a wide range of inflammatory markers [white blood cell (WBC) count, homocysteine, C-reactive protein (CRP), serum amyloid A (SAA), fibrinogen, plasminogen, fibronectin, plasminogen activator inhibitor-1 (PAI-1), and uric acid] in a large cohort of 15 805 newly diagnosed hypertensive patients (8299 men, 7506 women); 626 of them (4.0%) had thalassemia minor.

Results The levels of WBC, homocysteine, CRP, SAA, fibrinogen, and PAI-1 were significantly lower in thalassemia minor patients, but not of plasminogen, fibronectin, and uric acid. In multivariate linear regression analyses, the lower values of WBC (<0.001), CRP (<0.001), homocysteine (<0.001), fibrinogen (<0.001), and PAI-1 (0.008), but not of SAA, were independently associated with thalassemia minor. The interaction between thalassemia minor and body mass index had a significant impact only on WBC and CRP (P for the interaction 0.010 and 0.005, respectively), whereas the interaction between thalassemia minor and sex had a significant impact only on fibrinogen (P for the interaction 0.007).

Conclusion Thalassemia minor is followed by a favorable inflammatory profile that may contribute to the overall better cardiovascular health of the carriers.

aDepartment of Cardiology, Evangelismos General Hospital, Athens, Greece

bDepartment of Cardiology, Athens University Hospital Attikon, Athens, Greece

cUniversity of Cyprus Medical School, Nicosia, Cyprus

dDepartment of Medical Laboratories, Technological Institute of Athens, Athens, Greece

eFirst Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece

Correspondence to Dimitrios T. Farmakis, MD, PhD, FESC, University of Cyprus Medical School, Shakolas Educational Center for Clinical Medicine, Palaios dromos Lefkosias Lemesou No. 215/6, 2029 Aglantzia, Nicosia, Cyprus Tel: +357 22895235; e-mail:

Received 21 February, 2018

Revised 18 January, 2019

Accepted 16 February, 2019

© 2019 Italian Federation of Cardiology. All rights reserved.