Pattern of ABO and Rhesus blood group in hypertensive patients


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1.1 Background of the study The ABO blood group are the first red cell antigens while the Rhesus blood group are the most immunogenic red cell antigens discovered. They express their character in transfusion and pregnancy as important histocompatibility genes (Dacie JV, 1994). ABO and Rhesus blood groups are of vital clinical and immunological importance due to their frequent occurrence and capacity for stimulation of antibodies, which may lead to intravascular hemolysis in cases of incompatible blood transfusion or pregnancy in majority of Rhesus ‘D’ (RhD)-negative individuals (Dacie JV, 1994). The Rhesus antigen is present on red cell structural membrane (Carton JP, 1993) but not on white cells, platelets, tissue, or body fluids (Baker FJ, 1985). There are wide variations in racial distribution of ABO antigens. In Caucasian, prevalence of 46%, 42%, 9%, and 3% (Mourant AE,1976) were reported compared to 57%, 20.5%, 21.6%, and 1.4% for O, A, B, and AB in Blacks (Iyawe VI, 1999). The cellular expression of A and B antigens are determined by the H gene, which is inherited independently. This gene codes for an enzyme that converts a carbohydrate precursor into H substance. The A and B genes code for specific enzymes (glycosyl transferases), which converts H substance into A and B antigens by the terminal addition of N-acetyl-galactosamine and D-galactose, respectively (Dacie JV, 1994). The O gene produces an inactive transferase, so that H substance persists unchanged in group O individuals. In the extreme rare Bombay phenotype (Oh), the H genotype is silent (hh) and no H transferase is produced; therefore, no H substance is made, so A and B genes if present cannot be expressed. Such individuals have anti-A, anti-B, and anti-H in their plasma and can, therefore, only be safely transfused with Oh blood (Dacie JV, 1994). The ABO blood group system is used to denote the presence of one, both, or neither of the A and B antigens on erythrocytes. In human blood transfusions it is the most important of the 36 different blood type (or group) classification systems currently recognized (Storry, 2016). A very rare (in modern medicine) mismatch in this, or any other serotype, can cause a serious, potentially fatal, adverse reaction after a transfusion, or a contra-indicated immune response to an organ transplant (Muramatsu M, 2014). The associated anti-A and anti-B antibodies are usually IgM antibodies, which are produced in the first years of life by sensitization to environmental substances, such as food, bacteria, and viruses. The ABO blood types were discovered by Karl Landsteiner in 1901, for which he received the Nobel Prize in Physiology or Medicine in 1930. ABO blood types are also present in some other animals such as rodents and apes, including chimpanzees, bonobos, and gorillas (Maton, 1993). Hypertension is a disease that has a huge impact on the health of communities. It is widespread in the Arabian Gulf area, Middle East region, and the whole world (Saudi Hypertension Management Society, 2018). Since uncomplicated hypertension is an asymptomatic condition, many people are unaware that they have high blood pressure. Therefore, diagnosis of hypertensive patients is of paramount importance. However, to diagnose hypertension, recognition of its probable risk factors would be important (Eric HA, 2004). The ABO blood group system, which was the first human blood group system to be discovered, is exclusively and integrally heritable, genetically determined at conception and remain fixed for the life. Hence, its frequency distribution follows a known pattern governed by gene transmission from generation to generation and varies with the race and geographical distribution of the human being (Kearney PM, 2005). There is strong evidence in the literature to suggest that there is an association between ABO blood group and certain diseases (Reid ME, 2004). Familial patterns of primary hypertension suggest that there could be some genetic factors for the development of hypertension. There are reports of increased cardiovascular (CV) risks in different blood groups and increase in BP is considered as a common CV risk. The ABO system is one such genetic make-up that can provide much valuable information for early detection of vulnerable groups (Garratty, 1994). 1.2 Statement of the Problem Hypertension has been termed ‘silent killer’ a chronic illness with adverse effectsprincipally involving the central nervous system, the retina, the heart and the kidneys. Since hypertension is multifactorial, the ABO antigens may indirectly influence arterial pressure. This study was conducted to evaluate the prevalence of ABO and Rh blood groups among controls and hypertensives to assess the relationship between hypertension and blood group.This study will examine the pattern of ABO and Rhesus blood group in hypertensive patients attending AKTH. 1.3 Aim and Objective of the Study The main aim and objective of this study were to evaluate the prevalence of hypertension in various ABO and Rh blood group subjects, and to examine any association between ABO and Rh blood groups with hypertension. The specific objective of the study are: 1. Examine the history of ABO blood group types. 2. To evaluate the prevalence of ABO and Rhesus positive blood groups among patients in relation to hypertension. 3. To compare the prevalence of ABO and Rhesuspositive blood groups among patients in relation to hypertension. 1.4 Research Questions The research question for this study are: 1. What is the pattern of ABO and Rhesus blood group? 2. Did hypertensive patients have relation to ABO and Rhesus blood group? 3. What is the prevalence of ABO and Rhesus positive blood groups among patients in relation to hypertension? 1.5 Scope of the Study The scope of this study is to examine and analysis the pattern of ABO and Rhesus blood group in hypertensive patients attending AKTH. 1.6 Limitation of the Study Theresearchworkislimitedtopattern of ABO and Rhesus blood group in hyper.Themainconstraintoftheresearchisdividedintothefollowing parts. a) Timeconstraints-duetotheshorttimegivenforthestudy,the researchercouldnotgetalltherequiredinformationneededforthe study. b) Finance-asaresultofmoneyconstrainttheresearcherhadnot enoughmoneytocarryoutthestudybeyondthelevel.The researchercouldnotvisitplaceswherenecessaryinformation relevantto thestudycouldbeobtained. c) Attitudeofrespondents–someoftherespondentswereunwillingto cooperatewiththeresearcherbecausetheyfelt,theyhavenothing tobenefitfromthestudybothfinanciallyandotherwise.Besides theywereafraidoflosingtheirjobs,ifallinformationneededare releasedto theresearcher 1.7 Definition of the Study Hypertension: is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person’s blood exerts against the walls of their blood vessels. Patients:A patient is any recipient of health care services. The patient is most often ill or injured and in need of treatment by a physician, nurse, psychologist, dentist, veterinarian, or other health care provider. ABO Blood Group:Histo-blood group ABO system transferase is an enzyme with glycosyltransferase activity, which is encoded by the ABO gene in humans. It is ubiquitously expressed in many tissues and cell types. ABO determines the ABO blood group of an individual by modifying the oligosaccharides on cell surface glycoproteins. Rhesus Blood Group:The Rh blood group system is one of forty-five known human blood group systems. It is the second most important blood group system, after the ABO blood group system. The Rh blood group system consists of 49 defined blood group antigens, among which the five antigens D, C, c, E, and e are the most important. AKTH:Aminu Kano Teaching Hospital

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