The possible role of hypertension in aggravating hemolytic episodes in G-6PD deficient persons

Approximately 13 percent of American Negro males carry a mutant [A-variant] glucose-6-phosphate dehydrogenase enzyme in their red blood cells that predisposes them to hemolytic episodes following exposure to oxidant drugs such as primaquine. Most hemolytic episodes to standard prophylactic treatment are mild and self-limited, but as many as 2 percent of Negro males develop severe hemolysis when similarly treated. The exaggerated response may be due in part to the combination of G-6-PD deficiency and hypertension since hypertension can cause red cell fragmentation, and the stressed cells of G-6-PD deficient person would be more sensitive to such fragmentation.