Increased Indexes of Thrombin Activation in Advanced Stages of Hypertension

Abstract

Background: The hemostatic system plays an important role in thrombotic lesions, which can complicate the clinical course of hypertensive patients. The aim of this study was to verify a possible activation of the blood clotting processes, the evaluation of two markers of thrombin activation in 62 hypertensive patients, with and without vascular complications, compared with a control group. Methods and Results: In 22 patients with newly diagnosed uncomplicated essential hypertension, in 40 hypertensive patients with clinically evident vascular complications (20 patients with controlled blood pressure and 20 with uncontrolled and high blood pressure) and in 20 normotensive sex- and age-matched subjects, two indexes of thrombin generation and action, namely prothrombin fragment 1 + 2 (F1 + 2) and fibrinopeptide A (FPA) were evaluated. The observed values show an increase of the F1 + 2 levels in patients with overt vascular complications; those with higher blood pressure, moreover, showed FPA levels higher than those with controlled blood pressure. Conclusions: These results seem to indicate that plasma F1 + 2 levels are significantly elevated, as a marker of a thrombosis-prone status, in patients with organic damage. Successively, with progress of hypertension and increasing blood pressure, the evidence of elevated FPA levels seems to indicate a clear prethrombotic situation which could turn into a thrombotic state.

Hemostatic effects of diets containing olive or soy oil in hypertensive patients

“…Cardioprotective effects have been shown for an olive oil and rapeseed oil-based Mediterranean diet [8]. We found, in a previous study [9], that in advanced stages of hypertension there is an association between enhanced fibrin turnover and the extent of underlying atherosclerotic disease, so that the coagulation pathways are activated in these stages. In the present study, both soy oil and olive oil diets induced a lowering of diastolic BP and a significant decrease of t-PA, PAI-1 and F1+2 levels, whereas neither diet modified systolic blood pressure, BMI or lipid profile.…”

Endothelial dysfunction, platelet activation, thrombogenesis and fibrinolysis in patients with hypertensive crisis

“…This may suggest involvement of other prothrombotic pathways in hypertensive crisis-associated TMA. Previous studies have demonstrated that hypertension is associated with endothelial dysfunction, platelet activation, increased thrombin generation and inhibition of fibrinolysis [5][6][7]. The association of these prothrombotic changes with the ischaemic complications of hypertensive crisis or their role in the development of TMA has not been established.…”

Thrombin activatable fibrinolysis inhibitor and other hemostatic parameters in patients with essential arterial hypertension

“…A slightly different results are presented in the study by Sechi et al [11]. These investigators, like Trifletti et al [18], observed a positive correlation between F1+2 serum levels and systolic blood pressure in patients with hypertension-dependent multiple organ damage. This demonstrated a positive correlation between F1+2 high serum levels and diastolic blood pressure in patients treated with ACEI, and TAT activity with systolic and diastolic blood pressure in patients treated with β-blockers.…”