Plasma Concentration of Coagulation and Fibrinolysis Factors and Platelet Function in Hypertension

Abstract

Summary:Fifty-one patients with mild hypertension were evaluated in relation to the plasma concentrations of coagulation and fibrinolysis factors äs well äs for the aggregability of their platelets.In a considerable number of the patients (18/51), a significantly enhanced in vitro ADP aggregation was found. In the coagulation line significant increases could be demonstrated in fibrinogen, fibrin monomers and thrombin-antithrombin III. The fibrinolysis System showed significant increases for Ddimers, tissue plasminogen activator antigen and plasminogen activator Inhibitor, whereas the tissue plasminogen activator activity was significantly diminished. Remarkably, there seems to be a discrepancy between the (low) tissue plasminogen activator activity and the (higher) plasminogen activator antigen concentration.Alterations in the plasma concentrations of the investigated coagulation and fibrinolysis factors and in the aggregability of the platelets are indicative of an involvement of coagulation, fibrinolysis and platelets in hypertension, which can be considered äs partial risk factors for thrombophilia.

Effects of Medium-Term Antihypertensive Therapy on Haemostatic Parameters in Patients with Essential Hypertension

“…Perivas cular and intravascular lesions as well as ag gregation of red blood cells are atherogenic and coagulant risk factors; they were de scribed as significantly more frequent in peo ple suffering from stable arterial hypertension with a history of minor brain stroke [ 1 ]. Sever al studies in hypertensive subjects [2][3][4][5][6][7][8] have shown that platelet reactivity was increased with advancing age [9,10], and von Willebrand factor, co-antiplasmin, D-dimer (DD), tissue-type plasminogen activator (t-pA) and plasminogen activator inhibitor (PAI-1) were found to be significantly higher, compared with healthy subjects [2,11]. Furthermore, several studies have shown that various anti hypertensive drug regimens differ in their ef fects on haemostasis [12], These effects could be of importance for their proposed actions on cardiovascular morbidity and mortality [ 13], The present study was aimed at evaluat ing, after 6 and 12 months, the haemostatic effects of an angiotensin-converting enzyme (ACE) inhibitor in a group of patients with essential hypertension, precedently studied, without any evident haemostatic activation [2], At the initial stages of hypertension, the plasma levels of thrombomodulin (TM) as a marker of endothelium damage, (i-thromboglobulin (P-TG) as an indicator of platelet activation, DD which increases in hypercoagulable states, t-PA and PAI-1 were deter mined.…”

Independent contribution of psychological factors to fibrin turnover in subjects with sleep apnoea and/or systemic hypertension

“…Hypertension, age and BMI are traditional correlates of DD [21,27,28], a commonly used clinical marker of fibrin turnover [4]. Accordingly, we found higher DD levels in hypertensives than normotensives and a trend of association of DD with age (P 0.09).…”

“…Excess cardiac morbidity and mortality in subjects with OSA [12] could be explained in part by a hypercoagulable state related to either increased sympathetic nerve activity [18] or co-morbid hypertension [19]. Similarly, systemic hypertension has been associated with a hypercoagulable state [20], as evidenced by increased plasma levels of TAT, DD and vWF [21][22][23].…”

Hemostasis and Fibrinolysis Factors in First-Degree Relatives of Patients with Type 2 Diabetes without Hypertension

“…In particular, alterations in the plasma concentrations of coagulation and fibrinolysis factors are considered the link between diabetes mellitus and cardiovascular complications [7][8][9]. Also, in a hypertensive state, changes in Trifiletti/Lasco/Scamardi/Cincotta/Gaudio/ Barbera/Frisina the balance between hemostatic and antithrombotic processes, inducing a prethrombotic state, may contribute to hypertensive vascular complications [10][11][12].…”