Enhanced thrombin generation in patients with arterial hypertension.


Journal

Thrombosis research
ISSN: 1879-2472
Titre abrégé: Thromb Res
Pays: United States
ID NLM: 0326377

Informations de publication

Date de publication:
02 2019
Historique:
received: 11 10 2018
revised: 14 11 2018
accepted: 27 11 2018
pubmed: 1 1 2019
medline: 5 4 2019
entrez: 1 1 2019
Statut: ppublish

Résumé

Arterial hypertension is associated with greater risk of cardiovascular diseases and thrombotic complications, suggesting that hypertension is a prothrombotic state. To investigate the relationship between arterial hypertension and thrombin generation, and between blood pressure level and thrombin generation in hypertensive patients. A total of 165 hypertensive patients and 47 healthy adults controls were include in the study. Thrombin generation was assessed in both groups by the Calibrated Automated Thrombogram (CAT) method. Ambulatory blood pressure monitoring (ABPM) was also performed for all patients in the hypertensive group. Hypertensive patients had significantly higher levels of ETP and peak heights compared to healthy controls; means of ETP 1720.6 ± 267 and 1544.7 ± 302, respectively (P < 0.001) and means of peak height were 297.26 ± 48 and, 273 ± 53, respectively (P < 0.001). On multivariate linear regression analysis, hypertension remained independently associated with increased ETP (β = 0.185, P = 0.047). Analysis restricted to the hypertensive group with ABPM measurement showed statistically significant correlations between all measures of diastolic blood pressure (DBP) and ETP, and multivariate analysis showed that awake DBP was significantly associated with ETP (β = 0.194 for each 1-mm Hg increase in awake DBP, P = 0.012). Furthermore, hypertensive patients with cardiovascular complications had statistically elevated levels of peak height compared to hypertensive patients without cardiovascular complications. Hypertensive patients possess enhanced thrombin generation compared healthy controls. Diastolic blood pressure level is independently correlated with increased thrombin generation in hypertensive patients. These findings suggest that arterial hypertension is a prothrombotic state.

Sections du résumé

BACKGROUND
Arterial hypertension is associated with greater risk of cardiovascular diseases and thrombotic complications, suggesting that hypertension is a prothrombotic state.
OBJECTIVES
To investigate the relationship between arterial hypertension and thrombin generation, and between blood pressure level and thrombin generation in hypertensive patients.
METHODS
A total of 165 hypertensive patients and 47 healthy adults controls were include in the study. Thrombin generation was assessed in both groups by the Calibrated Automated Thrombogram (CAT) method. Ambulatory blood pressure monitoring (ABPM) was also performed for all patients in the hypertensive group.
RESULTS
Hypertensive patients had significantly higher levels of ETP and peak heights compared to healthy controls; means of ETP 1720.6 ± 267 and 1544.7 ± 302, respectively (P < 0.001) and means of peak height were 297.26 ± 48 and, 273 ± 53, respectively (P < 0.001). On multivariate linear regression analysis, hypertension remained independently associated with increased ETP (β = 0.185, P = 0.047). Analysis restricted to the hypertensive group with ABPM measurement showed statistically significant correlations between all measures of diastolic blood pressure (DBP) and ETP, and multivariate analysis showed that awake DBP was significantly associated with ETP (β = 0.194 for each 1-mm Hg increase in awake DBP, P = 0.012). Furthermore, hypertensive patients with cardiovascular complications had statistically elevated levels of peak height compared to hypertensive patients without cardiovascular complications.
CONCLUSIONS
Hypertensive patients possess enhanced thrombin generation compared healthy controls. Diastolic blood pressure level is independently correlated with increased thrombin generation in hypertensive patients. These findings suggest that arterial hypertension is a prothrombotic state.

Identifiants

pubmed: 30597342
pii: S0049-3848(18)30631-5
doi: 10.1016/j.thromres.2018.11.027
pii:
doi:

Substances chimiques

Thrombin EC 3.4.21.5

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

121-128

Informations de copyright

Copyright © 2018 Elsevier Ltd. All rights reserved.

Auteurs

Adi Elias (A)

Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel. Electronic address: ad_elias@rambam.health.gov.il.

Wasseem Rock (W)

Internal Medicine Department A, Emek Medical Center, Afula, Israel.

Ahmad Odetalla (A)

Department of Internal Medicine C, Emek Medical Center, Afula, Rapaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.

Gilat Ron (G)

Department of Internal Medicine C, Emek Medical Center, Afula, Rapaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel. Electronic address: Gilat_av@clalit.org.il.

Naama Schwartz (N)

Clinical Research Unit, Emek Medical Center, Afula, Israel; School of Public Health, University of Haifa, Israel.

Walid Saliba (W)

Translational Epidemiology Unit, Carmel Medical Center, Haifa, Rapaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel. Electronic address: Saliba_wa@clalit.org.il.

Mazen Elias (M)

Department of Internal Medicine C, Emek Medical Center, Afula, Rapaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel. Electronic address: elias_m@clalit.org.il.

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