PREDICTING PRECLINICAL THROMBOGENIC ABNORMALITIES IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION
https://doi.org/10.15829/1728-8800-2013-2-4-9
Abstract
Aim.To identify early (preclinical) markers of thrombogenic abnormalities in patients with essential arterial hypertension (EAH).
Material and methods. The study included 137 EAH patients, aged 30–60 years. The parameters of both coagulation and platelet haemostasis were assessed.
Results. In patients with EAH and obesity (O), the following parameters were elevated: activated partial thromboplastin time (aPTT); fibrinogen; and soluble fibrin monomer complex (SFMC). In EAH patients without O, the levels of spontaneous platelet aggregation were elevated. Among overweight patients, the levels of adreno-reactivity were associated with leptin levels (rs=0,8; р=0,007). In obese patients, there was a significant correlation between insulin and leptin levels (rs=0,7; р=0,0049). The correlation analysis of the neurohumoral and haemostatic parameters demonstrated an association between leptin and SFMC levels (rs=0,8; р=0,0007). In EAH patients, the changes in neurohumoral profile are linked to increased body mass, elevated levels of insulin (Н=9,6; р=0,0082), leptin (Н=12,1; р=0,0024), and adreno-reactivity (Н=8,8; р=0,0122).
Conclusion. In patients with EAH and O, the observed haemostatic abnormalities could be characterised as hypercoagulation syndrome. The findings obtained suggest that fibrinogen and SFMC could be regarded as early markers of thrombosis development in patients with EAH and O. Therefore, these parameters can be used in the screening programme, in order to identify the individuals with abnormalities of coagulation haemostasis and fibrinolysis.About the Authors
S. S. BunovaRussian Federation
L. P. Firstova
Russian Federation
A. V. Nelidova
Russian Federation
E. V. Usacheva
Russian Federation
References
1. Oganov RG, Maslennikova GY. Development of preventive cardiology in Russia. Cardiovascular Therapy and Prevention 2004; 3: 11–4. Russian (Оганов Р. Г., Масленникова Г. Я. Развитие профилактической кардио- логии в России. Кардиоваскулярная терапия и профилактика 2004; 3: 11–4).
2. Oganov RG, Maslennikova GY. Mortality from cardiovascular disease and other chronic non-communicable diseases among the Russian. Cardiovascular Therapy and Prevention 2002; 3: 4–8. Russian (Оганов Р. Г., Масленникова Г. Я. Смертность от сердечно-сосудистых и других хронических неинфекционных заболеваний среди трудоспособно- го населения России. Кардиоваскулярная терапия и профилактика 2002; 3: 4–8).
3. Sidorov MN, Aleksandrova AA, Burdenkova ES. Health and others in Russia: Statistical Yearbook. Goskomstat of Russia. Moscow 2001; 34–57. Russian (Сидоров М. Н., Александрова А. А., Бурденкова Е. С. и др. Здравоохранение в России: Статистический сборник. Госкомстат России. М. 2001; 34–57).
4. Shalnova SA, Balanova YA, Konstantinov VV, et al. Hypertension: prevalence, awareness, acceptance and effectiveness of antihypertensive treatment in the population of the Russian Federation. Russian Journal of Cardiology 2006; 4: 45–50. Russian (Шальнова С. А., Баланова Ю. А., Константинов В. В. и др. Артериальная гипертония: распространен- ность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения Российской Федерации. Российский кардиологический журнал 2006; 4: 45–50).
5. Shalnova SA, Deev AD, Oganov RG, et al. The role of systolic and diastolic blood pressure for the prediction of mortality from cardiovascular disease. Cardiovascular Therapy and Prevention 2002; 1: 10–5. Russian (Шальнова С. А., Деев А. Д., Оганов Р. Г. и др. Роль систолического и диастолического давления для прогноза смертности от сердечно- сосудистых заболеваний. Кардиоваскулярная терапия и профилак- тика 2002; 1: 10–5).
6. Lawes CM, Bennet DA, Feigin VL, et al. Blood pressure and stroke: an overview of published reviews. Stroke 2004; 35: 776–85.
7. Levi F, Lucchini F, Negri E, et al. Trends in mortality from cardiovascular and cerebrovascular diseases in Europe and other areas of the world. Heart 2002; 88: 119–24. 8. Obesity epidemic puts millions at risk from related diseases (press release). Geneva: World Health Organization; June 12,1997; 46.
8. Obesity: preventing and managing the global epidemic: report of a WHO consultation on obesity. WHO/NUT/NCD/981, WHO, Geneva 1998. 10. Xavier Pi-Sunyer F. The Obesity Epidemic: Pathophysiology and Consequences of Obesity. Obesity Research 2002; 10 (2): 97–104.
9. Stryuk RI, Dlusskiy IG. Adrenoreactivity and cardio-vascular system. Moscow 2003;160 p. Russian (Стрюк Р.И, Длусская И. Г. Адренореактив ность и сердечно-сосудистая система. М. 2003; 160 с).
10. Rebrova O. Mathematical analysis of medical data. Application software package STATISTICA. Moscow 2006; 305 p. Russian (Реброва О. Ю. Математический анализ медицинских данных. Применение пакета прикладных программ STATISTICA. М. 2006; 305 с).
11. Sonnenberg GE, Krakower GR, Kissebah AH. A novel pathway to the manifestation of metabolic syndrome. Obes Res 2004; 12 (2): 180–92.
12. Vanhala MG, Pitkajarvi TK, Kumpusalo ES, et al. Metabolic syndrome in middle-aged Finnish population. J Cardiovase Risk 1997; 4: 291–5.
13. Askari H, Liu J, Dagogo-Jack S. Hormonal regulation of human leptin in vivo: effects of hydrocortisone and insulin. Int J Obes Relat Metab Disord 2000; 24: 1254–9.
14. Gava E, Samad-Zadeh A, Zimpelmann J, et al. Angiotensin- (1–7) activates a tyrosine phosphatase and inhibits glucose-induced signalling in proximal tubular cells. Nephrol Dial Transplant 2009; 24 (6): 1766–73.
Review
For citations:
Bunova S.S., Firstova L.P., Nelidova A.V., Usacheva E.V. PREDICTING PRECLINICAL THROMBOGENIC ABNORMALITIES IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION. Cardiovascular Therapy and Prevention. 2013;12(2):4-9. (In Russ.) https://doi.org/10.15829/1728-8800-2013-2-4-9