Platelet Hyperactivity in Hypertensive Older Patients Is Controlled by Lowering Blood Pressure

Riondino, Silvia; Pignatelli, Pasquale; Pulcinelli, Fabio M.; Lenti, Luisa; Veroli, Claudio Di; Marigliano, Vincenzo; Gazzaniga, Pier Paolo

doi:10.1111/j.1532-5415.1999.tb01288.x

Cited by 29 publications

(17 citation statements)

References 26 publications

(27 reference statements)

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“…37 One study has found a nonsignificant reduction in soluble P-selectin with quinalapril and nifedipine. 38 The importance of our study is that we have demonstrated that in subjects at particularly high cardiovascular risk by virtue of having TOD, significant reductions in hemorheological, platelet, and endothelial markers (with the exception of fibrinogen) may be achieved by intensified BP control and risk factor management.…”

Section: Discussionmentioning

confidence: 99%

Von Willebrand Factor, Soluble P-Selectin, and Target Organ Damage in Hypertension

et al. 2002

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Abstract-To investigate the relationship between soluble markers of platelet, endothelial and rheological function, and target organ damage and their response to intensified management in a population of middle-age hypertensive patients at high risk of cardiovascular complications, we studied 382 consecutive patients (308 men; mean age, 63 years, SD 8) along with 60 normotensive controls free of cardiovascular disease. Patients were divided into those with target organ damage (TOD; nϭ107) and those free of end-organ damage. Plasma levels of soluble P-selectin (sP-sel), a marker of platelet activation, and von Willebrand factor (vWF), an index of endothelial damage/dysfunction (both enzyme-linked immunosorbent assay), and the rheological indices fibrinogen, plasma viscosity, hematocrit, platelet, and white cell count were measured. In 53 patients, variables were further measured after 6 months of intensified cardiovascular risk management. Patients with TOD had significantly higher vWF, 137 (SD 33) versus 125 (SD 33) IU/dL (Pϭ0.002,) and a greater proportion of smokers, 31% versus 16% (Pϭ0.002). There were no statistically significant differences in plasma viscosity, fibrinogen, hematocrit, white blood cell count, platelet count, or sP-sel between the 2 subgroups. In multivariate analysis, vWF was a significant independent predictor for TOD. After 6 months of intensified management in 53 patients who entered the trial, there were significant reductions in systolic blood pressure, total cholesterol, hematocrit, plasma viscosity, sP-sel, and vWF (all PϽ0.01) but no significant change in fibrinogen.

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Section: Discussionmentioning

confidence: 99%

Von Willebrand Factor, Soluble P-Selectin, and Target Organ Damage in Hypertension

et al. 2002

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“…57 In addition to the impairment of vascular reactivity and permeability, other anti-atherosclerotic functions of nitric oxide are also diminished in hypertension, which may result in activated monocyte, leukocyte, and platelet adhesion to endothelium and increased platelet aggregation. 59,60 Calcium antagonists may increase endothelial nitric oxide bioavailability by several mechanisms. 61,62 Our results may be a reflection of the action of calcium antagonist on nitric oxide.…”

Section: Discussionmentioning

confidence: 99%

Effects of efonidipine on platelet and monocyte activation markers in hypertensive patients with and without type 2 diabetes mellitus

2002

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We compared the levels of microparticles, platelet activation markers, soluble cell adhesion molecules, and soluble selectins between hypertensive patients with and without type 2 diabetes and control subjects. Binding of anti-glycoprotein IIb/IIIa and anti-glycoprotein Ib monoclonal antibodies to platelets did not differ significantly between the hypertensive patients and controls, but platelet expression of activation markers (CD62P, CD63, PAC-1, and annexin V) was higher in the hypertensive patients. Platelet-derived microparticle (PDMP) and monocyte-derived microparticle (MDMP) levels were significantly higher in the hypertensive patients than in the controls. Soluble ICAM-1, VCAM-1, P-selectin, and E-selectin levels were also higher in the

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“…53 These components appear to be related to target organ damage, longterm prognosis and are altered by treatment. 53,54 Many studies have also demonstrated abnormalities in coagulation factors, platelets and the endothelium in patients with PVD, where they are predictive of adverse outcome. For example, elevated fibrin Ddimer levels, an index of thrombogenesis and fibrin turnover, 55 have been found in patients with PVD, which correlate with clinical, haemodynamic and angiographic severity.…”

Section: Pathophysiological Considerationsmentioning

confidence: 99%

Peripheral vascular disease and hypertension: a forgotten association?

et al. 2001

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Peripheral vascular disease (PVD) is associated with a high cardiovascular morbidity and mortality. Intermittent claudication is the most common symptomatic manifestation of PVD, but is also an important predictor of cardiovascular death, increasing it by three-fold, and increasing all-cause mortality by two to five-fold. Hypertension is a common and important risk factor for vascular disorders, including PVD. Of hypertensives at presentation, about 2-5% have intermittent claudication, with this prevalence increasing with age. Similarly, 35-55% of patients with PVD at presentation also have hypertension. Patients who suffer from hypertension with PVD have a greatly increased risk of myocardial infarction and stroke. Apart from the epidemiolog-

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Platelet Hyperactivity in Hypertensive Older Patients Is Controlled by Lowering Blood Pressure

Cited by 29 publications

References 26 publications

Von Willebrand Factor, Soluble P-Selectin, and Target Organ Damage in Hypertension

Von Willebrand Factor, Soluble P-Selectin, and Target Organ Damage in Hypertension

Effects of efonidipine on platelet and monocyte activation markers in hypertensive patients with and without type 2 diabetes mellitus

Peripheral vascular disease and hypertension: a forgotten association?

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