COAGULATION AND INHIBITORY AND FIBRINOLYTIC PROTEINS IN ESSENTIAL-HYPERTENSION

Arterial hypertension (HTN) increases the risk of cerebral coronary, a nd other vascular complications that frequently involve platelet activ ation and blood coagulation. Several key proteins in the blood coagula tion, fibrinolytic and inhibitory systems were studied in 29 men with HTN (aged 45 +/- 3 yr) and 15 normal men of the same age. Plasma level s of high-molecular-weight kininogen and factors XII, IX, VII, X, II, and XIII, as well as von Willebrand factor (vWF), fibrinogen, fibronec tin, alpha2-antiplasmin, tissue-plasminogen activator, D-dimer, platel et factor-4, and protein C were measured by the use of appropriate fun ctional and immunologic assays before and after a cardiopulmonary exer cise stress test. The concentrations of vWF, alpha2-antiplasmin, and D -dimer were significantly (P < 0.02) higher in the HTN group as compar ed with the control group. The exercise stress test resulted in signif icant rises in the plasma vWF, alpha2-antiplasmin, and tissue-plasmino gen activator levels in the two groups. The concentrations of vWF and D-dimer were related to diastolic blood pressure (r = 0.44 and 0.40, r espectively; P< 0.02). Levels of vWF also were related to left ventric ular mass index and left ventricular posterior wall and septal thickne ss (r = 0.34, 0.43, and 0.34, respectively; P < 0.05). The constellati on of these findings suggests a low-grade fibrin formation and degrada tion, the magnitude of which is related to the diastolic blood pressur e. The observed abnormalities can potentially contribute to the cardio vascular complications of untreated HTN.