HEMOSTASIS IN NORMOTENSIVE AND HYPERTENSIVE MEN - RESULTS OF THE PROCAM STUDY

Background The greater than normal cardiovascular risk of hypertensive patients could be partly due to an impairment of hemostatic balance f ound in such individuals. Objective To examine the relationship betwee n hemostatic variables and blood pressures in 1950 apparently healthy male participants in the prospective cardiovascular Munster study aged 40-65 years. Methods Blood pressure and other variables were determin ed, including fibrinogen level, coagulation factor VII clotting activi ty, protein C level, antithrombin III level, plasminogen activator inh ibitor-1 level, euglobulin fibrinolytic activity, and von Willebrand f actor level. Results Age-adjusted mean values of coagulation factor VI I clotting activity, plasminogen activator inhibitor-1 level, antithro mbin ill level, and protein C level in hypertensives and borderline hy pertensives were significantly higher than those in normotensive men ( e,g, for hypertensive versus normotensive men, coagulation factor VII clotting factor activity 111.5 versus 106.1%, plasminogen activator in hibitor-1 level 5.05 versus 3.22 arbitrary units/ml, and protein C lev el 111.1 versus 107.0%, P< 0.05-0.01). For most of the hemostatic vari ables we found positive bivariate correlations to blood pressure (P le ss than or equal to 0.05), Exceptions were von Willebrand factor level (no correlation to blood pressure), and euglobulin fibrinolytic activ ity (a negative correlation to systolic blood pressure and no correlat ion to diastolic blood pressure). Significance persisted in the multip le logistic regression analysis with the exception of the relationship s between systolic and diastolic blood pressures and fibrinogen level as well as euglobin fibrinolytic activity after adjustment for age. Af ter adjustment for age and body mass index significance for relationsh ips between systolic blood pressure and coagulation factor VII clottin g activity as well as protein C level was also lost Conclusions We con clude that the greater than normal cardiovascular risk of hypertensive patients is partly due to an imbalance in hemostasis, I Hypertens 16: 917-923 (C) 1998 Lippincott-Raven Publishers.