Association of blood pressure with fibrinolytic potential in the Framingham Offspring population

Background-Hypertension is an established risk factor for acute coronary ev ents. Because fibrinolytic and hemostatic factors are also associated with cardiovascular disease, we examined the relations of systolic and diastolic blood pressures (SBP and DBP) to levels of plasminogen activator inhibitor antigen, tissue plasminogen activator antigen, fibrinogen, factor VII, von Willebrand factor, fibrinogen, and plasma viscosity in subjects of the Fra mingham Offspring Study. Methods and Results-We studied 1193 men and 1459 women after the exclusion of subjects with known cardiovascular disease and those receiving anticoagu lant or antihypertensive therapy. Linear regression models were used to eva luate SBP and DBP as predictors of fibrinolytic and hemostatic factor level s in separate sex models, with adjustment for age, body mass index, smoking , diabetes, total cholesterol, HDL, triglycerides, alcohol intake, and estr ogen use (in women). In both sexes, levels of plasminogen activator inhibit or and tissue plasminogen activator antigen were positively related to SBP and DBP (P<0.001). Plasma viscosity was positively related to SBP (P=0.008) and DBP (P=0.001) in women only, There was no association between SBP or D BP and fibrinogen, factor VII, or von Willebrand factor in either sex. Conclusions-These data suggest that impaired fibrinolysis may play; an impo rtant role in the pathogenesis of cardiovascular disease in hypertensive pa tients.