Wall U, Jern C, Bergbrant A, Jern S
Enhanced levels of tissue-type plasminogen activator in
borderline hypertension
Hypertension
(Nov) 26:796-800 1995
Recent data suggest that thrombogenic mechanisms may play an
important role in myocardial infarction, sudden death, and
stroke. Among the means whereby thrombotic tendencies may be
quantified are measurement of plasma levels of t-PA (tissue type
plasminogen activator) antigen and activity, and PAI-1 (plaminogen activator
inhibitor) levels. Abnormal levels of
PAI-1 predict recurrent MI, and abnormal levels of t-PA antigen
predict future MI, cardiac death, and thrombotic stroke.
Wall et al asked the question: Is endogenous fibrinolysis
abnormal in borderline hypertensive patients? They measured t-PA
antigen and activity levels, as well as PAI-1 levels in 39 young
(age 22-34) male subjects with borderline hypertension as well as
in 17 normotensive controls. Young subjects were purposefully
chosen to look for an early primary, as opposed to a secondary
defect in fibrinolysis. None of the patients were on any
medication
Blood was sampled before and after a 15 min period of venous
occlusion by armcuff between systolic and diastolic BP (Robertson
method). t-PA antigen and activity levels were very markedly
increased in the borderline hypertensive patients, especially
after venous occlusion. PAI-1 antigen levels were similar in the
two groups. Cholesterol, insulin, and obesity indices were
similar in the two groups. PAI-1 antigen levels correlated with
obesity, and t-PA activity levels correlated inversely with
BMI.
Comment:
Because of increased evidence linking specifically t-PA antigen
levels to cardiovascular events, this is an important study. The
mechanism for these abnormalities in fibrinolysis at this early
stage of hypertension remains to be explained.
(Daugirdas)
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H: Pathophysiology :
Coagulation abnormalities