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Association of aortic valve sclerosis with thrombin generation in hypertensive patients

M Iida1, M Yamamoto, M Yamazaki

  • 1Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Aichi, Japan. masato2_iida@mhi.co.jp

Journal of Human Hypertension
|July 18, 2008
PubMed

Insights

Hypertensive patients with aortic valve sclerosis (AVS) show persistently elevated thrombin generation, a marker of clotting activity. This heightened thrombin generation remains even after blood pressure treatment, suggesting AVS contributes to a prothrombotic state in hypertension.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Hypertension Research

Background:

  • Aortic valve sclerosis (AVS) is linked to cardiovascular events in hypertensive individuals.
  • Thrombin plays a role in non-thrombotic functions, including atherosclerosis progression and natriuretic peptide secretion.
  • Hypertension is a major risk factor for cardiovascular disease, and understanding its interplay with conditions like AVS is crucial.

Purpose of the Study:

  • To investigate the hypothesis that hypertensive patients with AVS exhibit persistently activated thrombin generation.
  • To assess the association between AVS and markers of thrombin generation and thrombus formation in never-treated hypertensive patients.
  • To evaluate the persistence of thrombin generation in hypertensive patients with AVS after valsartan treatment.

Main Methods:

  • Studied 234 asymptomatic, never-treated hypertensive patients, with 73 diagnosed with AVS via echocardiography.
  • Measured prothrombin F1+2 (thrombin generation marker) and fibrin D-dimer (thrombus formation marker), along with ANP and BNP.
  • Assessed glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula.

Main Results:

  • Hypertensive patients with AVS had higher F1+2 and ANP levels, and lower GFR compared to those without AVS.
  • F1+2 was independently associated with AVS after adjusting for cardiorenal function variables.
  • Following 6 months of valsartan treatment, F1+2 levels remained elevated in patients with AVS but decreased in those without.

Conclusions:

  • Thrombin generation is associated with AVS in untreated hypertensive patients.
  • This association between thrombin generation and AVS persists even after blood-pressure-lowering therapy with valsartan.
  • AVS may contribute to a prothrombotic state in hypertensive individuals, independent of blood pressure control.

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