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Decreased fibrinolytic response to adrenergic stimulation in hypertensive patients
A Palermo1, P Bertalero, N Pizza
1Clinica Medica, L. Sacco Hospital, University of Milan, Italy.
Insights
Essential hypertension patients show impaired fibrinolytic system function. Increased plasminogen activator inhibitor-1 (PAI-1) activity at rest and after stress may increase cardiovascular risk in these patients.
Area of Science:
- Cardiovascular Physiology
- Hemostasis and Thrombosis
- Hypertension Research
Background:
- The fibrinolytic system is crucial for maintaining vascular patency.
- Essential hypertension is associated with various cardiovascular complications.
- Understanding fibrinolytic function in hypertension is vital for risk assessment.
Purpose of the Study:
- To evaluate the fibrinolytic system's function in stable essential hypertension.
- To compare fibrinolytic response to adrenergic stimulation between hypertensives and normotensives.
- To investigate the role of tissue plasminogen activator and its inhibitor in hypertension.
Main Methods:
- Assessed fibrinolytic system activity at rest and post-adrenergic stimulation.
- Measured circulating levels of tissue plasminogen activator (t-PA).
- Quantified the activity of plasminogen activator inhibitor-1 (PAI-1).
Main Results:
- Hypertensive patients exhibited elevated resting levels of t-PA and increased PAI-1 activity.
- Fibrinolytic response to stress was blunted in hypertensives.
- Despite greater t-PA release after stress, PAI-1 activity remained elevated, impairing fibrinolysis.
Conclusions:
- Essential hypertension is linked to a dysregulated fibrinolytic system.
- Elevated PAI-1 activity, both at rest and post-stress, is a key finding.
- This impaired fibrinolysis may contribute to the increased cardiovascular risk in hypertensive individuals.
Abstract:
The aim of this study was to assess the function of the fibrinolytic system at rest and in response to adrenergic stimulation in patients with stable essential hypertension as compared with normotensives. At rest, essential arterial hypertensives were characterized by increased levels of circulating tissue-plasminogen activator, associated with an increased activity of its specific inhibitor, the PAI-1. After stress, fibrinolytic response was impaired in essential arterial hypertensives despite a greater release of tissue plasminogen activator by endothelial cells. Therefore, the PAI-1 activity may be increased in essential arterial hypertensives not only at rest, but also after stress. This may represent a risk factor for hypertensive patients.