Study of platelet adhesion in patients with uncomplicated hypertension

To evaluate platelet function in patients with essential hypertension by sensitive methods investigating platelet adhesion and expression of some platelet glycoproteins (GP), namely GPIIb/IIIa (CD41/alpha 2 beta 3) and GMP-140 (CD62/P-selectin/PADGEM). Other markers of platelet (beta-thromboglobulin) and endothelium activation (von Willebrand factor) were also measured.

We studied 21 uncomplicated essential hypertensive patients and 20 healthy normotensive control subjects, non-smokers, matched for age and sex. Resting and stimulated platelet adhesion was performed with a colorimetric method using the activity of platelet acid phosphatase for the determination of the number of platelets adhering to human plasma- or fibrinogen-coated microwells. Platelet activation was characterized by flow cytometric measurement of GPIIb/IIIa and GMP-140 in whole blood and washed platelets suspensions, with antihuman fluorescent monoclonal antibodies.

Thrombin-stimulated platelet adhesion to human plasma-coated microwells was significantly higher in hypertensive patients than in control subjects (0.05 U/ml thrombin: 13.4 +/- 1.0 versus 7.7 +/- 0.6% adhesion; 0.1 U/ml thrombin: 19.4 +/- 2.3 versus 12.6 +/- 1.8%; means +/- SEM), whereas platelet adhesion to fibrinogen-coated wells did not differ in the two groups. Flow-cytometry analysis of whole blood demonstrated a significantly increased expression of GMP-140 in hypertensive patients compared with normal subjects (percentage of CD62+ platelets: 7.3 +/- 1.2 versus 3.7 +/- 1; means +/- SEM), whereas the expression of GPIIb/IIIa did not differ in the two groups (percentage of CD41a+ platelets: 72.5 +/- 4.5 versus 70.4 +/- 3.9). Moreover, flow cytometry showed an increased size of platelets in hypertensive patients compared with that in control subjects (forwards scattering: 46.5 +/- 1.5 versus 38.9 +/- 1.1; means +/- SEM). Flow-cytometric evaluation of washed platelet suspensions showed no statistically significant differences between the expression of GMP-140 and GPIIb/IIIa in the two groups. beta-Thrombo-globulin plasma levels were higher in hypertensive patients than they were in normal subjects (36.3 +/- 2.0 versus 28.2 +/- 1.3 ng/ml; means +/- SEM). Von Willebrand factor plasma levels were not significantly different in the two groups (101.2 +/- 10.3 versus 86.3 +/- 5.6 U/dl).

These findings provide further evidence that there is a significant, albeit weak, platelet activation in hypertensive patients compared with normal subjects.