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Hemostasis in normotensive and hypertensive men: results of the PROCAM study. The prospective cardiovascular Münster
R Junker1, J Heinrich, H Schulte
1Institut für Klinische Chemie und Laboratoriumsmedizin, Westfälische Wilhelms-Universität Münster, Germany. junker@uni-muenster.de
Insights
Hypertension is linked to an impaired hemostatic balance, increasing cardiovascular risk. This study found significant differences in key hemostatic variables between hypertensive and normotensive men, highlighting a hemostatic imbalance.
Area of Science:
- Cardiovascular health
- Hemostasis and thrombosis
- Hypertension research
Background:
- Hypertensive patients exhibit elevated cardiovascular risk, potentially linked to hemostatic imbalances.
- Understanding these hemostatic alterations is crucial for managing cardiovascular risk in hypertension.
Purpose of the Study:
- To investigate the association between various hemostatic variables and blood pressure levels.
- To analyze these relationships in a cohort of apparently healthy middle-aged men.
Main Methods:
- Prospective study involving 1950 male participants aged 40-65 years.
- Measurement of blood pressure alongside key hemostatic factors: fibrinogen, factor VII, protein C, antithrombin III, PAI-1, euglobulin fibrinolytic activity, and von Willebrand factor.
- Statistical analysis including bivariate correlations and multiple logistic regression, adjusting for age and BMI.
Main Results:
- Hypertensive and borderline hypertensive men showed significantly higher levels of factor VII, PAI-1, antithrombin III, and protein C compared to normotensive men.
- Most hemostatic variables positively correlated with blood pressure, except for von Willebrand factor and euglobulin fibrinolytic activity.
- Adjustments for age and BMI altered the significance of some associations, particularly between blood pressure and factor VII/protein C.
Conclusions:
- The increased cardiovascular risk in hypertensive patients is partly attributable to a hemostatic imbalance.
- Specific hemostatic factors like PAI-1 and factor VII are implicated in the heightened risk associated with hypertension.
Background:
The greater than normal cardiovascular risk of hypertensive patients could be partly due to an impairment of hemostatic balance found in such individuals.
Objective:
To examine the relationship between hemostatic variables and blood pressures in 1950 apparently healthy male participants in the prospective cardiovascular Münster study aged 40-65 years.
Methods:
Blood pressure and other variables were determined, including fibrinogen level, coagulation factor VII clotting activity, protein C level, antithrombin III level, plasminogen activator inhibitor-1 level, euglobulin fibrinolytic activity, and von Willebrand factor level.
Results:
Age-adjusted mean values of coagulation factor VII clotting activity, plasminogen activator inhibitor-1 level, antithrombin III level, and protein C level in hypertensives and borderline hypertensives were significantly higher than those in normotensive men (e.g. for hypertensive versus normotensive men, coagulation factor VII clotting factor activity 111.5 versus 106.1%, plasminogen activator inhibitor-1 level 5.05 versus 3.22 arbitrary units/ml, and protein C level 111.1 versus 107.0%, P < 0.05-0.01). For most of the hemostatic variables we found positive bivariate correlations to blood pressure (P < or = 0.05). Exceptions were von Willebrand factor level (no correlation to blood pressure), and euglobulin fibrinolytic activity (a negative correlation to systolic blood pressure and no correlation to diastolic blood pressure). Significance persisted in the multiple logistic regression analysis with the exception of the relationships between systolic and diastolic blood pressures and fibrinogen level as well as euglobin fibrinolytic activity after adjustment for age. After adjustment for age and body mass index significance for relationships between systolic blood pressure and coagulation factor VII clotting activity as well as protein C level was also lost.
Conclusions:
We conclude that the greater than normal cardiovascular risk of hypertensive patients is partly due to an imbalance in hemostasis.