Varughese George I, Lip Gregory Y H
Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
Curr Hypertens Rep. 2005 Jun;7(3):168-73. doi: 10.1007/s11906-005-0005-4.
Hypertension is complicated by thrombosis-related events (such as myocardial infarction and stroke), and despite the high vascular pressures, these thrombotic occlusive events paradoxically occur more often than hemorrhagic episodes. The predisposition for thrombogenesis is increased in hypertension, which leads to changes in the platelets, endothelium, and matrix metalloproteinases and their inhibitors, as well as the coagulation and fibrinolytic pathways, which help promote the induction and the maintenance of this prothrombotic or hypercoagulable state. Other cardiovascular diseases, such as atrial fibrillation, congestive heart failure, and left ventricular hypertrophy, which may occur as a result of untreated hypertension, can also activate the prothrombotic state. These changes can, to a certain degree, be reversed by the treatment of hypertension, although the effects may be inconsistent. The evidence for antithrombotic therapy is less consistent, but in "high risk" hypertensive patients, antiplatelet therapy is useful.
高血压常并发与血栓形成相关的事件（如心肌梗死和中风），尽管血管压力很高，但这些血栓闭塞性事件比出血性事件更常发生，这一现象看似矛盾。高血压会增加血栓形成的易感性，导致血小板、内皮细胞、基质金属蛋白酶及其抑制剂发生变化，同时也会影响凝血和纤维蛋白溶解途径，这些变化有助于促进这种血栓前状态或高凝状态的诱导和维持。其他心血管疾病，如心房颤动、充血性心力衰竭和左心室肥厚，可能是未治疗的高血压导致的，也会激活血栓前状态。尽管治疗效果可能不一致，但通过治疗高血压，这些变化在一定程度上可以得到逆转。抗血栓治疗的证据不太一致，但在“高危”高血压患者中，抗血小板治疗是有效的。
