Tabak O, Gelisgen R, Uzun H, Kalender B, Balci H, Curgunlu A, Simsek G, Karter Y
Department of Internal Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey.
Clin Invest Med. 2009 Dec 1;32(6):E285. doi: 10.25011/cim.v32i6.10664.
Hypertension is one of the principal risk factors for cardiovascular disease. We aimed to evaluate the impact of hypertension on fibrinolytic balance and endothelial function by measuring plasma levels of plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator antigen (tPA), tPA/PAI-1 complex and fibrinogen.
Patients enrolled into the study were divided into four groups: 22 essential hypertensive (EH), 22 white coat hypertensive (WCH), 22 renovascular hypertensive (RH) and 22 normotensive control subjects. Plasma PAI-1, tPA, tPA/PAI-1 complex levels were measured by enzyme linked immunosorbent assays.
There was no difference in the systolic and diastolic blood pressure measurements of the EH and RH groups. The four groups were comparable for age, gender, smoking habits and BMI. Patients with EH, RH and WCH had increased plasma levels of PAI-1, tPA, tPA/PAI-1 complex and fibrinogen compared with controls. No fibrinolytic parameter was associated with blood pressure in hypretensive subjects.
This prospective study showed that fibrinolytic markers such as PAI-1, tPA, tPA/PAI-1 complex are independently associated with the development of hypertension. This supports the hypothesis that disturbances in fibrinolysis precede a cardiovascular event. Therefore, hypertension may be associated with impaired fibrinolysis.
高血压是心血管疾病的主要危险因素之一。我们旨在通过测量血浆纤溶酶原激活物抑制剂-1（PAI-1）、组织纤溶酶原激活物抗原（tPA）、tPA/PAI-1复合物和纤维蛋白原的水平，评估高血压对纤溶平衡和内皮功能的影响。
纳入研究的患者分为四组：22例原发性高血压（EH）患者、22例白大衣高血压（WCH）患者、22例肾血管性高血压（RH）患者和22例血压正常的对照者。采用酶联免疫吸附测定法测量血浆PAI-1、tPA、tPA/PAI-1复合物水平。
EH组和RH组的收缩压和舒张压测量值无差异。四组在年龄、性别、吸烟习惯和体重指数方面具有可比性。与对照组相比，EH、RH和WCH患者的血浆PAI-1、tPA、tPA/PAI-1复合物和纤维蛋白原水平升高。在高血压患者中，没有纤溶参数与血压相关。
这项前瞻性研究表明，PAI-1、tPA、tPA/PAI-1复合物等纤溶标志物与高血压的发生独立相关。这支持了纤溶功能紊乱先于心血管事件发生的假说。因此，高血压可能与纤溶功能受损有关。
