Yilmaz Hakki, Cakmak Muzaffer, Inan Osman, Darcin Tahir, Aktas Aynur, Gurel Ozgul Malcok, Bilgic Mukadder Ayse, Bavbek Nuket, Akcay Ali
a Department of Internal Medicine, Section of Nephrology , Dr. A. Y. Ankara Oncology Training and Research Hospital , Ankara , Turkey .
b Department of Internal Medicine , Turgut Ozal University, School of Medicine , Ankara , Turkey .
Ren Fail. 2015;37(9):1409-13. doi: 10.3109/0886022X.2015.1074472. Epub 2015 Sep 3.
Increased arterial stiffness is strongly associated with cardiovascular diseases, while thrombotic events are more common than hemorrhagic events in hypertensive patients. Markers of a hypercoagulable state may also predict future cardiovascular events in hypertensive patients. Here, we speculated that increased arterial stiffness might lead to the development of a hypercoagulable state that can play a role in the thrombotic complications of hypertension. Soluble endothelial protein C receptor (sEPCR) is one such marker of hypercoagulation. The ambulatory arterial stiffness index (AASI) could be accepted as a non-invasive measure of arterial stiffness. The aim of this study was to investigate association of AASI with levels of sEPCR in newly diagnosed hypertensive patients.
The study included 263 newly diagnosed essential hypertensive patients and 55 healthy normotensive controls. All subjects underwent 24 h ambulatory blood pressure monitoring (ABPM); the AASI was derived from ABPM tracings. Plasma sEPCR was measured by ELISA.
Hypertensive patients (n = 263) had higher AASI, C-reactive protein (CRP) and sEPCR versus the normotensive healthy group (n = 55). Univariate analysis showed that AASI was positively associated with age (r = 0.212, p < 0.001) body mass index (r = 0.412, p < 0.001), pulse pressure (r = 0.350, p < 0.001), plasma sEPCR (r = 0.894, p < 0.001), 24-h heart rate (r = 0.176, p = 0.001) and inversely related to high-density lipoprotein (HDL) (r = -0.293, p < 0.001). Multivariate analyses revealed that sEPCR and HDL are independently correlated to AASI.
We suggest that increased AASI is associated with elevated sEPCR. It might be responsible for subsequent thrombotic events in newly diagnosed hypertensive patients.
动脉僵硬度增加与心血管疾病密切相关，而在高血压患者中，血栓形成事件比出血事件更为常见。高凝状态标志物也可能预测高血压患者未来的心血管事件。在此，我们推测动脉僵硬度增加可能导致高凝状态的发展，而这种状态可能在高血压的血栓形成并发症中起作用。可溶性内皮蛋白C受体（sEPCR）就是这样一种高凝标志物。动态动脉僵硬度指数（AASI）可作为一种无创的动脉僵硬度测量方法。本研究的目的是调查新诊断高血压患者中AASI与sEPCR水平之间的关联。
本研究纳入了263例新诊断的原发性高血压患者和55例血压正常的健康对照者。所有受试者均接受了24小时动态血压监测（ABPM）；AASI由ABPM记录得出。采用酶联免疫吸附测定法（ELISA）检测血浆sEPCR。
高血压患者（n = 263）的AASI、C反应蛋白（CRP）和sEPCR均高于血压正常的健康组（n = 55）。单因素分析显示，AASI与年龄（r = 0.212，p < 0.001）、体重指数（r = 0.412，p < 0.001）、脉压（r = 0.350，p < 0.001）、血浆sEPCR（r = 0.894，p < 0.001）、24小时心率（r = 0.176，p = 0.001）呈正相关，与高密度脂蛋白（HDL）呈负相关（r = -0.293，p < 0.001）。多因素分析显示，sEPCR和HDL与AASI独立相关。
我们认为AASI升高与sEPCR升高有关。它可能是新诊断高血压患者随后发生血栓形成事件的原因。
