Centre of Excellence for Nutrition (CEN).
Hypertension in Africa Research Team (HART), Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
J Hypertens. 2019 Dec;37(12):2361-2370. doi: 10.1097/HJH.0000000000002204.
Plasminogen activator inhibitor-1 (PAI-1) has consistently shown positive associations with blood pressure (BP). Whether elevations in PAI-1 levels precede or result from raised BP is still under debate and data on prospective studies are limited. Hence, we investigated the prospective associations of PAI-1 and the 4G/5G polymorphism with brachial and central BP and pulse pressure (PP) over a 10-year period.
Black South Africans aged 30 years and older were included. Baseline data collection commenced in 2005 (n = 2010) with follow-up data collection in 2010 (n = 1288) and 2015 (n = 926). Plasma PAI-1 activity (PAI-1act), 4G/5G polymorphism genotyping, waist circumference and BP measurements were performed and analysed using sequential regression and mixed models.
In multivariable adjusted analyses, PAI-1act and the 4G/4G (vs. the 5G/5G) genotype increased the odds of developing hypertension in the total group [1.04 (1.01; 1.08) and 1.82 (1.07; 3.12) respectively]. Furthermore, PAI-1act was prospectively associated with brachial SBP (r = 0.0815) and PP (r = 0.0832) in the total group, and with central PP in women (r = 0.1125; all P < 0.05). Addition of waist circumference to the models either decreased or nullified the contribution of PAI-1act to BP and hypertension development.
PAI-1act and the 4G/4G (vs. the 5G/5G) genotype increased the odds of developing hypertension. Furthermore, PAI-1act associated prospectively with both brachial and central BP. These associations were mediated in part by central adiposity. The study supports the hypothesis that PAI-1 also contributes to hypertension development rather than solely being a consequence thereof.
纤溶酶原激活物抑制剂-1（PAI-1）与血压（BP）一直呈正相关。PAI-1 水平升高是先于还是后于血压升高仍存在争议，前瞻性研究的数据有限。因此，我们在 10 年内研究了 PAI-1 与 4G/5G 多态性与肱动脉和中心血压以及脉搏压（PP）的前瞻性关联。
纳入南非黑人年龄在 30 岁及以上者。基线数据收集于 2005 年开始（n=2010），2010 年（n=1288）和 2015 年（n=926）进行了随访数据收集。进行了血浆 PAI-1 活性（PAI-1act）、4G/5G 多态性基因分型、腰围和血压测量，并使用逐步回归和混合模型进行了分析。
在多变量调整分析中，PAI-1act 和 4G/4G（与 5G/5G 相比）基因型增加了总体人群患高血压的几率[1.04（1.01；1.08）和 1.82（1.07；3.12）]。此外，PAI-1act 与总体人群的肱动脉 SBP（r=0.0815）和 PP（r=0.0832）以及女性的中心 PP 呈前瞻性相关（r=0.1125；所有 P<0.05）。将腰围纳入模型会降低或消除 PAI-1act 对血压和高血压发展的贡献。
PAI-1act 和 4G/4G（与 5G/5G 相比）基因型增加了患高血压的几率。此外，PAI-1act 与肱动脉和中心血压呈前瞻性相关。这些关联部分由中心肥胖介导。该研究支持了这样一种假设，即 PAI-1 也有助于高血压的发展，而不仅仅是其结果。
