Kassa Mitku, Gelaw Yemataw, Arkew Mesay, Asmerom Haftu, Gemechu Kabtamu, Shiferaw Elias
Department of Medical Laboratory Sciences, Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia.
Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2025 Aug 12;20(8):e0329022. doi: 10.1371/journal.pone.0329022. eCollection 2025.
Hypertension is a global public health problem and associated with metabolic, cellular, and blood disturbances. Hematological and hemostatic disturbance have been documented in individuals with hypertension, playing a pivotal role in hypertension associated vascular complications. Despite this, there is a scarcity of evidence and reports regarding the coagulation profiles are contradicting among hypertensive patients. Thus, this study aimed to compare the platelet count and coagulation profiles of adult hypertensive patients with those of normotensive controls at Felege Hiwot Comprehensive Specialized Hospital in Northwest Ethiopia, from June to August, 2023.
A comparative cross-sectional study was conducted among a total of 180 study participants (120 hypertensive patients and 60 healthy individuals) recruited by consecutive sampling technique. Socio-demographic, clinical and anthropometric data were collected using structured questionnaires and checklist. A total of six milliliters of venous blood (3 ml in EDTA tube and 3 mL in citrate tube) was collected for platelet count and coagulation profile determination. Platelet count and coagulation profile were determined using Uni Cel DxH800 hematology analyzer and Huma cue due plus coagulation analyzer, respectively. One-way ANOVA, Kruskal Wallis test, and correlation analysis was used during data analysis. A p-value of <0.05 was considered statistically significant.
In the present study, the median (interquartile range) age was 42.5 (36.0-50.0) years for newly diagnosed, 50.0 (45.0-65.0) years for treatment and 40.0 (35.0-45.7) years for the control group (P < 0.001). The overall hemostatic abnormality in hypertensive patient was 83 (69.2%), and significant difference was found in the median of activated partial thromboplastin time, prothrombin time and international normalized ratio between hypertensive patients as compared to control. Statistically significant difference was observed in the median (interquartile range) of activated partial thromboplastin time (P = 0.041), prothrombin time (P < 0.001), and international normalized ratio (P < 0.001) results between newly diagnosed hypertensive patients and healthy controls. Moreover, there was also a significant difference in activated partial thromboplastin time (P = 0.020), prothrombin time (P = 0.011), and international normalized ratio (P = 0.012) results between hypertensive patients undergoing treatment and healthy controls.
Hemostatic abnormality was observed in majority of hypertensive patients. Compered to healthy controls, the median values of activated partial thromboplastin time, prothrombin time and international normalized ratio were significantly higher in hypertensive patients. This finding highlights the importance of assessing coagulation parameters in hypertensive patients in order to prevent complications related to abnormal blood clotting. However, further longitudinal studies are necessary to gain better understanding of the changes in coagulation observed in hypertensive patients.
高血压是一个全球性的公共卫生问题，与代谢、细胞和血液紊乱相关。高血压患者存在血液学和止血功能紊乱，在高血压相关血管并发症中起关键作用。尽管如此，关于高血压患者凝血指标的证据稀缺，且报告相互矛盾。因此，本研究旨在比较2023年6月至8月在埃塞俄比亚西北部费莱格·希沃特综合专科医院成年高血压患者与血压正常对照组的血小板计数和凝血指标。
采用连续抽样技术招募了总共180名研究参与者（120名高血压患者和60名健康个体）进行比较横断面研究。使用结构化问卷和检查表收集社会人口统计学、临床和人体测量数据。总共采集6毫升静脉血（3毫升置于乙二胺四乙酸管中，3毫升置于柠檬酸盐管中）用于血小板计数和凝血指标测定。分别使用Uni Cel DxH800血液分析仪和Huma cue due plus凝血分析仪测定血小板计数和凝血指标。数据分析采用单因素方差分析、Kruskal Wallis检验和相关性分析。p值<0.05被认为具有统计学意义。
在本研究中，新诊断患者的年龄中位数（四分位间距）为42.5（36.0 - 50.0）岁，治疗患者为50.0（45.0 - 65.0）岁，对照组为40.0（35.0 - 45.7）岁（P < 0.001）。高血压患者的总体止血异常率为83（69.2%），与对照组相比，高血压患者活化部分凝血活酶时间、凝血酶原时间和国际标准化比值的中位数存在显著差异。新诊断高血压患者与健康对照组之间，活化部分凝血活酶时间（P = 0.041）、凝血酶原时间（P < 0.001）和国际标准化比值（P < 0.001）结果的中位数（四分位间距）存在统计学显著差异。此外，接受治疗的高血压患者与健康对照组之间，活化部分凝血活酶时间（P = 0.020）、凝血酶原时间（P = 0.011）和国际标准化比值（P = 0.012）结果也存在显著差异。
大多数高血压患者存在止血异常。与健康对照组相比，高血压患者活化部分凝血活酶时间、凝血酶原时间和国际标准化比值的中位数显著更高。这一发现凸显了评估高血压患者凝血参数以预防与异常凝血相关并发症的重要性。然而，需要进一步的纵向研究以更好地了解高血压患者凝血变化情况。
