Junker R, Heinrich J, Schulte H, Erren M, Assmann G
Institut für Klinische Chemie und Laboratoriumsmedizin, Westfälische Wilhelms-Universität Münster, Germany.
J Hypertens. 1998 Jul;16(7):917-23. doi: 10.1097/00004872-199816070-00004.
The greater than normal cardiovascular risk of hypertensive patients could be partly due to an impairment of hemostatic balance found in such individuals.
To examine the relationship between hemostatic variables and blood pressures in 1950 apparently healthy male participants in the prospective cardiovascular Münster study aged 40-65 years.
Blood pressure and other variables were determined, including fibrinogen level, coagulation factor VII clotting activity, protein C level, antithrombin III level, plasminogen activator inhibitor-1 level, euglobulin fibrinolytic activity, and von Willebrand factor level.
Age-adjusted mean values of coagulation factor VII clotting activity, plasminogen activator inhibitor-1 level, antithrombin III level, and protein C level in hypertensives and borderline hypertensives were significantly higher than those in normotensive men (e.g. for hypertensive versus normotensive men, coagulation factor VII clotting factor activity 111.5 versus 106.1%, plasminogen activator inhibitor-1 level 5.05 versus 3.22 arbitrary units/ml, and protein C level 111.1 versus 107.0%, P < 0.05-0.01). For most of the hemostatic variables we found positive bivariate correlations to blood pressure (P < or = 0.05). Exceptions were von Willebrand factor level (no correlation to blood pressure), and euglobulin fibrinolytic activity (a negative correlation to systolic blood pressure and no correlation to diastolic blood pressure). Significance persisted in the multiple logistic regression analysis with the exception of the relationships between systolic and diastolic blood pressures and fibrinogen level as well as euglobin fibrinolytic activity after adjustment for age. After adjustment for age and body mass index significance for relationships between systolic blood pressure and coagulation factor VII clotting activity as well as protein C level was also lost.
We conclude that the greater than normal cardiovascular risk of hypertensive patients is partly due to an imbalance in hemostasis.
高血压患者心血管风险高于正常水平，部分原因可能是这类个体存在止血平衡受损的情况。
在1950名年龄在40 - 65岁的明斯特前瞻性心血管研究中表面健康的男性参与者中，研究止血变量与血压之间的关系。
测定血压及其他变量，包括纤维蛋白原水平、凝血因子VII凝血活性、蛋白C水平、抗凝血酶III水平、纤溶酶原激活物抑制剂-1水平、优球蛋白溶解活性和血管性血友病因子水平。
高血压患者和临界高血压患者中，凝血因子VII凝血活性、纤溶酶原激活物抑制剂-1水平、抗凝血酶III水平和蛋白C水平经年龄调整后的平均值显著高于血压正常的男性（例如，高血压男性与血压正常男性相比，凝血因子VII凝血因子活性分别为111.5%和106.1%，纤溶酶原激活物抑制剂-1水平分别为5.05和3.22任意单位/毫升，蛋白C水平分别为111.1%和107.0%，P < 0.05 - 0.01）。对于大多数止血变量，我们发现其与血压呈正相关二元关系（P ≤ 0.05）。例外情况是血管性血友病因子水平（与血压无相关性）和优球蛋白溶解活性（与收缩压呈负相关，与舒张压无相关性）。在多因素逻辑回归分析中，除年龄调整后收缩压和舒张压与纤维蛋白原水平以及优球蛋白溶解活性之间的关系外，其他关系的显著性依然存在。在调整年龄和体重指数后，收缩压与凝血因子VII凝血活性以及蛋白C水平之间关系的显著性也消失了。
我们得出结论，高血压患者心血管风险高于正常水平部分归因于止血失衡。
