| Background and Objective: Despite high arterial pressure in patients with essential hypertension, hypertension with thromboembolic disease was more than hemorrhagic disease. That phenomenon may be relevant to prothrombotic state that was conferred by hypertension just as varying results have been reported. Abnormalities in the coagulation and fibrinolytic pathways, as well as in platelets and the endothelium may play an important role in that phenomenon. The objective of this study was to confirm the prothrombotic state exsiting in hypertension and then investigate the mechanism of hypertension leading to thromboembolic disease by examining the marker of prothrombotic state such as abnormalities in the coagulation and fibrinolytic pathways, as well as in platelets. Methods: Eighty-one inpatients were enrolled in this study. All the patients with hypertension according to their blood pressure readings were divided into the following groups: grade 1, 2, 3 and the normotensives represented the control group. The percentages of CD62P+ and CD61+ platelets of all patients were determined by flow cytometry. Blood platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), the plasma concentrations of fibrinogen (FG), activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) were also measured. Measurement of demographic data was expressed by the form of mean±SD (±s). Differences between group means were evaluated with t tests (continuous variables) or chi-square analyses (categorical variables). Significance was defined as P <0.05. Results: (1) The percentages of CD62P+ platelets were (60.82±9.74)% and (47.84±10.01)% in hypertension group and in control group respectively (P<0.001); the value of PLT were (239.6±62.4)×109/L and (167.2±42.5)×109/L in hypertension group and in control group respectively (P<0.05); the concentration of FG were (2.91±0.60)g/l and (2.61±0.35)g/l in hypertension group and in control group respectively (P<0.05); the Value of MPV, PDW, PT, APTT and TT were (8.37±2.00)fl, (16.82±1.65)%, (12.20±1.62)s, (32.44±3.73)s and (23.99±3.54)s in hypertension group respectively and that were (9.95±2.04)fl, (18.07±1.15)%, (13.30±2.52)s, (35.20±3.64)s and (26.00±4.66)s in control group. There were significant difference between these parameters in hypertension group and control group (P<0.05). The percentages of CD61+ platelets were (89.52±4.02)% and (88.69±6.21)% in hypertension group and in control group respectively and there were no significant differences(P=0.47). (2) The percentages of CD62P+ platelets: (52.14±6.80)% in hypertension grade 1, (61.23±5.68)% in hypertension grade 2, (67.87±8.68)% in hypertension grade 3, (47.84±10.01)% in control group. There were no significant differences between hypertension grade 1 and control group (P=0.114) and there were significant differences among the other groups (P<0.05).The percentages of CD62P+ platelets increases with the grade of hypertension. The percentages of CD61+ platelets: (89.32±2.45)% in hypertension grade 1, (88.64±4.76)% in hypertension grade 2, (90.35±4.47)% in hypertension grade 3, (88.69±6.21)% in control group. There were no significant differences between all the groups (P>0.05). The value of PLT: (209.17±63.72)×109/L in hypertension grade 1, (240.38±42.97)×109/L in hypertension grade 2, (271.59±58.24)×109/L in hypertension grade 3, and (167.2±42.5)×109/L in control group. There were no significant differences between hypertension grade 2 and grade 3 (P=0.065) and there were significant differences between any other two groups (P<0.05).The value of PLT increases with the grade of hypertension. The value of MPV: (10.02±1.99)fl in hypertension grade 1, (7.65±1.21)fl in hypertension grade 2, (7.58±1.64)fl in hypertension grade 3, (9.95±2.04)fl in control group. There were no significant differences between hypertension grade 1 and control group (P=0.90) and there were no significant differences between hypertension grade 2 and grade 3(P=0.857). There were significant differences between any other two groups (P<0.05). The value of MPV decreases with the grade of hypertension. The value of PDW: (17.85±1.76)% in hypertension grade 1, (16.59±0.49)% in hypertension grade 2, (16.15±1.78)% in hypertension grade 3, (18.07±1.15)% in control group. There were no significant differences between hypertension grade 2 and grade 3 (P=0.47) and there were significant differences any other two groups (P<0.05). The value of PDW decreases with the grade of hypertension. The value of FG: (2.45±0.47)g/l in hypertension grade 1, (2.58±0.37)g/l in hypertension grade 2, (3.36±0.51)g/l in hypertension grade 3, and (2.61±0.35)g/l in control group. There were no significant differences between hypertension grade 1 and control group (P=0.224) and there were no significant differences between hypertension grade 1 and grade 2 (P=0.079). There were significant differences between any other two groups (P<0.05). The value of FG increases with the grade of hypertension. The value of PT: (13.59±1.18)s in hypertension grade 1, (11.98±1.23)s in hypertension grade 2, (11.18±1.43)s in hypertension grade 3, (13.30±2.52)s in control group. There were no significant differences between hypertension grade 1 and control group (P=0.462) and there were significant differences between any other two groups (P<0.05). The value of PT decreases with the grade of hypertension. The value of APTT: (34.83±2.99)s in hypertension grade 1, (32.13±2.45)s in hypertension grade 2, (30.65±4.15)s in hypertension grade 3, (35.20±3.64)s in control group. There were no significant differences between hypertension grade 1 and control group (P=0.76) and there were no significant differences between hypertension grade 3 and grade 2 (P=0.188). There were significant differences between any other two groups (P<0.05). The value of APTT decreases with the grade of hypertension. The value of TT: (25.79±2.87)s in hypertension grade 1, (23.74±3.61)s in hypertension grade 2, (22.67±3.84)s in hypertension grade 3, (26.00±4.66)s in control group. There were no significant differences among hypertension grade 1, grade 2 and control group (P=0.168) and there were no significant differences between hypertension grade 2 and grade 3 (P=0.39). There were significant differences between any other two groups (P<0.05). The value of TT decreases with the grade of hypertension. Conclusion: The percentages of CD62P+ platelets increase significantly in patients with hypertension. The value of PLT and FG also increase significantly in patients with hypertension. The value of MPV, PDW, APTT, PT and TT decreases significantly in patients with hypertension. And the differences are more and more significant with the increase of hypertension grade. |
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