The Relationship Between Thrombin Activatable Fibrinolysis Inhibitor And Essential Hypertension In The Elderly:A Case-control Study

Objective: Based on an epidemiological survey of community residents,a case-control study was conducted to investigate the relationship between serum thrombin activatable fibrinolysis inhibitor(TAFI)levels and elderly patients with essential hypertension aged 60 years and older,in order to provide evidence for the further study of hypertension and development of prevention measures.Methods: From August 2017 to October 2017,we selected community residents aged 60 years and older who participated in the Residents Health Management Engineering Physical Examination Project in Texi District Shenyang City,Liaoning Province.Those with essential hypertension were case groups,and healthy people were Control group.A total of 471 subjects were included in the study,including 223 in the hypertension group and 248 in the control group.The concentration of TAFI in serum was determined by immunoturbidimetry.Statistical analysis was performed using SPSS 20.0 and SAS 9.3.2.Univariate analysis,multivariate logistic regression model,dose-response relationship,and Spearman correlation analysis were used to explore the influencing factors of essential hypertension and the relationship with TAFI.The ROC curve was used to explore the diagnostic and predictive effects of TAFI on hypertension.Results: 1.The serum levels of TAFI in the hypertension group were lower than those in the healthy control group,and the difference was statistically significant(P=0.022).There was a statistically significant difference between the poor blood pressure control group and the healthy control group(P=0.048),and there was no significant difference between in the well controlled group(P=0.092).The level of TAFI in the serum of the male group was lower than that of the healthy control group,but there was no difference in women.2.Multivariate logistic regression models showed that higher serum concentrations may be an independent protective factor for hypertension.The level of TAFI in serum in the group of 19.79-22.96μg/ml was 0.48 times of the group of ￡ 17.38μg/ml(OR=0.48,95%CI:0.27-0.85,P=0.012).3.Spearman correlation analysis showed a negative correlation between serum TAFI concentration and hypertension and blood pressure levels,but the correlation was weak(r=-0.106,P=0.022;r=-0.104,P=0.023).4.The result of dose-response relationship was that the risk of hypertension gradually decreased with the increase of serum TAFI concentration in all,but the relationship was not statistically significant(P=0.202).However in men,the risk of developing hypertension also decreased with increasing serum levels of TAFI,and this relationship was statistically significant(P=0.034).Conclusions: 1.The results showed that the concentration of TAFI in serum of patients with hypertension was significantly lower than that of the control group.The serum concentration of TAFI in patients with poor blood pressure control was significantly lower than that of the control group.2.The concentration of TAFI in the serum of male patients with hypertension was significantly lower than that of the control group,but the difference was not significant among women.3.The risk of hypertension is gradually reduced with the level of TAFI in serum.It is suggested that TAFI in serum may protect against hypertension.