Platelet Hyperactivity in Hypertensive Older Patients Is Controlled by Lowering Blood Pressure
1999
OBJECTIVE
Patients with hypertension tend to have a high prevalence of atherothrombotic accidents. Platelet hyperactivity is frequently associated with hypertension. Because the vascular disease associated with hypertension evolves over the years, we investigated platelet activity parameters in a population of older hypertensive patients with no other risk factors for cardiovascular disease.
PARTICIPANTS
We studied 34 older, nonsmoking patients (mean age 74 ± 5 years) with uncomplicated hypertension before and after the normalization of blood pressure (BP) was achieved with the angiotensin-converting enzyme inhibitor quinapril alone or in combination with the Ca2+ antagonist nifedipine.
MEASUREMENTS
Platelet aggregation, P-selectin (CD62) expression on the platelet surface, serum levels of Interleukin-1β (IL-1β) and of Interleukin-6 (IL-6), as well as plasma levels of soluble P-selectin and Endothelin-1 (ET-1), were analyzed.
RESULTS
All platelet hyperactivity parameters were reduced significantly with the normalization of BP at the end of antihypertensive drug treatment (systolic/diastolic: 186.2 ± 2.7/103.4 ± 1.1 mm Hg vs 135.0 ± 1.3/85.9 ± 1.9 mm Hg; P < .001). Those factors more strictly associated with endothelium injury, such as ET-1 and IL-6, did not show variations. A significant correlation (Spearman Rank test) was observed among all platelet function parameters and blood pressure values.
CONCLUSIONS
This study demonstrated that even in a population of older hypertensive patients with no other risk factor for atherogenic disease, normalization of blood pressure induces a significant reduction of the parameters of enhanced platelet hyperactivity independent of the action exerted, at the platelet level, by the antihypertensive drugs.
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