title: Long-term angiotensin-converting enzyme inhibition with ramipril reduces thrombin generation in human hypertension.
abstract: Antihypertensive treatment reduces the risk of thromboembolic events in hypertension. The aim of this study was to examine the influence of angiotensin-converting enzyme inhibition on blood coagulation in subjects with mild-to-moderate essential hypertension. Fibrinogen, thrombin-antithrombin complex (TAT) and Factor VII were determined in plasma at rest and after a mental stress test following placebo for 6 weeks, or ramipril for 6 weeks or 6 months. Ramipril reduced resting TAT, and tended to reduce fibrinogen; Factor VII remained unchanged. Mental stress increased fibrinogen, but did not alter TAT or Factor VII activity. The reduced thrombin generation in patients taking ramipril may explain in part why angiotensin-converting enzyme inhibitors reduce thromboembolic complications in patients with cardiovascular disease.
authors.affiliation: Section of Cardiology, Division of Internal Medicine, Karolinska Institutet, Danderyd Hospital, S-182 88 Stockholm, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Ekholm
authors.forename: N Håkan
authors.initials: NH
authors.lastname: Wallén
authors.forename: Hans
authors.initials: H
authors.lastname: Johnsson
authors.forename: Keith
authors.initials: K
authors.lastname: Eliasson
authors.forename: Thomas
authors.initials: T
authors.lastname: Kahan
mesh_terms: D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D000991:Antithrombins / Q000032:analysis / Q000378:metabolism; D001777:Blood Coagulation / Q000187:drug effects; D005167:Factor VII / Q000032:analysis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000494:pharmacology* / Q000627:therapeutic use; D013315:Stress, Psychological / Q000097:blood; D013917:Thrombin / Q000032:analysis / Q000378:metabolism*; D013997:Time Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000991:Antithrombins; D005167:Factor VII; D005340:Fibrinogen; D013917:Thrombin; D017257:Ramipril