Long-term angiotensin-converting enzyme inhibition with ramipril reduces thrombin generation in human hypertension.
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.
Ekholm
Mikael
M
Section of Cardiology, Division of Internal Medicine, Karolinska Institutet, Danderyd Hospital, S-182 88 Stockholm, Sweden.
Wallén
N Håkan
NH
Johnsson
Hans
H
Eliasson
Keith
K
Kahan
Thomas
T
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
D000806:Angiotensin-Converting Enzyme Inhibitors; D000991:Antithrombins; D005167:Factor VII; D005340:Fibrinogen; D013917:Thrombin; D017257:Ramipril