Determinants of platelet activation in human essential hypertension.
Experimental data suggest that oxidative stress might be enhanced in hypertension and contribute to platelet activation. We hypothesized that both oxidative stress and platelet activation could be related to the clinical characteristics of hypertensive patients. The urinary excretion of 11-dehydrothromboxane (TX) B2, reflecting in vivo platelet activation, was measured in 75 patients with mild to severe essential hypertension and 75 pair-matched, healthy controls. The urinary excretion of 8-iso-prostaglandin (PG) F2alpha was determined as an index of in vivo lipid peroxidation. Urinary 11-dehydro-TXB2 was significantly higher in essential hypertensives compared with controls. Although no statistically significant difference in urinary 8-iso-PGF2alpha was observed between patients and controls, plasma vitamin C was lower and plasma homocysteine higher in hypertensive patients than in controls. Both urinary 11-dehydro-TXB2 and 8-iso-PGF2alpha were higher in patients with advanced hypertensive retinopathy compared with patients without retinopathy. Multivariate linear regression analysis identified urinary 8-iso-PGF2alpha, plasma fibrinogen, homocysteine, and vitamin E as the only variables independently correlated with urinary 11-dehydro-TXB2. Logistic regression analysis showed that high urinary 8-iso-PGF2alpha, plasma fibrinogen, and homocysteine, as well as low plasma vitamin E, advanced retinopathy, elevated diastolic blood pressure, and the absence of antihypertensive treatment, were predictors of high urinary 11-dehydro-TXB2. We demonstrated increased oxidative stress and persistent platelet activation in essential hypertensives with advanced vascular lesions. These findings might help identify hypertensive patients who are at increased risk of cardiovascular events and who might benefit from long-term antiplatelet therapy.
Minuz
Pietro
P
Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy. pietro.minuz@univr.it
Patrignani
Paola
P
Gaino
Stefania
S
Seta
Francesca
F
Capone
Marta L
ML
Tacconelli
Stefania
S
Degan
Maurizio
M
Faccini
Giovanni
G
Fornasiero
Anna
A
Talamini
Giorgio
G
Tommasoli
Rosamaria
R
Arosio
Enrico
E
Santonastaso
Clara Lechi
CL
Lechi
Alessandro
A
Patrono
Carlo
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D015237:Dinoprost / Q000031:analogs & derivatives*; D028441:F2-Isoprostanes / Q000652:urine; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis / Q000652:urine; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D015539:Platelet Activation; D013929:Thromboxane B2 / Q000031:analogs & derivatives* / Q000652:urine
D028441:F2-Isoprostanes; C075750:8-epi-prostaglandin F2alpha; D013929:Thromboxane B2; C049235:11-dehydro-thromboxane B2; D015237:Dinoprost