title: Association of prothrombotic status with markers of cerebral small vessel disease in elderly hypertensive patients.
abstract: BACKGROUND
  Aging and hypertension are well-known risk factors for cerebral white matter lesions. Prothrombotic status has been shown to be a risk factor for cardiovascular disease. In this study, we investigated the relationships among prothrombotic status, ambulatory blood pressure (ABP), and white matter hyperintensity (WMH) in elderly hypertensives.
  
  
  METHODS
  Measurement of prothrombin fragments 1+2 (F1+2), von Willebrand Factor (vWF) and plasminogen activator inhibitor-1 (PAI-1), ABP monitoring (ABPM), and brain magnetic resonance imaging (MRI) were performed in 514 Japanese elderly hypertensives (72.3 years old, male 37%). WMH cases were further divided into deep subcortical white matter lesion (DWML) or periventricular hyperintensity (PVH).
  
  
  RESULTS
  Deep WMH (DWMH) had significant positive correlations with age, use of antiplatelet agents, log F1+2, log vWF, log PAI-1, and 24-h systolic BP (SBP). PVH had significant positive correlations with age, male gender, smoking, use of antiplatelet agents, white coat hypertension (WCH), log vWF, and 24-h SBP. Severe PVH had significant positive correlations with age, use of antiplatelet agents, WCH, and 24-h SBP, and that was marginally correlated with log F1+2. In the logistic linear regression analysis, log F1+2 was significantly associated with DWMH (P < 0.01) and severe PVH (P < 0.05) adjusted for age and 24-h SBP. Log PAI-1 was significantly associated with DWMH (P < 0.05) adjusted for age and 24-h SBP.
  
  
  CONCLUSIONS
  In the present study, F1+2 and PAI-1 were positively associated with WMH after adjustment for 24-h SBP in elderly hypertensives. In addition to the conventional risk factors, prothrombotic status might serve as a significant determinant for WMH.
authors: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: Michiaki
authors: M
authors: Nagai
authors: Satoshi
authors: S
authors: Hoshide
authors: Kazuomi
authors: K
authors: Kario
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018660:Blood Pressure Monitoring, Ambulatory; D001921:Brain / Q000473:pathology; D059345:Cerebral Small Vessel Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D017395:Plasminogen Activator Inhibitor 1; D011498:Protein Precursors; D014841:von Willebrand Factor; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D011516:Prothrombin