title: Platelet activation in essential hypertension during exercise: pre- and post-treatment changes with an angiotensin II receptor blocker.
abstract: BACKGROUND
  Acute exercise may exert deleterious effects on the cardiovascular system through a variety of pathophysiological mechanisms, including increased platelet activation. However, the degree of exercise-induced platelet activation in untreated hypertensive (UH) individuals as compared with normotensive (NT) individuals has yet to be established. Furthermore, the effect of antihypertensive treatment on exercise-induced platelet activation in essential hypertension (EH) remains unknown.
  
  
  METHODS
  Study 1 consisted of 30 UH and 15 NT subjects. UH subjects who received treatment were included in study 2 and were followed-up after a 3-month treatment period with an angiotensin II receptor blocker (ARB; valsartan). Circulating monocyte-platelet aggregates (MPA) and platelet P-selectin were measured as platelet activation markers at baseline, immediately after a treadmill exercise test, and 10, 30, and 90 minutes later.
  
  
  RESULTS
  Maximal platelet activation was observed at 10 minutes after peak exercise in both groups. In UH subjects, MPA levels remained increased at 30 minutes after peak exercise, despite BP fall to baseline levels. MPA levels were significantly higher in UH subjects than NT subjects at maximal exercise and at 10 and 30 minutes of recovery. Post-treatment MPA levels increased significantly only at 10 minutes into recovery and were similar to those of NT subjects.
  
  
  CONCLUSIONS
  Acute high-intensity exercise exaggerates platelet activation in untreated patients with EH compared with NT individuals. Angiotensin II receptor blockade with adequate BP control greatly improves exercise-induced platelet activation in EH. Further studies are needed to clarify whether this phenomenon depends purely on BP lowering or benefits also from the pleiotropic effects of ARBs.
authors: 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors: Eugenia
authors: E
authors: Gkaliagkousi
authors: Eleni
authors: E
authors: Gavriilaki
authors: Efi
authors: E
authors: Yiannaki
authors: Dimitra
authors: D
authors: Markala
authors: Nikolaos
authors: N
authors: Papadopoulos
authors: Areti
authors: A
authors: Triantafyllou
authors: Panagiota
authors: P
authors: Anyfanti
authors: Konstantinos
authors: K
authors: Petidis
authors: Vasileia
authors: V
authors: Garypidou
authors: Michael
authors: M
authors: Doumas
authors: Albert
authors: A
authors: Ferro
authors: Stella
authors: S
authors: Douma
mesh_terms: D000328:Adult; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D059168:Carotid Intima-Media Thickness; D000075222:Essential Hypertension; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects*; D013777:Tetrazoles / Q000627:therapeutic use*; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine
keywords: P-selectin; blood pressure; essential hypertension; exercise; hypertension; monocyte-platelet aggregates; platelet activation.