Association of ambulatory arterial stiffness index with sEPCR in newly diagnosed hypertensive patients.
OBJECTIVE
Increased arterial stiffness is strongly associated with cardiovascular diseases, while thrombotic events are more common than hemorrhagic events in hypertensive patients. Markers of a hypercoagulable state may also predict future cardiovascular events in hypertensive patients. Here, we speculated that increased arterial stiffness might lead to the development of a hypercoagulable state that can play a role in the thrombotic complications of hypertension. Soluble endothelial protein C receptor (sEPCR) is one such marker of hypercoagulation. The ambulatory arterial stiffness index (AASI) could be accepted as a non-invasive measure of arterial stiffness. The aim of this study was to investigate association of AASI with levels of sEPCR in newly diagnosed hypertensive patients.


METHODS
The study included 263 newly diagnosed essential hypertensive patients and 55 healthy normotensive controls. All subjects underwent 24 h ambulatory blood pressure monitoring (ABPM); the AASI was derived from ABPM tracings. Plasma sEPCR was measured by ELISA.


RESULTS
Hypertensive patients (n = 263) had higher AASI, C-reactive protein (CRP) and sEPCR versus the normotensive healthy group (n = 55). Univariate analysis showed that AASI was positively associated with age (r = 0.212, p <  0.001) body mass index (r = 0.412, p < 0.001), pulse pressure (r = 0.350, p < 0.001), plasma sEPCR (r = 0.894, p < 0.001), 24-h heart rate (r = 0.176, p = 0.001) and inversely related to high-density lipoprotein (HDL) (r = -0.293, p < 0.001). Multivariate analyses revealed that sEPCR and HDL are independently correlated to AASI.


CONCLUSIONS
We suggest that increased AASI is associated with elevated sEPCR. It might be responsible for subsequent thrombotic events in newly diagnosed hypertensive patients.
a Department of Internal Medicine, Section of Nephrology , Dr. A. Y. Ankara Oncology Training and Research Hospital , Ankara , Turkey .
Hakki
H
Yilmaz
b Department of Internal Medicine , Turgut Ozal University, School of Medicine , Ankara , Turkey .
Muzaffer
M
Cakmak
c Department of Internal Medicine , Yenimahalle Training and Research Hospital , Ankara , Turkey .
Osman
O
Inan
d Department of Internal Medicine , Agri State Hospital , Agri , Turkey .
Tahir
T
Darcin
e Department of Internal Medicine, Section of Endocrinology , Dr. A. Y. Ankara Oncology Training and Research Hospital , Ankara , Turkey .
Aynur
A
Aktas
f Department of Cardiology , Turgut Ozal University, School of Medicine , Ankara , Turkey , and.
Ozgul Malcok
OM
Gurel
g Department of Internal Medicine, Section of Nephrology , Turgut Ozal University, School of Medicine , Ankara , Turkey.
Mukadder Ayse
MA
Bilgic
g Department of Internal Medicine, Section of Nephrology , Turgut Ozal University, School of Medicine , Ankara , Turkey.
Nuket
N
Bavbek
g Department of Internal Medicine, Section of Nephrology , Turgut Ozal University, School of Medicine , Ankara , Turkey.
Ali
A
Akcay
D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D000074283:Endothelial Protein C Receptor; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D016014:Linear Models; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011956:Receptors, Cell Surface / Q000097:blood*; D059289:Vascular Stiffness / Q000502:physiology*
D015703:Antigens, CD; D015415:Biomarkers; D000074283:Endothelial Protein C Receptor; D008075:Lipoproteins, HDL; C478370:PROCR protein, human; D011956:Receptors, Cell Surface; D002097:C-Reactive Protein
Ambulatory arterial stiffness index; arterial stiffness; hypertension; sEPCR; thrombosis