Decreased fibrinolytic activity is associated with carotid artery stiffening in arterial hypertension
Abstract
Background: A prothrombotic state is associated with the presence and severity of organ damage in hypertensive patients. In these
patients, evidence of subclinical carotid functional changes anticipates major cardiovascular events. The aim of this study was to
investigate the association of hemostatic markers with carotid artery stiffness in hypertension. Materials and Methods: In 116
untreated essential hypertensive patients recruited at a referral center in the University of Udine, we assessed common carotid artery
stiffness by B?mode ultrasonography and measured plasma fibrinogen, D?dimer, plasminogen activator inhibitor?1 (PAI?1), and
homocysteine by the currently available methods. For statistical reasons, the patients were divided according to the median value of
each index of carotid stiffness, and continuous variables were further analyzed by univariate correlation and stepwise multivariate
regression analysis. Results: PAI?1 levels were significantly higher in patients with low coefficient of distensibility (P = 0.018) and
high Young’s elastic modulus (P = 0.012), whereas no association of fibrinogen, D?dimer, and homocysteine levels was observed with
carotid coefficient of distensibility, Young’s elastic modulus, and ??stiffness. On univariate analysis, Young’s elastic modulus was
significantly and positively correlated with PAI?1 levels (r = 0.286, P = 0.002), a correlation that on multivariate regression resulted
to be independent of other confounders (? = 0.289, P = 0.028). Conclusion: An independent association of plasma PAI?1 levels
with carotid artery stiffness suggests a possible contribution of decreased fibrinolytic activity to the early functional abnormalities
of arterial vessels in hypertensive patients. This contribution might be relevant for subsequent development of hypertension?related
cardiovascular complications.
patients, evidence of subclinical carotid functional changes anticipates major cardiovascular events. The aim of this study was to
investigate the association of hemostatic markers with carotid artery stiffness in hypertension. Materials and Methods: In 116
untreated essential hypertensive patients recruited at a referral center in the University of Udine, we assessed common carotid artery
stiffness by B?mode ultrasonography and measured plasma fibrinogen, D?dimer, plasminogen activator inhibitor?1 (PAI?1), and
homocysteine by the currently available methods. For statistical reasons, the patients were divided according to the median value of
each index of carotid stiffness, and continuous variables were further analyzed by univariate correlation and stepwise multivariate
regression analysis. Results: PAI?1 levels were significantly higher in patients with low coefficient of distensibility (P = 0.018) and
high Young’s elastic modulus (P = 0.012), whereas no association of fibrinogen, D?dimer, and homocysteine levels was observed with
carotid coefficient of distensibility, Young’s elastic modulus, and ??stiffness. On univariate analysis, Young’s elastic modulus was
significantly and positively correlated with PAI?1 levels (r = 0.286, P = 0.002), a correlation that on multivariate regression resulted
to be independent of other confounders (? = 0.289, P = 0.028). Conclusion: An independent association of plasma PAI?1 levels
with carotid artery stiffness suggests a possible contribution of decreased fibrinolytic activity to the early functional abnormalities
of arterial vessels in hypertensive patients. This contribution might be relevant for subsequent development of hypertension?related
cardiovascular complications.
Keywords
Beta stiffness, carotid artery, fibrinolysis, plasminogen activator inhibitor?1, primary hypertension, Young’s elastic modulus