TY - JOUR
T1 - The prothrombotic state in hypertension and the effects of antihypertensive treatment
AU - Nadar, Sunil
AU - Lip, Gregory Y.H.
N1 - Funding Information:
We thank Dr Tongwen Wang for providing Yeast strain S. cerevisiae EGY48. We also wish to thank all the colleagues for valuable advice. This work was supported by National Natural Science Foundation of China, grant No. 30170866.
PY - 2003
Y1 - 2003
N2 - Hypertension is associated with the flow of blood under high pressures, yet the complications of hypertension, such as myocardial infarction or stroke are paradoxically thrombotic rather than haemorrhagic. This could be explained by increasing evidence which suggests that hypertension fulfils the pre-requisites of the Virchow's triad for thrombogenesis, leading to a prothrombotic or hypercoagulable state. Hypertension leads to changes in the platelets, endothelium and the coagulation and fibrinolytic pathways which help to promote the induction and the maintenance of this prothrombotic state. These changes can to a certain extent be reversed by the treatment of hypertension, although different antihypertensive agents may have variable effects in reversing these changes. Some of the effects may be simply related to normalisation of blood pressure, but certain groups of drugs such as those acting on the renin-angiotensin-aldosterone system appear to have an effect over and above this. Anti-platelet agents have also been shown to confer a degree of benefit to 'high risk' hypertensive patients. The study of the prothrombotic state in hypertension is therefore of paramount importance, as understanding the pathogenic processes underlying it can help prevent many of the complications associated with this condition.
AB - Hypertension is associated with the flow of blood under high pressures, yet the complications of hypertension, such as myocardial infarction or stroke are paradoxically thrombotic rather than haemorrhagic. This could be explained by increasing evidence which suggests that hypertension fulfils the pre-requisites of the Virchow's triad for thrombogenesis, leading to a prothrombotic or hypercoagulable state. Hypertension leads to changes in the platelets, endothelium and the coagulation and fibrinolytic pathways which help to promote the induction and the maintenance of this prothrombotic state. These changes can to a certain extent be reversed by the treatment of hypertension, although different antihypertensive agents may have variable effects in reversing these changes. Some of the effects may be simply related to normalisation of blood pressure, but certain groups of drugs such as those acting on the renin-angiotensin-aldosterone system appear to have an effect over and above this. Anti-platelet agents have also been shown to confer a degree of benefit to 'high risk' hypertensive patients. The study of the prothrombotic state in hypertension is therefore of paramount importance, as understanding the pathogenic processes underlying it can help prevent many of the complications associated with this condition.
KW - Antihypertensive agents
KW - Antiplatelet agents
KW - Endothelial dysfunction
KW - Hypertension
KW - Platelet activation
KW - Thrombosis
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U2 - 10.2174/1381612033454559
DO - 10.2174/1381612033454559
M3 - Review article
C2 - 12871204
AN - SCOPUS:0042490656
SN - 1381-6128
VL - 9
SP - 1715
EP - 1732
JO - Current Pharmaceutical Design
JF - Current Pharmaceutical Design
IS - 21
ER -