TY - JOUR
T1 - Platelet indexes in relation to target organ damage in high-risk hypertensive patients
T2 - A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT)
AU - Nadar, Sunil K.
AU - Blann, Andrew D.
AU - Kamath, Sridhar
AU - Beevers, D. Gareth
AU - Lip, Gregory Y.H.
N1 - Funding Information:
This study was supported by the Peel Medical Research Trust and the City Hospital Research and Development Program for the Haemostasis Thrombosis and Vascular Biology Unit.
PY - 2004/7/21
Y1 - 2004/7/21
N2 - Objectives We sought to investigate the relationship between target organ damage (TOD) in hypertension and a prothrombotic/hypercoagulable state, using a new technique of "platelet lysis" to quantify the amount of P-selectin per platelet (pP-sel), and to correlate it with other platelet markers (e.g., mass, volume and granularity, soluble P-selectin [sP-sel], and beta-thromboglobulin [beta-TG]). Background The increased risk of TOD in hypertension may be related to a prothrombotic/hypercoagulable state, with abnormalities in platelets, such as increased expression of P-selectin. Methods We studied 199 patients (mean age 68 years, 75% men) with hypertension. Of these, 125 had TOD (e.g., stroke, previous myocardial infarction, angina, left ventricular hypertrophy). Values obtained were compared with those from 59 healthy normotensive control subjects (mean age 68 years, 58% men). Results Hypertensive patients had a higher mean platelet volume, mass, pP-sel, sP-sel, and beta-TG and lower platelet granularity (all p < 0.01), but a similar platelet count, as compared with controls. Within the hypertensive group, those with evidence of TOD had significantly larger platelets with greater mass but had lower granularity, sP-sel, and pP-sel levels than those without TOD, possibly reflecting increased aspirin use. On multivariate analysis, aspirin use was a determinant of pP-sel (p = 0.03) and sP-sel (p = 0.01), but the use of other drugs or other co-morbidity (e.g., diabetes, smoking) did not influence either P-selectin value. Conclusions Patients with hypertension have evidence of changes in platelet physiology, as reflected by a higher level of pP-sel. Patients with TOD also had larger platelets, with greater mass, and the use of aspirin lowered pP-sel and sP-sel levels. These changes may have implications for the pathophysiology of cardiovascular and cerebrovascular disease in hypertension.
AB - Objectives We sought to investigate the relationship between target organ damage (TOD) in hypertension and a prothrombotic/hypercoagulable state, using a new technique of "platelet lysis" to quantify the amount of P-selectin per platelet (pP-sel), and to correlate it with other platelet markers (e.g., mass, volume and granularity, soluble P-selectin [sP-sel], and beta-thromboglobulin [beta-TG]). Background The increased risk of TOD in hypertension may be related to a prothrombotic/hypercoagulable state, with abnormalities in platelets, such as increased expression of P-selectin. Methods We studied 199 patients (mean age 68 years, 75% men) with hypertension. Of these, 125 had TOD (e.g., stroke, previous myocardial infarction, angina, left ventricular hypertrophy). Values obtained were compared with those from 59 healthy normotensive control subjects (mean age 68 years, 58% men). Results Hypertensive patients had a higher mean platelet volume, mass, pP-sel, sP-sel, and beta-TG and lower platelet granularity (all p < 0.01), but a similar platelet count, as compared with controls. Within the hypertensive group, those with evidence of TOD had significantly larger platelets with greater mass but had lower granularity, sP-sel, and pP-sel levels than those without TOD, possibly reflecting increased aspirin use. On multivariate analysis, aspirin use was a determinant of pP-sel (p = 0.03) and sP-sel (p = 0.01), but the use of other drugs or other co-morbidity (e.g., diabetes, smoking) did not influence either P-selectin value. Conclusions Patients with hypertension have evidence of changes in platelet physiology, as reflected by a higher level of pP-sel. Patients with TOD also had larger platelets, with greater mass, and the use of aspirin lowered pP-sel and sP-sel levels. These changes may have implications for the pathophysiology of cardiovascular and cerebrovascular disease in hypertension.
KW - ASCOT
KW - Anglo-Scandinavian Cardiac Outcomes Trial
KW - DBP
KW - MI
KW - MPG
KW - MPM
KW - MPV
KW - P-selectin per platelet
KW - SBP
KW - beta-TG
KW - beta-thromboglobulin
KW - diastolic blood pressure
KW - mean platelet granularity
KW - mean platelet mass
KW - mean platelet volume
KW - myocardial infarction
KW - pP-sel
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UR - http://www.scopus.com/inward/citedby.url?scp=3242725128&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2004.03.067
DO - 10.1016/j.jacc.2004.03.067
M3 - Article
C2 - 15261941
AN - SCOPUS:3242725128
SN - 0735-1097
VL - 44
SP - 415
EP - 422
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 2
ER -