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Platelet Hyperactivity in Hypertensive Older Patients Is Controlled by Lowering Blood Pressure
Author(s) -
Riondino Silvia,
Pignatelli Pasquale,
Pulcinelli Fabio M.,
Lenti Luisa,
Veroli Claudio Di,
Marigliano Vincenzo,
Gazzaniga Pier Paolo
Publication year - 1999
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1999.tb01288.x
Subject(s) - medicine , blood pressure , nifedipine , platelet , endothelin receptor , platelet activation , population , endocrinology , cardiology , gastroenterology , calcium , receptor , environmental health
OBJECTIVE Patients with hypertension tend to have a high prevalence of atherothrombotic accidents. Platelet hyperactivity is frequently associated with hypertension. Because the vascular disease associated with hypertension evolves over the years, we investigated platelet activity parameters in a population of older hypertensive patients with no other risk factors for cardiovascular disease. PARTICIPANTS We studied 34 older, nonsmoking patients (mean age 74 ± 5 years) with uncomplicated hypertension before and after the normalization of blood pressure (BP) was achieved with the angiotensin‐converting enzyme inhibitor quinapril alone or in combination with the Ca 2+ antagonist nifedipine. MEASUREMENTS Platelet aggregation, P‐selectin (CD62) expression on the platelet surface, serum levels of Interleukin‐1β (IL‐1β) and of Interleukin‐6 (IL‐6), as well as plasma levels of soluble P‐selectin and Endothelin‐1 (ET‐1), were analyzed. RESULTS All platelet hyperactivity parameters were reduced significantly with the normalization of BP at the end of antihypertensive drug treatment (systolic/diastolic: 186.2 ± 2.7/103.4 ± 1.1 mm Hg vs 135.0 ± 1.3/85.9 ± 1.9 mm Hg; P < .001). Those factors more strictly associated with endothelium injury, such as ET‐1 and IL‐6, did not show variations. A significant correlation (Spearman Rank test) was observed among all platelet function parameters and blood pressure values. CONCLUSIONS This study demonstrated that even in a population of older hypertensive patients with no other risk factor for atherogenic disease, normalization of blood pressure induces a significant reduction of the parameters of enhanced platelet hyperactivity independent of the action exerted, at the platelet level, by the antihypertensive drugs.