Key result
Combination antihypertensives are linked to greater clot density and endothelial dysfunction versus monotherapy or none.
Why the study?
Hypertension is associated with hemostatic disorders and endothelial dysfunction, and understanding these factors under antihypertensive pharmacotherapy could help personalize treatment and reduce thrombotic complications.
Does the intensity of antihypertensive pharmacotherapy affect hemostatic potential and endothelial function in hypertensive patients?
Cross-Sectional (n=185)
Does the intensity of antihypertensive pharmacotherapy affect hemostatic potential and endothelial function in hypertensive patients?
p-value: p=0.0001
Patients on combination antihypertensive therapy exhibit a procoagulant state and persistent endothelial dysfunction despite achieving target blood pressure, suggesting a potential need for adjunctive vasoprotective or antithrombotic therapies.
Abstract:: Hypertension is associated with hemostatic disorders and endothelial dysfunction. Un-derstanding hemostatic potential and endothelial function under antihypertensive pharmacotherapy can help personalize treatment and reduce the risk of thrombotic complications. Objective:: To conduct a comparative analysis of endothelial function and hemostatic potential in hypertensive patients receiving different types of pharmacological therapy. Methods:: This cross-sectional study included 185 patients diagnosed with hypertension. Partici-pants were divided into four groups based on their therapy regimen: Group 1—no therapy, Group 2—monotherapy, Group 3—two-drug therapy, and Group 4—three-drug therapy. Differences in hemostatic potential and endothelial function, assessed using piezothromboelastography and the Celermajer DS test, were analyzed using the Kruskal-Wallis and Mann-Whitney tests. Results:: Piezothromboelastography revealed a progressive increase in maximum clot density am-plitude (MA) from Group 1 to Group 4: 502 (437.75; 556.75) rel. units (Group 1), 525 (463; 572) rel. units (Group 2), 577 (536; 628) rel. units (Group 3), and 596 (504; 651) rel. units (Group 4) (p = 0.0001). The Celermajer DS test indicated the highest degree of endothelial dysfunction in Groups 3 and 4: 10.87 (7.14; 17.02) % and 7.84 (5; 9.76)% respectively (p = 0.006). Conclusion:: Despite achieving target blood pressure, patients on combination antihypertensive therapy exhibit a procoagulant state and persistent endothelial dysfunction. These findings may guide the use of antithrombotic or vasoprotective therapies to prevent thrombohemorrhagic com-plications.
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Zolotarev et al. (2026) conducted a cross-sectional in hypertension (n=185). Combination antihypertensive therapy (two-drug or three-drug) vs. No therapy or monotherapy was evaluated on Hemostatic potential (maximum clot density amplitude) and endothelial function (p=0.0001). Combination antihypertensive therapy in hypertensive patients was associated with a progressive increase in maximum clot density amplitude (P=0.0001) and persistent endothelial dysfunction (P=0.006).
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