January 1, 2002
View Full PaperBaseline abnormalities of endothelial function and thrombogenesis in relation to prognosis in essential hypertension
Key Result
High baseline systolic blood pressure (≥ median) was associated with shortened event-free survival for death or adverse cardiovascular events in hypertensive patients (P=0.0078).
Study Design
Type
Cohort (n=178)
Multicenter
No
Structured PICO
Do baseline markers of a hypercoagulable state predict subsequent cardiovascular events in patients with essential hypertension?
P
Population
178 patients with essential hypertension followed for a mean of 45 months to assess markers of a hypercoagulable state and cardiovascular events.
E
Exposure
Baseline markers of thrombosis and haemostasis (fibrinogen, fibrin D-dimer, plasminogen activator inhibitor, soluble P-selectin, von Willebrand factor, and viscosity)
O
Outcome
Composite of death or adverse cardiovascular eventcomposite
In patients with essential hypertension, high baseline systolic blood pressure, rather than markers of thrombogenesis or endothelial dysfunction, is the primary predictor of shortened event-free survival.
Main Result
p-value: p=0.0078
Abstract
The present study was designed to test the hypothesis that markers of a hypercoagulable state predict subsequent cardiovascular events in hypertensives. To do this, we performed a prospective follow-up analysis of 178 patients (86 male; mean age, 54 years (standard deviation, 15); mean blood pressure, 188/103 mmHg) recruited from a hypertension clinic in a city-centre teaching hospital serving a multi-ethnic population. The main outcome measures were clinical and echocardiographic details, and laboratory markers of thrombosis and haemostasis (fibrinogen, fibrin D-dimer, plasminogen activator inhibitor, soluble P-selectin, von Willebrand factor, and viscosity) that were measured at baseline. After a mean follow-up of 45 months (interquartile range, 37-54), 30 subjects experienced one of a number of endpoints that included death or adverse cardiovascular event. These patients were older (P or = median) baseline systolic blood pressures were associated with a shortened event-free survival (log rank test, P= 0.0078). We conclude that hypertensive patients who experienced a new cardiovascular event were much older and had more endothelial dysfunction and thrombogenesis than those who were free of complications. However, only high baseline systolic blood pressures were associated with a shortened event-free survival.