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).
Cross-Sectional (n=185)
Does the intensity of antihypertensive pharmacotherapy affect hemostatic potential and endothelial function in hypertensive patients?
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.
p-value: p=0.0001
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.
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).