|
|
|
 |
|
|
30-Oct-2001
|
 |
|
Arch Hellen Med, 2000, 17(Supplement):119-123
ORIGINAL PAPER
Genetic abnormalities related to the hemostatic balance
of hypertensive patients
A. GIALERAKI, Th. MAKRIS, A. HATZIZACHARIAS, C. TSOUKALA,
D. XANTHIS,
P. CRESPI, V. VOTTEAS, M. KYRIAKIDIS, T. MANDALAKI
2nd Regional Blood Transfusion and Haemophilia
Center, Department of Cardiology,
"Laikon" General Hospital, Athens, Greece
OBJECTIVE Angiotensin converting
enzyme (ACE) gene polymorphism has been associated with an increased incidence
of myocardial infarction. Recent studies have investigated a potential influence
of ACE gene polymorphism on fibrinolysis or endothelial function. It has been
previously established that essential hypertension is accompanied by endothelial
dysfunction and fibrinolytic balance disorders. The aim of our study was to
study the relation between ACE gene polymorphism and fibrinolytic/hemostatic
as well as endothelial cell damage markers in hypertensive patients and to determine
the prevalence of FV 1691 G-A mutation, known to be involved in thrombosis in
the same population.
METHOD The following parameters were evaluated
in 104 previously untreated hypertensives: plasminogen activator inhibitor-1
(PAI-1), tissue plasminogen activator antigen (tPA-Ag), fibrinogen, D-dimer
and von Willebrand factor (vWF). The genotype of the ACE gene was also determined
(PCR method) and patients were characterised according to the observed alleles
as deletion/deletion (DD), insertion/insertion (II), or insertion/deletion (ID).
Moreover FV 1691 G-A mutation was studied in the above population and compared
to its prevalence in a matched blood donor group.
RESULTS Those with DD genotype (n=42) had significantly
higher plasma levels of PAI-1 Ag (P=0.012), tPA-Ag (P=0.0001), fibrinogen (P=0.0002),
D-dimer (P=0.0001) and vWF (P=0.0004) compared to ID (n=30) or II (n=32) genotypes.
The ACE gene genotypes appeared to be significant predictors for plasma PAI-1
Ag, tPA-Ag, fibrinogen, D-dimer and vWF even after adjustment with age, gender,
BMI, triglycerides, cholesterol and blood pressure. Additionally, FV 1691 G-A,
although not statistically significant, seems to be more prevalent in hypertensives.
CONCLUSIONS Our findings suggest that ACE/DD genotype
is associated with hemostasis balance disturbances reflecting hypercoagulability
and endothelial damage in untreated hypertensives.
Key words: Angiotensin converting enzyme, Arterial hypertension, FV 1691 G-A, Hemostatic balance.
