FIBRINOLYSIS FACTORS AND LIPID-COMPOSITION OF THE BLOOD IN TREATED AND UNTREATED HYPERTENSIVE PATIENTS

The correlations between the cardiovascular risk factors hypertension, overweight, hyperlipidemia and fibrinolysis parameters were studied in a group of 54 otherwise healthy patients (age 19 to 70 years) with essential hypertension of moderate severity. Of the 54 patients 43 were treated with antihypertensive drugs and eleven were not. The patients included in this study, who were treated with antihypertensive drugs were, in spite of their treatment, still hypertensive. Lipoprotein levels and fibrinolysis parameters did not differ between the untreated and treated patients. In the patient group we found significant incidences of hypertriglyceridemia (46%) elevated LDL-cholesterol (28%) and elevated lipoprotein (a) levels (43%). In comparison with a healthy control group the hypertensive patient group showed a decreased median tissue plasminogen activator activity (interquartile range): 0.23 (0.79) IU.10(3)/l vs 1.5 (0.47) IU.10(3)/l in the controls (p < 0.0001), an increased tissue plasminogen activator antigen concentration:8.2 (4.5)mu-g/l vs 5.1 (3.9)mu-g/l in the controls (p < 0.0001), an elevated plasminogen activator inhibitor-1 level: 2.8 (2.5) AU.10(3)/l vs 1.1 (2.0) AU.10(3)/l in the controls (p < 0.01) and a slightly increased alpha-2-antiplasmin concentration: 110(8)% vs 98 (16)% in the controls (p < 0.0001). Median D-dimer-concentration levels were substantially increased in the hypertensive patients: 315 (263)mu-g/l vs 199 (146)mu-g/l in the controls (p < 0.0001). Median plasminogen concentrations did not differ significantly between the hypertensive patients 101 (16)% and controls 1.8 (16)%. Triglycerides were correlated with tissue plasminogen activator antigen (r = 0.44, p = 0.003) and with plasminogen activator inhibitor-1 levels (r = 0.47, p = 0.004) and tended to correlate with plasminogen (r = .26, p = 0.07) and D-dimer levels (r = 0.24, p = 0.10). The Quetelet-index correlated with tissue plasminogen activator antigen(r = 0.32, p = 0.03). In conclusion, this group of mildly hypertensive patients showed a disadvantageous blood lipid profile in correlation with signs of an impaired fibrinolysis indicated by a decreased tissue plasminogen activator activity and an elevated plasminogen activator inhibitor-1 concentration. These data link fibrinolysis parameters with hypertension and hyperlipidemia and are as such compatible with a multifactorial interaction of cardiovascular risk factors.