(Circulation. 2000;101:264.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Association of Blood Pressure With Fibrinolytic Potential in the Framingham Offspring Population
From Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Mass (K.A.P., M.G.L., J.C.E., P.A.S., P.W.F.W., D.L.); Institute for the Prevention of Cardiovascular Disease, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (K.A.P., G.H.T., I.L., M.A.M., J.E.M.); National Heart, Lung and Blood Institute, Bethesda, Md (P.W.F.W., D.L.); and Department of Mathematics, Boston University, Boston, Mass (M.G.L., J.C.E., P.A.S., R.B.D.).
Correspondence to Daniel Levy, MD, Framingham Heart Study, Five Thurber Street, Framingham, MA 01702.
Background—Hypertension is an established risk factor for acute coronary events. Because fibrinolytic and hemostatic factors are also associated with cardiovascular disease, we examined the relations of systolic and diastolic blood pressures (SBP and DBP) to levels of plasminogen activator inhibitor antigen, tissue plasminogen activator antigen, fibrinogen, factor VII, von Willebrand factor, fibrinogen, and plasma viscosity in subjects of the Framingham Offspring Study.
Methods and Results—We studied 1193 men and 1459 women after the exclusion of subjects with known cardiovascular disease and those receiving anticoagulant or antihypertensive therapy. Linear regression models were used to evaluate SBP and DBP as predictors of fibrinolytic and hemostatic factor levels in separate sex models, with adjustment for age, body mass index, smoking, diabetes, total cholesterol, HDL, triglycerides, alcohol intake, and estrogen use (in women). In both sexes, levels of plasminogen activator inhibitor and tissue plasminogen activator antigen were positively related to SBP and DBP (P<0.001). Plasma viscosity was positively related to SBP (P=0.008) and DBP (P=0.001) in women only. There was no association between SBP or DBP and fibrinogen, factor VII, or von Willebrand factor in either sex.
Conclusions—These data suggest that impaired fibrinolysis may play an important role in the pathogenesis of cardiovascular disease in hypertensive patients.
Key Words: hypertension • fibrinolysis • cardiovascular diseases
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