Μελέτη των συσσωματωμάτων αιμοπεταλίων - μονοκυττάρων στην ιδιοπαθή αρτηριακή υπέρταση ; Monocyte - platelet aggregates in essential hypertension

Essential hypertension (EH) is associated with an increased incidence of arterial thrombotic complications, which is sustained by a number of factors: endothelial dysfunction, clinically detectable atherosclerosis, increased activity of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS), changes in coagulation and fibrinolysis and increased platelet activation. When platelets are activated, they aggregate with each other and with monocytes forming monocyte–platelet aggregates (MPA). Circulating MPA levels represent the most sensitive and robust marker in several clinical settings. The objective of this study was to investigate the presence of ιIncreased thrombotic tendency and factors associating with it from the early stages of EH.Therefore, we enrolled newly diagnosed and untreated patients with EH and no comorbidities (UH) and healthy normotensive controls (NT). We utilized the exercise test (Bruce protocol) to model the effect of acute blood pressure (BP) rising after intense physical activity. MPA levels were studied by flow cytometry in both groups while resting and during acute exercise. Furthermore, we studied platelet P-selectin by flow cytometry and representative markers of coagulation and fibrinolysis, TAT (thrombin-antithrombin) complex and PAI-1 (plasminogen activator inhibitor-1) using ELISA kits. Changes of these markers were also studied after 3- month antihypertensive treatment. Then, we aimed to study the presence of subclinical atherosclerosis, endothelial dysfunction and arterial stiffness while resting and during acute exercise, when possible. Subclinical atherosclerosis was detected by carotid intima-media thickness (CIMT) using ultrasound measurements and endothelial dysfunction by asymmetric dimethylarginine (ADMA) using ELISA. Arterial stiffness was measured by aortic pulse wave velocity (aPWV) using applanation tonometry. High sensitivity C-reactive protein (hsCRP) and cardiotrophin-1 were also measured by ELISA.We studied 30 UH and 15 NT. No difference ...