Last update:

   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.


© 2001, Archives of Hellenic Medicine