Von Willebrand Factor, Soluble P-Selectin, and Target Organ Damage in Hypertension: A Substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT)

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2002-07, Vol.40 (1), p.61-66
• Main Authors: Spencer, Charles G.C, Gurney, David, Blann, Andrew D, Beevers, D Gareth, Lip, Gregory Y.H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Amlodipine - therapeutic use; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Atenolol - therapeutic use; Bendroflumethiazide - therapeutic use; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - drug effects; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Cross-Sectional Studies; Electrocardiography; Female; Hematocrit; Hemorheology - drug effects; Humans; Hypertension - blood; Hypertension - drug therapy; Hypertension - physiopathology; Hypertrophy, Left Ventricular - pathology; Hypertrophy, Left Ventricular - physiopathology; Male; Medical sciences; Middle Aged; P-Selectin - blood; P-Selectin - drug effects; Perindopril - therapeutic use; Regression Analysis; Single-Blind Method; Treatment Outcome; von Willebrand Factor - drug effects; von Willebrand Factor - metabolism
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/01.HYP.0000022061.12297.2E

To investigate the relationship between soluble markers of platelet, endothelial and rheological function, and target organ damage and their response to intensified management in a population of middle-age hypertensive patients at high risk of cardiovascular complications, we studied 382 consecutive patients (308 men; mean age, 63 years, SD 8) along with 60 normotensive controls free of cardiovascular disease. Patients were divided into those with target organ damage (TOD; n=107) and those free of end-organ damage. Plasma levels of soluble P-selectin (sP-sel), a marker of platelet activation, and von Willebrand factor (vWF), an index of endothelial damage/dysfunction (both enzyme-linked immunosorbent assay), and the rheological indices fibrinogen, plasma viscosity, hematocrit, platelet, and white cell count were measured. In 53 patients, variables were further measured after 6 months of intensified cardiovascular risk management. Patients with TOD had significantly higher vWF, 137 (SD 33) versus 125 (SD 33) IU/dL (P =0.002,) and a greater proportion of smokers, 31% versus 16% (P =0.002). There were no statistically significant differences in plasma viscosity, fibrinogen, hematocrit, white blood cell count, platelet count, or sP-sel between the 2 subgroups. In multivariate analysis, vWF was a significant independent predictor for TOD. After 6 months of intensified management in 53 patients who entered the trial, there were significant reductions in systolic blood pressure, total cholesterol, hematocrit, plasma viscosity, sP-sel, and vWF (all P