Relation of thrombogenesis in systemic hypertension to angiogenesis and endothelial damage/dysfunction (a Substudy of the Anglo-Scandinavian Cardiac Outcomes Trial [ASCOT])

• Published in: The American journal of cardiology 2003-08, Vol.92 (4), p.400-405
• Main Authors: Felmeden, Dirk C, Spencer, Charles G.C, Chung, Natali A.Y, Belgore, Funmi M, Blann, Andrew D, Beevers, D.Gareth, Lip, Gregory Y.H
• Format: Article
• Language: English
• Subjects: Arterial hypertension. Arterial hypotension; Arteriosclerosis - blood; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Endothelial Growth Factors - blood; Endothelium, Vascular - physiopathology; Female; Humans; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Hypertension - blood; Hypertension - complications; Hypertension - drug therapy; Hypertension - physiopathology; Intercellular Signaling Peptides and Proteins - blood; Lymphokines - blood; Male; Medical sciences; Middle Aged; Neovascularization, Pathologic - physiopathology; Risk Factors; Thrombophilia - complications; Thrombophilia - physiopathology; Thromboplastin - analysis; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors; Vasodilation; von Willebrand Factor - analysis
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(03)00657-X

Increasing evidence points toward a prothrombotic state in hypertension and atherosclerosis, conditions associated with thrombosis-related complications, such as myocardial infarction and stroke. We hypothesized that this increased risk of thrombogenesis may be related to endothelial damage/dysfunction and abnormal angiogenesis, and thus, an increased risk of future cardiovascular disease. Thrombogenesis, endothelial damage/dysfunction, and angiogenesis can be assessed by measurement of tissue factor (TF), von Willebrand Factor (vWF), flow-mediated dilatation (FMD), and vascular endothelial growth factor (VEGF), respectively. To test this hypothesis, we measured TF, vWF, FMD, and VEGF in 76 patients with systemic hypertension (71 men; mean age 64; mean blood pressure 167/72 mm Hg), considered additional risk factors such as diabetes, and related them to the patient’s 10-year cardiovascular and cerebrovascular risk score using the Framingham equation. Patients were compared with 48 healthy normotensive controls. In these patients, the effects of 6 months of intensified blood pressure and (where appropriate) lipid-lowering treatment were investigated. In our patients, TF, VEGF, and vWF levels were higher, but FMD was lower (all p