RESUMO
To study the relationship between plasminogen activator inhibitor-1[PAL-1], soluble P-selectin[sP-selectin] and von Willebrand factor[vWF] activity with target organ damage [TOD] in essential hypertension, this case-control study was conducted on 51 patients with essential hypertension [30 men and 21 women], attending the hypertensive clinic of Assiut university hospital. Their mean age was 47.3 +/- 8.6 years. Patients were classified into two groups, a group without TOD [included 18 patients]. The second group included 33 patients with an evidence of TOD. Out of the latter group, 18 patients had echocardiographic left ventricular hypertrophy [LVH], 12 patients had microalbuminuria and 3 patients with hypertensive retinopathy. Twenty normotensive age and sex matched healthy individuals served as a control group. We measured plasma levels of von Willebrand factor [vWF, a marker of endothelial damage/dysfunction], soluble P-selectin [sP-sel, a marker of platelet activation] and plasminogen activator inhibitor-1 [PAI-1 as an index of fibrinolysis], all were assayed by ELISA. Fibrinogen level was measured by Clauss method. The results of this study revealed that the levels of sP-sel, PAI-I, vWF and fibrinogen were significantly higher in hypertensive patients than controls [with P value < 0.001, <0.001, <0.001 and <0.01 respectively]. When patients with TOD were compared with those without TOD, a significant increase was detected for PAI-1, vWF and fibrinogen in the TOD group [with P value <0.01, <0.05 and <0.01 respectively], SP-sel was not statistically different between the two groups. In comparing patients with LVH and patients without TOD, only vWF and fibrinogen levels were significantly higher in LVH patients [P<0.01 for both]. For all the studied markers, no significant difference could be detected between microalbuminuric patients and those without TOD. PAI-I was positively correlated with both systolic [r = 0.613, P<0.001] and diastolic [r = 0.480, P<0.001] blood pressure in hypertensive patients. Elevated vWF and fibrinogen levels and decreased fibrinolytic potential [elevated PAI-I] are associated with TOD, and could be considered as risk markers that may predict preclinical TOD. However, only raised fibrinogen and vWF levels are associated with LVH which may predispose those patients to hypertensive complications