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(Hypertension. 2004;43:64.)
© 2004 American Heart Association, Inc.

Scientific Contributions

Determinants of Platelet Activation in Human Essential Hypertension

Pietro Minuz; Paola Patrignani; Stefania Gaino; Francesca Seta; Marta L. Capone; Stefania Tacconelli; Maurizio Degan; Giovanni Faccini; Anna Fornasiero; Giorgio Talamini; Rosamaria Tommasoli; Enrico Arosio; Clara Lechi Santonastaso; Alessandro Lechi; Carlo Patrono

From the Departments of Biomedical and Surgical Sciences (P.M., M.D., A.F, G.T., E.A., C.L.S., A.L.) and Morphological and Biomedical Sciences (S.G., G.F, R.T, C.L.S.), University of Verona, Verona; the Center of Excellence on Aging (P.P, F.S., M.L.C, S.T., C.P.), G. D’Annunzio University of Chieti, Chieti; and the Department of Pharmacology (C.P.), La Sapienza University of Rome, Rome, Italy.

Correspondence to Pietro Minuz, MD, Medicina Interna C, Policlinico GB Rossi, 37134 Verona, Italy. E-mail pietro.minuz{at}univr.it

Experimental data suggest that oxidative stress might be enhanced in hypertension and contribute to platelet activation. We hypothesized that both oxidative stress and platelet activation could be related to the clinical characteristics of hypertensive patients. The urinary excretion of 11-dehydrothromboxane (TX) B₂, reflecting in vivo platelet activation, was measured in 75 patients with mild to severe essential hypertension and 75 pair-matched, healthy controls. The urinary excretion of 8-iso-prostaglandin (PG) F₂ was determined as an index of in vivo lipid peroxidation. Urinary 11-dehydro-TXB₂ was significantly higher in essential hypertensives compared with controls. Although no statistically significant difference in urinary 8-iso-PGF₂ was observed between patients and controls, plasma vitamin C was lower and plasma homocysteine higher in hypertensive patients than in controls. Both urinary 11-dehydro-TXB₂ and 8-iso-PGF₂ were higher in patients with advanced hypertensive retinopathy compared with patients without retinopathy. Multivariate linear regression analysis identified urinary 8-iso-PGF₂, plasma fibrinogen, homocysteine, and vitamin E as the only variables independently correlated with urinary 11-dehydro-TXB₂. Logistic regression analysis showed that high urinary 8-iso-PGF₂, plasma fibrinogen, and homocysteine, as well as low plasma vitamin E, advanced retinopathy, elevated diastolic blood pressure, and the absence of antihypertensive treatment, were predictors of high urinary 11-dehydro-TXB₂. We demonstrated increased oxidative stress and persistent platelet activation in essential hypertensives with advanced vascular lesions. These findings might help identify hypertensive patients who are at increased risk of cardiovascular events and who might benefit from long-term antiplatelet therapy.

Key Words: hypertension, essential • platelets • thromboxanes • oxidative stress • urine

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