Current Hypertension Reviews

Prof. Kazuomi Kario
Jichi Medical University
School of Medicine
Tochigi
Japan

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The Effects of Angiotensin II Signaling Blockade on Platelet Activity in Subjects with Hypertension

Author(s): Nabeel Ahmed, Anoop Mansoor, Joban Sehmi, Keith Gomez, Amarjit Sethi.

Graphical Abstract:


Abstract:

Background: To investigate the effects of Angiotensin II receptor blockade (ARB) and angiotensin converting enzyme (ACE) inhibition on platelet reactivity in patients with mild to moderate hypertension. PFA-100 evaluates platelet function (expressed in seconds as closure time, CT) in anti-coagulated whole blood in vitro at high shear rates. The test cartridge is impregnated with either collagen and epinephrine (Col/Epi) or collagen and ADP (Col/ADP).

Methods: 33 patients were randomized to perindopril 4mg (n = 9), valsartan 80mg/d (n = 9) and for lifestyle modification (n = 15) for 4 weeks. Platelet reactivity was measured at baseline and after 4 weeks by PFA-100. Normotensive controls (n = 11) were also tested at baseline to standardize PFA-100 CT. Haematocrit, platelet count and plasma vWF antigen levels were measured.

Results: There was no difference in baseline haematocrit, platelet count or vWF antigen level between the groups. The vWF antigen levels measured after 4 weeks showed no significant difference either. Significant blood pressure reduction was seen in the treated group (SBP P = 0.002 and DBP P = 0.005) when compared to the life style modification group (SBP P = 0.06 and DBP P = 0.04) after 4 weeks. There was no significant statistical difference in Col/ADP CT in treated and non-treated groups but increase in CT (P = 0.05) in treated group with Col/Epi seen after 4 weeks.

Conclusion: In patients with mild to moderate hypertension, valsartan and perindopril compared to life style modification demonstrate a significant decrease in platelet reactivity.

Keywords: ACE, ARB, hypertension, PFA-100, platelets, platelet reactivity.

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Article Details

VOLUME: 11
ISSUE: 2
Year: 2015
Page: [116 - 122]
Pages: 7
DOI: 10.2174/157340211102150731114920
Price: $58