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Potential Risk Factors Associated With Vascular Diseases in Patients Receiving Treatment for Hypertension

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Background: Currently, the hypertension (HTN) patients undergo appropriate medical treatment, and traditional risk factors are highly controlled. Therefore, potential risk factors of atherosclerotic vascular diseases (AVD) and venous thromboembolisms (VTE) in HTN should be reconsidered. We investigated thrombophilic genetic mutations and existing biomarkers for AVD or VTE in HTN patients receiving treatment. Methods: A total of 183 patients were enrolled: AVD with HTN (group A, n=45), VTE with HTN (group B, n=62), and HTN patients without any vascular diseases (group C, n=76). The lipid profile, homocysteine (Hcy) levels, D-dimers, fibrinogen, antithrombin, lupus anticoagulant, and anti-cardiolipin antibody (aCL) were evaluated. Prothrombin G20210A, Factor V G1691A, and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C were analyzed. Results: All patients revealed wild type prothrombin G20210A and Factor V G1691A polymorphisms. The frequency of MTHFR polymorphisms was 677CT (n=84, 45.9%); 677TT (n=46, 25.1%); 1298AC (n=46, 25.1%); and 1298CC (n=2, 1.1%). The MTHFR 677TT genotype tended to increase the odds ratio (OR) to AVD events in HTN patients (OR 2.648, confidence interval 0.982-7.143, P=0.05). The group A demonstrated significantly higher Hcy levels (P=0.009), fibrinogen (P=0.004), and platelet counts (P=0.04) than group C. Group B had significantly higher levels of D-dimers (P=0.0001), platelet count (P=0.0002), and aCL (P=0.02) frequency than group C. Conclusions: The MTHFR 677TT genotype and Hcy level could be potential risk factors associated with development of AVD in HTN patients receiving treatment. D-dimer and aCL might be useful to estimate the occurrence of VTE in them.

Abstract

Background: Currently, the hypertension (HTN) patients undergo appropriate medical treatment, and traditional risk factors are highly controlled. Therefore, potential risk factors of atherosclerotic vascular diseases (AVD) and venous thromboembolisms (VTE) in HTN should be reconsidered. We investigated thrombophilic genetic mutations and existing biomarkers for AVD or VTE in HTN patients receiving treatment. Methods: A total of 183 patients were enrolled: AVD with HTN (group A, n=45), VTE with HTN (group B, n=62), and HTN patients without any vascular diseases (group C, n=76). The lipid profile, homocysteine (Hcy) levels, D-dimers, fibrinogen, antithrombin, lupus anticoagulant, and anti-cardiolipin antibody (aCL) were evaluated. Prothrombin G20210A, Factor V G1691A, and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C were analyzed. Results: All patients revealed wild type prothrombin G20210A and Factor V G1691A polymorphisms. The frequency of MTHFR polymorphisms was 677CT (n=84, 45.9%); 677TT (n=46, 25.1%); 1298AC (n=46, 25.1%); and 1298CC (n=2, 1.1%). The MTHFR 677TT genotype tended to increase the odds ratio (OR) to AVD events in HTN patients (OR 2.648, confidence interval 0.982-7.143, P=0.05). The group A demonstrated significantly higher Hcy levels (P=0.009), fibrinogen (P=0.004), and platelet counts (P=0.04) than group C. Group B had significantly higher levels of D-dimers (P=0.0001), platelet count (P=0.0002), and aCL (P=0.02) frequency than group C. Conclusions: The MTHFR 677TT genotype and Hcy level could be potential risk factors associated with development of AVD in HTN patients receiving treatment. D-dimer and aCL might be useful to estimate the occurrence of VTE in them.

참고문헌 (40)

  1. Guidelines Subcommittee, "1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension", J Hypertens, 17, pp.151~183 (1999)
  2. Kearney PM, "Global burden of hypertension: analysis of worldwide data", Lancet, 365, pp.217~223 (2005)
  3. Pedrinelli R, "Hypertension and acute myocardial infarction: an overview", J Cardiovasc Med (Hagerstown), 13, pp.194~202 (2012)
  4. Gaciong Z, "Blood pressure control and primary prevention of stroke: summary of the recent clinical trial data and meta-analyses", Curr Hypertens Rep, 15, pp.559~574 (2013)
  5. Wolf PA, "Probability of stroke: a risk profile from the Framingham Study", Stroke, 22, pp.312~318 (1991)
  6. Yano Y, "Isolated systolic hypertension in young and middle-aged adults and 31-year risk for cardiovascular mortality: the Chicago Heart Association Detection Project in Industry study", J Am Coll Cardiol, 65, pp.327~335 (2015)
  7. Ageno W, "Cardiovascular risk factors and venous thromboembolism: a meta-analysis", Circulation, 117, pp.93~102 (2008)
  8. Mahan CE, "New antithrombotics: the impact on global health care", Thromb Res, 127, pp.518~524 (2011)
  9. Cordoba I, "Risk of placenta-mediated pregnancy complications or pregnancy-related VTE in VTE-asymptomatic families of probands with VTE and heterozygosity for factor V Leiden or G20210 prothrombin mutation", Eur J Haematol, 89, pp.250~255 (2012)
  10. Saemundsson Y, "Homozygous factor V Leiden and double heterozygosity for factor V Leiden and prothrombin mutation", J Thromb Thrombolysis, 36, pp.324~331 (2013)
  11. Clarke R, "Homocysteine and coronary heart disease: meta-analysis of MTHFR case-control studies, avoiding publication bias", PLoS Med, 9, pp.e1001177~ (2012)
  12. Gao XH, "Correlations of MTHFR 677C>T polymorphism with cardiovascular disease in patients with end-stage renal disease: a meta-analysis", PLoS One, 9, pp.e102323~ (2014)
  13. Gariglio L, "Comparison of homocysteinemia and MTHFR 677CT polymorphism with Framingham Coronary Heart Risk Score", Arch Cardiol Mex, 84, pp.71~78 (2014)
  14. Fukasawa M, "The methylentetrahydrofolate reductase C677T point mutation is a risk factor for vascular access thrombosis in hemodialysis patients", Am J Kidney Dis, 41, pp.637~642 (2003)
  15. Soltanpour MS, "Methylenetetrahydrofolate reductase C677T mutation and risk of retinal vein thrombosis", J Res Med Sci, 18, pp.487~491 (2013)
  16. Spiroski I, "Association of methylenetetrahydrofolate reductase (MTHFR-677 and MTHFR-1298) genetic polymorphisms with occlusive artery disease and deep venous thrombosis in Macedonians", Croat Med J, 49, pp.39~49 (2008)
  17. Kara H, "D-dimer and D-dimer", fibrinogen ratio in predicting pulmonary embolism in patients evaluated in a hospital emergency department, 2014, pp.69, 240~245
  18. D’Angelo A, "Homocysteine and thrombotic disease", Blood, 90, pp.1~11 (1997)
  19. Lin LJ, "Compliance with antithrombotic prescribing guidelines for patients with atrial fibrillation--a nationwide descriptive study in Taiwan", Clin Ther, 30, pp.1726~1736 (2008)
  20. Sode BF, "Risk of venous thromboembolism and myocardial infarction associated with factor V Leiden and prothrombin mutations and blood type", CMAJ, 185, pp.E229~E237 (2013)
  21. Bozok Çetintaş V, "Association between polymorphism of MTHFR c.677C>T and risk of cardiovascular disease in Turkish population: a meta-analysis for 2.780 cases and 3.022 controls", Mol Biol Rep, 41, pp.397~409 (2014)
  22. Neff MJ, "ACEP releases clinical policy on evaluation and management of pulmonary embolism", Am Fam Physician, 68, pp.759~760 (2003)
  23. Schutgens RE, "Combination of a normal D-dimer concentration and a non-high pretest clinical probability score is a safe strategy to exclude deep venous thrombosis", Circulation, 107, pp.593~597 (2003)
  24. Misita CP, "Antiphospholipid antibodies", Circulation, 112, pp.e39~e44 (2005)
  25. Fagher B, "Platelet counts in myocardial infarction, angina pectoris and peripheral artery disease", Acta Med Scand, 217, pp.21~26 (1985)
  26. Pengo V, "Update of the guidelines for lupus anticoagulant detection. Subcommittee on Lupus Anticoagulant", Antiphospholipid Antibody of the Scientific and Standardisation Committee of the International Society on Thrombosis and Haemostasis, 2009, pp.7, 1737~1740
  27. Nygård O, "Total homocysteine and cardiovascular disease", J Intern Med, 246, pp.425~454 (1999)
  28. Chang JD, "Genetic background of nontraumatic osteonecrosis of the femoral head in the Korean population", Clin Orthop Relat Res, 466, pp.1041~1046 (2008)
  29. Kim YW, "Absence of factor V Leiden mutation in Koreans", Thromb Res, 86, pp.181~182 (1997)
  30. Joachim E, "The methylenetetrahydrofolate reductase polymorphism (MTHFR c.677C>T) and elevated plasma homocysteine levels in a U.S. pediatric population with incident thromboembolism", Thromb Res, 132, pp.170~174 (2013)
  31. 이소영, "MTHFR C677T Polymorphism as a Risk Factor for Vascular Calcification in Chronic Hemodialysis Patients", Journal of Korean Medical Science, 26(3), pp.461~465 (2011), 대한의학회
  32. Aucella F, "The C677T methylenetetrahydrofolate reductase gene mutation does not influence cardiovascular risk in the dialysis population: results of a multicentre prospective study", Nephrol Dial Transplant, 20, pp.382~386 (2005)
  33. Haviv YS, "The common mutations C677T and A1298C in the human methylenetetrahydrofolate reductase gene are associated with hyperhomocysteinemia and cardiovascular disease in hemodialysis patients", Nephron, 92, pp.120~126 (2002)
  34. Wrone EM, "An MTHFR variant, homocysteine, and cardiovascular comorbidity in renal disease", Kidney Int, 60, pp.1106~1113 (2001)
  35. Antoniades C, "Homocysteine and coronary atherosclerosis: from folate fortification to the recent clinical trials", Eur Heart J, 30, pp.6~15 (2009)
  36. 박경하, "Impact of Framingham Risk Score, Flow-Mediated Dilation, Pulse Wave Velocity, and Biomarkers for Cardiovascular Events in Stable Angina", Journal of Korean Medical Science, 29(10), pp.1391~1397 (2014), 대한의학회
  37. Vuckovic BA, "Clinical significance of determining plasma homocysteine: case-control study on arterial and venous thrombotic patients", Croat Med J, 54, pp.480~488 (2013)
  38. Brattström L, "Homocysteine and cardiovascular disease: cause or effect?", Am J Clin Nutr, 72, pp.315~323 (2000)
  39. Paul GK, "Correlation of platelet count and acute ST-elevation in myocardial infarction", Mymensingh Med J, 19, pp.469~473 (2010)
  40. Monreal M, "Platelet count and venous thromboembolism. A useful test for suspected pulmonary embolism", Chest, 100, pp.1493~1496 (1991)

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