Indicators of plasma hemostasis in hypertensive patients of different age groups

Abstract

Background. Scientific works of several authors determine age-related differences in hemocoagulation hemostasis. Thus, in older people, changes in hemovascular hemostasis are noted with impaired vasomotor, anticoagulant and fibrinolytic activity of the endothelium. Anticoagulant system disorders increase with age. There are few studies on plasma hemostasis in arterial hypertension patients, especially in older age groups. Aim: The study aimed at a complex research and comparative assessment of the plasma state hemostasis parameters in older and middle-aged hypertensive patients. Materials and methods. 134 patients who were divided into 2 groups were examined. Group I (n = 65) – the older hypertensive patients (60 - 74 years); group II (n = 69) – the middle-aged hypertensive patients (45 - 59 years) respectively. 15 people were involved in the control for each of the studied groups (group III – the older persons and group IV – the middle-aged persons) comparable to the main in terms of age and sex. They were divided into 2 groups of 24-hour day profile of blood pressure: dippers and non-dippers. Fibrinogen (g/l) was determined on an Amelung KC 1A hemocoagulometer to assess the plasma hemostasis state. The fibrinolytic activity of plasma (min) was according to the Kowalski method, antithrombin III (%) with the help of Humalyzer Junior filter photometer. Results. When comparing the plasma hemostasis indicators in the older and the middle-aged patients the value of antithrombin III in the middle-aged persons exceeded the similar indicator in the older persons. That is, in older patients, on the contrary, suppression of fibrinolytic and anticoagulant activity is noted. A significant slowing of the indicator of fibrinolysis activity was found in the middle-aged patients of the dipper group compared to the control group. A significant decrease in the fibrinogen level was found in the older patients in the dipper group and its increase in the non-dipper group relative to the control. The level of the antithrombin III significantly decreased in the non-dipper group compared to normative indicators. Conclusions. 1. The significant decrease in anticoagulant activity against the background of suppressed fibrinolysis according to indicators of the plasma hemostasis of the older patients was noted. 2. The thrombogenicity of blood plasma revealed by us during the study of plasma hemostasis indicates the high probability of thrombotic complications developing in patients. _________________________________________________________________________________________ Keywords: arterial hypertension; essential hypertension; plasma hemostasis; fibrinogen; fibrinolytic activity of plasma; antithrombin III