Ann Lab Med.  2016 May;36(3):215-222. 10.3343/alm.2016.36.3.215.

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

• Kim H
• Park J
• Chae H
• Lee GD
• Lee SY
• Lee JM
• Oh YS
• Kim M
• Kim Y

• KMID: 2373530
• DOI: http://doi.org/10.3343/alm.2016.36.3.215

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.

Keyword

MTHFR C677T; Homocysteine; Venous thrombosis; Atherosclerotic vascular disease; Hypertension

MeSH Terms

Adult
Aged
Antihypertensive Agents/therapeutic use
DNA/analysis
Factor V/genetics
Female
Fibrin Fibrinogen Degradation Products/analysis
Genotype
Homocysteine/blood
Humans
Hypertension/*complications/drug therapy
Lipids/blood
Male
Methylenetetrahydrofolate Reductase (NADPH2)/genetics
Middle Aged
Odds Ratio
Platelet Count
Polymorphism, Single Nucleotide
Prothrombin/genetics
Real-Time Polymerase Chain Reaction
Republic of Korea
Risk Factors
Vascular Diseases/*etiology/genetics
Venous Thrombosis/*etiology/genetics
Antihypertensive Agents
DNA
Factor V
Fibrin Fibrinogen Degradation Products
Homocysteine
Lipids
Methylenetetrahydrofolate Reductase (NADPH2)
Prothrombin

Figure

• 

  Fig. 1 The odds ratios and 95% confidence intervals of MTHFR 677 and 1298 genotypes and laboratory markers between the atheroscleotic vascular disease (AVD) and hypertension (HTN) only groups (top), and between the venous thromboembolism (VTE) and HTN only groups (bottom). The numbers in parentheses on Y-axis show the P values by odds ratio analysis.*P values were statistically significant.Abbreviations: 677, MTHFR 677 genotypes; 1298, MTHFR 1298 genotypes; Hyper-Hcy, hyperhomocysteinemia; LA, lupus anticoagulant; aCL, anticardiolipin antibody.

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