Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2023; 11(24): 5678-5691
Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5678
Relevant detection indicator of prethrombotic state in patients with primary hypertension
Jie Luo, Tuo Yang, Lan Ding, Jian-Hui Xiong, Teng Ying, Fen Xu
Jie Luo, Medical Technology Department, Jiangxi Medical College, Shangrao 334000, Jiangxi Province, China
Tuo Yang, Inspection Department, Guangdong Zhanjiang Health School Labor Union, Zhanjiang 524094, Guangzhou Province, China
Lan Ding, Fen Xu, Department of Medical Technology, Jiangxi Medical College, Shangrao 334000, Jiangxi Province, China
Jian-Hui Xiong, Teng Ying, Department of Cardiology, The First Affiliated Hospital of Jiangxi Medical College, Shangrao 334000, Jiangxi Province, China
Author contributions: Luo J and Yang T concepted the study; Luo J, Xiong JH and Yang T collected the data; Luo J, Xiong JH, Ding L and Ying T contributed to the formal analysis; Luo J and Xu F contributed to the investigation; Luo J, Xu F and Xiong JH contributed to the methodology; Luo J, Ying T, Yang T and Xu F supervised the study; Ding L validated the study; Ding L and Luo J contributed to the visualization of the study; Ding L and Luo J originally drafted the manuscript; Jie Luo, Tuo Yang, Jian-Hui Xiong, Lan Ding, Teng Ying, Fen Xu reviewed and edited the manuscript.
Supported by The Science and Technology Research Project of Jiangxi Provincial Department of Education, No. GJJ2205812.
Institutional review board statement: This study has approved by the Ethical Committee of the First Affiliated Hospital of Jiangxi Medical College.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fen Xu, MD, Associate Professor, Department of Medical Technology, Jiangxi Medical College, No. 399 Zhimin Avenue, Xinzhou District, Shangrao 334000, Jiangxi Province, China. xfen202304@163.com
Received: May 19, 2023
Peer-review started: May 19, 2023
First decision: June 1, 2023
Revised: June 2, 2023
Accepted: August 3, 2023
Article in press: August 3, 2023
Published online: August 26, 2023
Processing time: 97 Days and 23 Hours
Abstract
BACKGROUND

Hypertension is a common chronic disease that affects many people worldwide. Only a few reports related to the exploration of relevant indicators of the prethrombotic state in patients with primary hypertension (PH) in clinical settings were available.

AIM

To detect prethrombotic state-related indicators in patients with PH and analyze their differences in different patient populations to provide a laboratory basis for the clinical prevention and control of hypertensive thrombotic diseases.

METHODS

The general data of patients with PH who attended the Department of Cardiovascular Medicine, The First Affiliated Hospital of Jiangxi Medical College, from January 2022 to December 2022 were collected retrospectively. The patients were divided into three groups of 40 patients each according to the Grade of PH: Grade 1, Grade 2, and Grade 3 hypertension experimental group. The baseline data of 40 volunteers, who underwent physical examination in our hospital but were not diagnosed with PH during the same period, were included in the control group. The relevant indicators of prethrombotic state of the participants were compared, and mainly included inflammation-related indicators, hemorheology-related indicators, and coagulation function related indicators. The relationship between the aforementioned indicators and the progression of PH was analyzed.

RESULTS

No significant differences were observed in age, sex, diabetes mellitus, smoking history, drinking history, body mass index, New York Heart Association functional classification, or the course of hypertension among the four groups (P > 0.05). The expressions of high-sensitivity C-reactive protein (hs-CRP), thrombomodulin (TM), hematocrit (Hct), erythrocyte sedimentation rate (ESR), P-selectin on platelet surface (CD62P), and fibrinogen (FIB) in the control group were < Grade 1 hypertension group < Grade 2 hypertension group < Grade 3 hypertension group, and the expressions of platelet (PLT), activated partial thromboplastin time (APTT), prothrombin (PT), and plasma thrombin time (TT) in the control group was > Grade 1 hypertension group > Grade 2 hypertension group > Grade 3 hypertension group, and the difference was statistically significant (P < 0.05). The results of the multivariate logistic regression model showed that the expression of hs-CRP, TM, Hct, ESR, CD62P, PLT, APTT, PT, TT, and FIB in the included participants was related to the progression of PH. Among these, high expression of hs-CRP, TM, Hct, ESR, CD62P, APTT, PT, and TT, and low expression of PLT and FIB were risk factors for PH (OR > 1, P < 0.05). The results of the receiver operating characteristic curve analysis showed that the area under the curve of hs-CRP, TM, ESR, CD62P, APTT, PT, TT, and FIB for the prediction of PH were > 0.80, and the prediction value was ideal. Linear correlation analysis with bivariate Spearman showed that hs-CRP, TM, Hct, ESR, CD62P, APTT, PT, and TT were positively correlated with each other (r > 0, P < 0.05); PLT and FIB were negatively correlated with hs-CRP, TM, Hct, ESR, CD62P, APTT, PT, and TT (r < 0, P < 0.05); and PLT and FIB were positively correlated (r > 0, P < 0.05). Linear correlation analysis using bivariate Spearman showed that hs-CRP, TM, Hct, ESR, CD62P, and FIB were positively correlated with each other (r > 0, P < 0.05), whereas PLT, APTT, PT, and TT were negatively correlated with hs-CRP, TM, Hct, ESR, CD62P, and FIB (r < 0, P < 0.05). There was a positive correlation between PLT, APTT, PT, and TT (r > 0, P < 0.05).

CONCLUSION

The relevant indicators of the prethrombotic state in patients with PH, such as hs-CRP, TM, Hct, ESR, CD62P, PLT, APTT, PT, TT, and FIB, showed differences. High expression of hs-CRP, TM, Hct, ESR, CD62P, and FIB, and low expression of PLT, APTT, PT, and TT are the keys to the occurrence, progression, and thrombotic state of PH. Based on the above serum indicators’ expression in patients, targeted interventions can be administered to patients with abnormal expression levels to control the progression of their disease and reduce the risk of developing a prethrombotic state.

Keywords: Primary hypertension; Prethrombotic state; Hematocrit; P-selectin on platelet surface; Activated partial thromboplastin time; Erythrocyte sedimentation rate

Core Tip: This study aimed to identify prethrombotic state-related indicators in primary hypertension (PH) patients and analyze their differences in different PH patient populations. The study found that high expression of inflammation-related indicators, vascular endothelial injury-related indicator, hemorheology-related indicators, platelet-related indicator, and coagulation function related indicators were risk factors for PH. Meanwhile, low expression of platelet and fibrinogen was also a risk factor. The study suggested that targeted interventions could be administered based on abnormal expression levels to control disease progression and reduce the risk of developing a prethrombotic state.