Abstract P228: Endothelial Dysfunction Markers and Coagulation Factors Are Elevated in Individuals With Hypertensive Emergency

Abstract

Introduction: Hypertensive crisis (HC) is characterized as sudden and symptomatic elevation of diastolic blood pressure (BP) > 120mmHg. HC can be classified in emergency (HE), condition that presents target organ damage (TOD) and hypertensive urgency (HU), situation without TOD. Evidences have shown that the coagulation markers and endothelial dysfunction (ED) play an important role in the pathogenesis of chronic elevation of BP. However, scarce studies have demonstrated the involvement of these markers in the complications of acute elevation of BP. Objectives: To characterize biochemical profile of HU and HE, and to evaluate the participation of C-reactive protein (CRP), intercellular adhesion molecule (ICAM-1) and coagulation factors (fibrinogen and PAI-1) in subjects with HC. Methods: It was a cross-sectional study with 74 normotensive (NT), 74 controlled hypertensive (CH), 50 with HU and 78 individuals with HE. It was used MULTIPLEX technique for evaluating the clotting factors. Analysis of variance was used for comparative study among the groups, with significant p-value<0.05. Results: The diastolic BP and heart rate were higher in the HC group (120mmHg and 85bpm, respectively) compared to the CH group (75mmHg and 68 bpm, respectively). Individuals with HE were older. Glycaemia was significantly higher in the HE group (113mg/dL) in comparison to NT and CH (91mg/dL and 98mg/dL, respectively; p<0.05). It was also higher in the HU group (109mg/dL) compared with NT. Potassium was significantly lower in HE group (4,2mEq/l) compared to NT, CH and HU groups (4.5, 4.4 and 4.4mEq/L, respectively). CRP, fibrinogen, and PAI-1 were significantly higher in patients with HE (0.75, 0.04 and 2.46, respectively) in comparison to NT (0.19, 0.01 and 2.1, respectively) and CH (0.14, 0.01 and 2.25, respectively) groups, except ICAM-1. Logistic regression showed that CRP and fibrinogen were markers for HC development with odds ratios of 2.6 (1.24 to 5.50) and 8.72 (4.07 to 18.68), respectively. Conclusions: Individuals with HC present biochemical changes. Markers of ED and coagulation factors are higher in EH group compared to controls. This suggests the role of ED markers and coagulation factors in the pathogenesis of acute hypertensive event.