Abstract
The aim: to determine the peculiarities of the indices of coagulation hemostasis in patients with the former occurrence of hemorrhagic stroke, developed as a complication of essential hypertension, in comparison to the hypertensive patients without complications.
 Materials and methods. There were formed 2 groups of patients: the main group and the comparison group. The main group included 20 patients (10 women and 10 men, middle age 52.9±1.7 (M±m) years old) who had undergone hemorrhagic stroke as a complication of essential hypertension 6 months and more previously, had no normalization of blood pressure over this period of time. The comparison group included 20 patients (10 women and 10 men, middle age 52.5±1.7 years old) suffered from essential hypertension without complications. They were matched groups according to key indicators. All the above-mentioned people underwent fasted analysis of venous blood with detection of coagulation hemostasis indices.
 Results. In the main and the comparison group the indices of coagulation hemostasis were the following ones, respectively: thrombin time 10.6±0.6 and 11.5±0.8 s, international normalized ratio 1.0±0.1 and 1.0±0.1, activated partial thromboplastin time 50.4±2.1 and 44.7±1.8 s (p<0.05), protein C 139.2±8.0 and 143.8±10.2 %, fibrinogen 2,4±0.4 and 2.6±0.3 g/l, soluble fibrin-monomer complexes 3.9±0.2 and 3.7±0.1 μg/mL, XIIa-dependent fibrinolysis 6.3±0.9 and 10.2±0.6 min (p<0.05), antithrombin-III 90.0±6.6 and 76.1±6.8 %.
 Conclusions. In the main group relatively to the comparison group there was slowing of the internal pathway of coagulation hemostasis with the quicker fibrinolysis. There was detected that 100 % of patients from the main group had at least one of the following factors out of normal values and with predisposition to bleeding: activated partial thromboplastin time >48 s, XIIa-dependent fibrinolysis <5 min, fibrinogen <2 g/l, or antithrombin-III >120 %. This information should be taken into account while prescribing the treatment, influencing hemostasis indices, in a category of hypertensive patients after hemorrhagic stroke
Highlights
Hemorrhagic stroke is a severe complication of essential hypertension (EH) with a high risk of death in the acute and subacute phases
Discussion of research results As the patients were in the stable phase after the hemorrhagic stroke their indices of coagulation hemostasis were at the basic level
The extrinsic coagulation pathway is probably enhanced by the atherosclerotic process, as it is leading in the influence of atherosclerosis on the coagulation hemostasis system and acts as a trigger for further avalanche-like enhancement of blood coagulation due to the intrinsic pathway [18]
Summary
Hemorrhagic stroke is a severe complication of essential hypertension (EH) with a high risk of death in the acute and subacute phases. Blood pressure and low-density lipoproteins (LDL) level are among of them taking into account the findings of more developed atherosclerosis of the major cervical arteries in this category of patients, published in the previous works [2]. In many studies there are conflicting data on the feasibility and safety of correction of lipid profile in patients who have suffered a hemorrhagic stroke, due to the increased risk of re-bleeding [5, 6]. The reason is that statins reduce thrombin production [8] This factor should be taken into account that highlights the necessity for better understanding the coagulation hemostasis
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