PP.01.01

Abstract

Objective: Hypertension is related, with the atherosclerosis, as well as with disturbances in the system of hemostasis /fibrinolysis and continues to be associated with an elevated risk of cardiovascular disorders, mainly thrombotic. The purpose was to make a research concerning the effect of the antihypertensives, such as the Converting Enzyme Inhibitor of Angiotensin 1 and the Angiotensin receptor blockers type 1 of ANG-II in the secretion of the Tissue Plasminogen Activator (t-PA) and the Plasminogen Activator Inhibitor 1 (PAI-1), as well as in the activity of the Matrix Metalloproteinases (MMPs) and the Tissue Inhibitors of Metalloproteinases (TIMPs) in coronary artery patients who were treated with the hypertensives Perindopril, Losartan and Irbesartan. Design and method: A group of 8 healthy volunteers and 90 patients participated who were diagnosed for essential hypertension, with known CAD. 69 patients reacted positively. It was ascertained that during the primary and the secondary hypertension the levels of the mechanism of pro-matrix metalloproteinase 2 (pro-MMP-2), the activity of the pro-MMP-2 and the pro-MMP-9 as well as the levels of PAI-1 in plasma are elevated, whereas the levels of the tissue inhibitor of metalloproteinase 1 (TIMP-1), the issue inhibitor of metalloproteinases-2 (TIMP-2) and the tPA are not affected. Results: The Irb and Los drugs reduce the pro-MMP-2 and pro-MMP-9 activity and the pro-MMP-2 and PAI-1 levels, while they increase the TIMP-1, TIMP-2 and tPA levels in patients’ plasma examined from the 7th to the 90th day of treatment in comparison to the levels in patients’ plasma before the beginning of the treatment. The Per drug reduces the pro-MMP-2 levels and the pro-MMP-2 and pro-MMP-9 activity in the patients’ plasma from the 7th to the 90th day of treatment, whereas the TIMP-1, TIMP-2 and tPA levels are not affected. Conclusions: a) The MMP-2 and MMP-9 activity is increased during the rupture of the atherosclerotic plaque and the left ventricular hypertrophy because of the elevated afterload and that b) the hypertension is associated with disturbances in the system of hemostasis /fibrinolysis, increasing the PAI-1 levels and decreasing the tPA levels, causing thus prothrombotic complications.