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image of Comparative Analysis of Endothelial Status and Hemostatic Potential in Hypertensive Patients under Different Types of Drug Therapy

Abstract

Introduction

Hypertension is associated with hemostatic disorders and endothelial dysfunction. Understanding hemostatic potential and endothelial function under antihypertensive pharmacotherapy can help personalize treatment and reduce the risk of thrombotic complications. To conduct a comparative analysis of endothelial function and hemostatic potential in hypertensive patients receiving different types of pharmacological therapy.

Methods

This cross-sectional study included 185 patients diagnosed with hypertension. Participants were divided into four groups based on their therapy regimen: Group 1—no therapy, Group 2—monotherapy, Group 3—two-drug therapy, and Group 4—three-drug therapy. Differences in hemostatic potential and endothelial function, assessed using piezothromboelastography and the Celermajer DS test, were analyzed using the Kruskal-Wallis and Mann-Whitney tests.

Results

Piezothromboelastography revealed a progressive increase in maximum clot density amplitude (MA) from Group 1 to Group 4: 502 (437.75; 556.75) rel. units (Group 1), 525 (463; 572) rel. units (Group 2), 577 (536; 628) rel. units (Group 3), and 596 (504; 651) rel. units (Group 4) ( = 0.0001). The Celermajer DS test indicated the highest degree of endothelial dysfunction in Groups 3 and 4: 10.87 (7.14; 17.02) % and 7.84 (5; 9.76)% respectively ( = 0.006).

Discussion

In Group 1 the low frequency of endothelial dysfunction and “normocoagulation” status is determined by the duration of the disease. In Group 2, the endothelium protective effects of monotherapy reduce the incidence of endothelial dysfunction. However, in Groups 3 and 4 a chronometric hypocoagulation shift was observed.

Conclusion

Despite achieving target blood pressure, patients on combination antihypertensive therapy exhibit a procoagulant state and persistent endothelial dysfunction. These findings may guide the use of antithrombotic or vasoprotective therapies to prevent thrombohemorrhagic complications.

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2026-01-13
2026-02-27

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Comparative Analysis of Endothelial Status and Hemostatic Potential in Hypertensive Patients under Different Types of Drug Therapy
Bentham Science Publishers ; https://doi.org/10.2174/0115734021411271251124103558
/content/journals/chyr/10.2174/0115734021411271251124103558
/content/journals/chyr/10.2174/0115734021411271251124103558
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  • Article Type:     Research Article
Keywords: hemodynamics ; drugs lowering blood pressure ; cardiovascular drug ; Pharmaceutical preparations ; blood pressure ; cardiology

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