Hiperactividade plaquetária e hipofunção do sistema fibrinolítico na hipertensão arterial

• Autor(a) principal: Machado, António Pedro
• Data de Publicação: 1994
• Outros Autores: Alcântara, Paula
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/2470
• topic: hipertensão arterial; agregação plaquetária; fibrinólise; acidente vascular cerebral; enfarte do miocárdio; arterial hypertension; platelet aggre­gation; fibrinolysis; cerebrovascular accident; myo­cardial infarction

Several reasons have been pointed out to explain the relative failure of antihypertensive therapy in the prevention of the atherosclerotic complicati­ons of high blood pressure. The decrease of blood pressure has proved to reduce the hypertensive ( mechanical) complications of hypertension but it did not prevent myocardial infarction, an atheros­ clerotic complication, as expected by the results of the epidemiological studies. ln addition, it is not clear the real effect of antihypertensive therapy in the prevention of ischemic cerebrovascular acci­dents. Both situations are the result of thrombotic events and are straightly related to endothelial function, platelet aggregation, fibrinolytic system and coagulation. ln the last ten years it was demonstrated that increased platelet aggregation and decreased fi­brinolytic activity are dysfunctions related to hypertension. They appear to be independent ma­rkers of hypertension and not a consequence of the increased blood pressure. Blood pressure normalisation with diuretics and beta-blockers, the main therapies used in the big trials, failed to normalise those dysfunctions, unaffecting the action of factors with a crucial role in atherogenesis and thrombogenesis. The introduction of new antihypertensive thera­pies, which decrease platelet aggregation and in­ crease fibrinolytic activity, permit us to question if with their utilisation will it be possible to pre­vent the atherosclerotic complications of arterial hypertension.