2020, Number 3
Response of hypertensive subjects to antiplatelet drugs
Language: Spanish
References: 19
Page: 1-13
PDF size: 793.28 Kb.
ABSTRACT
Introduction: Therapy with antiplatelet drugs is recommended as secondary prevention of cardiovascular events in people with arterial hypertension. However, in the clinical practice, there are people who do not respond to treatment and evidence a recurrence of vascular events.Objective: To evaluate the response of hypertensive patients to antiplatelet drugs.
Material and Methods: Cross-sectional, observational, descriptive and comparative study that included 299 subjects with arterial hypertension and 96 non-hypertensive subjects (control group) who were taking antiplatelet drugs. The hypertensive subjects were grouped according to the consumption of antihypertensive drugs. Platelet aggregation collagen in platelet-rich plasma was determined using the turbidimetric Born's method. The response to the antiplatelet therapy was classified in four categories (good, moderate, poor and non-responsiveness) in accordance with the platelet aggregation.
Results: There was a slightly better response to antiplatelet drugs, although it was not statistically significant in hypertensive subjects without antihypertensive drugs (35,7 % good and 42,9% moderate) in relation to hypertensive subjects who were taking antihypertensive drugs (32,7 % good and 26,5 % moderate) and the non-hypertensive ones (30,2 % good and 30,2 % moderate).Besides, it was found that 17,7 % of non-hypertensive subjects and 14,3 % of the hypertensive ones without antihypertensive drugs and 13,2 % of hypertensive subjects with antihypertensive drugs were not responding to the treatment with antiplatelet drugs.
Conclusions: The response of hypertensive patients to antiplatelet drugs, either taking antihypertensive drugs or not, is heterogeneous and similar to the response of the non-hypertensive subjects.
REFERENCES
Hou Y, Carrim N, Wang W, Gallant RC, Marshall A, Ni H. Platelets in hemostasis and thrombosis: Novel mechanisms of fibrinogen-independent platelet aggregation and fibronectin-mediated protein wave of hemostasis. J Biomed Res [Internet]. 2015 Oct [Citado 15/01/2018];29(6):[About 9 p.]. Disponible en: Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662204/
Dabrowski R. Use of antiplatelet and anticoagulant drugs in hypertension. Journal of Cardiology Practice [Internet].2015 Dec [Citado 12/03/2017]; 13(37):[About 10 p.]. Disponible en: Disponible en: http://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-13/use-of-antiplatelet-and-anticoagulant-drugs-in-hypertension
Patrono C, Morais J, Baigent C, Collet JP, Fitzgerald D, Halvorsen S, et al. Antiplatelet agents for the treatment and prevention of coronary atherothrombosis. JACC [Internet]. 2017 Oct [Citado 05/03/2018];70(14):1760-76. Disponible en: Disponible en: https://www.onlinejacc.org/content/accj/70/14/1760.full.pdf
Bonney PA, Yim B, Brinjikji W, Walcott BP. Pharmacogenomic considerations for antiplatelet agents: the era of precision medicine in stroke prevention and neurointerventional practice. Cold Spring Harb Mol Case Stud [Internet]. 2019 Apr [Citado 21/02/2018];5(2):[About 23 p.]. Disponible en: Disponible en: http://www.molecularcasestudies.cshlp.org/content/5/2/a003731.long
Pérez Caballero MD, León Álvarez JL, Dueñas Herrera A, Alfonzo Guerra JP, Navarro Despaigne DA, De la Noval García R, et al. Guía cubana de diagnóstico, evaluación y tratamiento de la hipertensión arterial. Rev cubana med [Internet]. 2017 Dic [Citado 02/04/2019];56(4):242-321. Disponible en:Disponible en:http://www.scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232017000400001&lng=es
Lip GYH, Felmeden DC, Dwivedi G. Antiplatelet agents and anticoagulants for hypertension. Cochrane Database of Systematic Reviews [Internet]. 2011 Dec [Citado 20/01/2017];(12):1465-1858. Disponible en: Disponible en: http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003186.pub3/media/CDSR/CD003186/CD003186.pdf
Yi Heng L, Chih Yuan F, Chang Hsieh I, Wei Chun H, Tsung Hsien L, Shih Hsien S, et al. 2018 Expert consensus on the management of adverse effects of antiplatelet therapy for acute coronary syndrome in Taiwan. Acta Cardiol Sin [Internet]. 2018 May [Citado 08/01/2019];34(3):201-10. Disponible en: Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968336/
Ostrowska M, Kubica J, Adamski P, Kubica A, Eyileten C, Postula M, et al. Stratified approaches to antiplatelet therapies based on platelet reactivity testing. Front Cardiovasc Med [Internet]. 2019 [Citado 20/02/2019];6:[About 20 p.]. Disponible en: Disponible en: https://www.doi.org/10.3389/fcvm.2019.00176