期刊
JOURNAL OF HYPERTENSION
卷 37, 期 12, 页码 2361-2370出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0000000000002204
关键词
4G/5G polymorphism; brachial blood pressure; central blood pressure; hypertension; plasminogen activator inhibitor-1
资金
- SANPAD (South Africa - Netherlands Research Programme on Alternatives in Development) [08/15]
- South African National Research Foundation (NRF GUN) [2069139, 86895, FA2006040700010, FA2007042600011]
- South African Medical Research Council
- North-West University, Potchefstroom, South Africa
- Population Health Research Institute, Ontario, Canada
Objectives: Plasminogen activator inhibitor-1 (PAI-1) has consistently shown positive associations with blood pressure (BP). Whether elevations in PAI-1 levels precede or result from raised BP is still under debate and data on prospective studies are limited. Hence, we investigated the prospective associations of PAI-1 and the 4G/5G polymorphism with brachial and central BP and pulse pressure (PP) over a 10-year period. Methods: Black South Africans aged 30 years and older were included. Baseline data collection commenced in 2005 (n = 2010) with follow-up data collection in 2010 (n = 1288) and 2015 (n = 926). Plasma PAI-1 activity (PAI-1(act)), 4G/5G polymorphism genotyping, waist circumference and BP measurements were performed and analysed using sequential regression and mixed models. Results: In multivariable adjusted analyses, PAI-1(act) and the 4G/4G (vs. the 5G/5G) genotype increased the odds of developing hypertension in the total group [1.04 (1.01; 1.08) and 1.82 (1.07; 3.12) respectively]. Furthermore, PAI-1(act) was prospectively associated with brachial SBP (r= 0.0815) and PP (r= 0.0832) in the total group, and with central PP in women (r = 0.1125; all P< 0.05). Addition of waist circumference to the models either decreased or nullified the contribution of PAI-1(act) to BP and hypertension development. Conclusion: PAI-1(act) and the 4G/4G (vs. the 5G/5G) genotype increased the odds of developing hypertension. Furthermore, PAI-1(act) associated prospectively with both brachial and central BP. These associations were mediated in part by central adiposity. The study supports the hypothesis that PAI-1 also contributes to hypertension development rather than solely being a consequence thereof.
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