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Association of platelet function in hypertensive patients with left ventricular hypertrophy, transient myocardial ischemia, and coronary artery disease.

The aim of the study was to evaluate how platelet aggregation relates to left ventricular hypertrophy, presence of transient myocardial ischemia and coronary atherosclerosis in essential hypertensive patients. For that purpose platelet aggregation, symptom-limited treadmill-test, echocardiography and coronary angiography were performed in 65 male patients with uncomplicated essential hypertension. Aggregation was monitored both by a turbidometric method and by a method based on real-time estimation of mean aggregate size. Platelet function was also studied in 18 male normotensive subjects. Hypertensive patients with transient myocardial ischemia were characterized by increased platelet sensitivity to adenosine diphosphate, thromboxane A2 mimetic-U46619, serotonin, platelet activating factor and by increased spontaneous aggregability of platelets compared with normotensive subjects and to patients without myocardial ischemia. Platelet aggregation induced by low doses of agonists positively correlated with the degree of left ventricular hypertrophy. This study provides evidence that platelets play an important role in myocardial ischemia. Besides, it was found that platelet activity positively correlated with the degree of left ventricular hypertrophy. This may provide an additional link between left ventricular hypertrophy and coronary heart disease in hypertensive patients.